Aid data critical to crisis response threatened by funding cuts

This article is published in association with United Nations.

One woman continues to die during pregnancy and childbirth every two minutes on average worldwide – that’s 712 each and every day.

Furthermore, unprecedented aid cuts are putting global progress to end maternal deaths at risk, UN agencies have warned in a new report that calls for greater investment in midwives and other health workers.

The Trends in maternal mortality report was published by the UN Children’s Fund (UNICEF), the World Health Organization (WHO) and UN sexual and reproductive health agency UNFPA, in observance of World Health Day on 7 April.

It shows that maternal deaths declined by 40 per cent between 2000 and 2023, largely due to improved access to essential health services.

However, the pace of improvement has slowed significantly since 2016, and an estimated 260,000 women died in 2023 due to complications during pregnancy and childbirth, or roughly one death every two minutes.

Deadly peril in Sudan

Frontline health workers have long raised alarms about the perils of giving birth in conflict settings.

In Sudan’s Al Jazirah State, a midwife named Awatef told UNFPA that she helped four women deliver babies while fleeing violence: “I delivered them in the bush, with only very basic sterilization – I had nothing but water and soap.”

One woman, Amina, had to give birth by Caesarean section – on the floor of a stranger’s home where a local doctor was assisting deliveries – while listening to the drum of gunfire just outside. “I had to start walking again just six hours later, carrying my baby while my wounds were still fresh and painful,” she said.

Urgent action needed

As aid funding cuts force countries to roll back vital services for maternal, newborn and child health, the UN agencies appeal for urgent action to prevent maternal deaths, particularly in humanitarian settings where numbers are already alarmingly high.

“While this report shows glimmers of hope, the data also highlights how dangerous pregnancy still is in much of the world today – despite the fact that solutions exist to prevent and treat the complications that cause the vast majority of maternal deaths,” said WHO Director-General Tedros Adhanom Ghebreyesus.

“In addition to ensuring access to quality maternity care, it will be critical to strengthen the underlying health and reproductive rights of women and girls – factors that underpin their prospects of healthy outcomes during pregnancy and beyond.”

Pregnancy and the pandemic

The report also provides the first global account of the COVID-19 pandemic’s impact on maternal survival.

An estimated 40,000 more women died due to pregnancy or childbirth in 2021, rising to 282,000 in 2022, and to 322,000 the following year.

This increase was linked not only to direct complications caused by COVID-19 but also widespread interruptions to maternity services, highlighting the importance of ensuring that this care is available during pandemics and other emergencies.

Invest in midwives

“When a mother dies in pregnancy or childbirth, her baby’s life is also at risk. Too often, both are lost to causes we know how to prevent,” said UNICEF Executive Director Catherine Russell.

With global funding cuts putting more mums-to-be at risk, especially in the most fragile settings, “the world must urgently invest in midwives, nurses, and community health workers to ensure every mother and baby has a chance to survive and thrive,” she added.

Inequalities and slowdowns

The report also highlights persistent inequalities between regions and countries, as well as uneven progress.

With maternal mortality declining by around 40 per cent between 2000 and 2023, sub-Saharan Africa achieved significant gains. It was also among just three UN regions to see significant drops after 2015, with the others being Australia and New Zealand, and Central and Southern Asia.

Yet, sub-Saharan Africa still accounted for approximately 70 per cent of the global burden of maternal deaths in 2023 due to high rates of poverty and multiple conflicts.

Meanwhile, five regions saw progress stagnate after 2015: Northern Africa and Western Asia, Eastern and South-Eastern Asia, Oceania (excluding Australia and New Zealand), Europe and North America, and Latin America and the Caribbean.

UNFPA Sudan

A midwife visiting pregnant women in a shelter for internally displaced persons in Sudan.

A global responsibility

Dr. Natalia Kanem, UNFPA’s Executive Director, upheld that access to quality maternal health services is a right, not a privilege.

She stressed the urgent responsibility to build well-resourced health systems that safeguard the lives of pregnant women and newborns.

“By boosting supply chains, the midwifery workforce, and the disaggregated data needed to pinpoint those most at risk, we can and must end the tragedy of preventable maternal deaths and their enormous toll on families and societies,” she said.

Childbirth in crisis settings

The report also highlighted the plight of pregnant women living in humanitarian emergencies, who face some of the highest risks globally.  Nearly two-thirds of global maternal deaths now occur in countries affected by fragility or conflict.

Beyond ensuring critical services during pregnancy, childbirth and the postnatal period, the report emphasized the importance of efforts to enhance women’s overall health by improving access to family planning services, as well as preventing underlying health conditions that increase risks, such as anaemia, malaria and noncommunicable diseases.

Furthermore, it is also vital to ensure that girls stay in school, and that they and women have the knowledge and resources to protect their health.

Source: WHO/UNICEF/UNFPA/World Bank/UN Population Division

Maternal mortality ratio (MMR) trends by region.