Donors making a difference to maternal health: the urgent drive to save women’s lives across the world

^{Sarah Wambui Chege monitors a patient in active labour and listens to the baby's activity at Mama Lucy Kibaki Hospital, a government county referral hospital serving the residents of Nairobi's populous Eastlands area. Photo by: WHO/Khadija Farah}

Globally each year 287,000 women die in pregnancy or childbirth. Most maternal deaths are caused by severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions that can be aggravated by pregnancy (such as HIV/AIDS and malaria).

Most maternal deaths are preventable with access to high quality healthcare. Ending preventable maternal death must remain at the top of the global agenda.

WHO works with a range of partners and national health authorities across its six Regions to strengthen maternal health services for all pregnant women. Read below powerful stories about a wide range of WHO activities, with many women's lives being saved, thanks to donors' support.

Working with traditional birth attendants in Latin America

^{Mercedes Panamantamba, traditional birth attendant from Otavalo, Ecuador, receives training provided by PAHO on the use of biomedical tools to complement ancestral practices. Photo credit: PAHO/WHO}

In rural and remote communities of Latin America, ancestral practices such as traditional midwifery have been passed down from generation to generation. In these areas, where geographical barriers and cultural differences can hinder access to healthcare centres, the practical and spiritual support of traditional birth attendants can make the difference between life and death.

The WHO Region for the Americas (Pan American Health Organization - PAHO), with support from the Government of Canada, has been working with over a thousand traditional birth attendants in Bolivia, Colombia, Ecuador, Honduras, and Peru since 2021 to provide them with knowledge of warning signs to help prevent maternal and neonatal deaths.

PAHO conducted training sessions and knowledge dialogues on topics such as family planning, prenatal care, identification of warning signs, and childbirth care. Meetings have yielded results that can benefit the entire region, such as the development of the tool for promoting culturally safe childbirth.

These activities are part of 'Improved health of women and adolescent girls in situations of vulnerability', a joint project between PAHO and Global Affairs Canada.

Read about the success of combining knowledge of ancestral and modern medicine.

No woman should die giving birth in Tanzania

^{Dorcas Simon, an informal trader in Kigoma region, Tanzania, who said it took the timely transportation of her newborn child and her to the hospital to save their lives. Photo by: WHO/Clemence Eliah}

In Kigoma region, Tanzania, maternal mortality was on the rise due to difficult access to health facilities and other factors. The region had limited capacity in terms of a referral system and diagnostic capacity.

"Looking at the year 2020, we had 119 maternal deaths. In 2021, they dropped to 75 but in 2022 there were 102 deaths." Dr Jesca Leba, Regional Medical Officer, Ministry of Health, Kigoma Region, Tanzania.

The Government of Tanzania with support from WHO and partners set out to address this problem. With funding from the Norwegian Embassy, WHO procured ambulances for easy transportation of pregnant women. The ambulances have so far served over 2000 women from various districts across the region. Additionally, 15 ultrasound machines were provided for health facilities and 300 health workers were trained how to use them.

^{The Chief Medical Officer in Buhigwe District Health Centre appreciates the donor support with ultrasound equipment that expanded the centre's capacity to provide services. Photo credit: WHO/Clemence Eliah}

Today, the Kigoma region has since witnessed a sharp decline in maternal mortality from 119 maternal deaths per 100 000 live births in 2020 to just 26 in 2024.

See this photo story.

Birth plan helps reduce maternal deaths in Cote d'Ivoire

^{Ms Konaté followed the entire process of the birth plan. Her baby was born in good conditions at the urban health center in the Belleville district, in Bouaké. She is congratulated by the midwife who gives her the baby. Photo credit: WHO Côte d'Ivoire}

In Cote d'Ivoire, in 2017, the maternal mortality rate was 614 maternal deaths per 100 000 live births, (Demographic Health Survey 2012) far from the target of 140 maternal deaths per 100 000 live births expected by 2030. In 2021, WHO, with support from the Swedish Government and the French MUSKOKA fund, targeted the Gbeke region, which has one of the highest mortality rates in the country, through the "Gbeke Là-Haut Là" initiative.

The initiative included implementation of a childbirth preparation or delivery plan, starting with first prenatal consultations, an emergency trolley in the delivery room and capacity-building for midwives in the management of risk factors during pregnancy and childbirth.

By 2022, 46% of pregnant women attending antenatal clinics benefited from a childbirth preparation plan, compared to none previously. 181 midwives from 18 health facilities were trained in key life-saving clinical skills.

Between 2019 and 2022, the proportion of maternal deaths at Bouake University Hospital from the 3 urban health districts of Gbeke fell from 93% to 36%, a reduction of 57%. The proportion of maternal deaths due to post-partum haemorrhage fell by 27%, from 56% to 29%.

Read how birth plan helps reduce maternal deaths in Cote d'Ivoire

Research in Indonesia influences policy

^{Close patient monitoring by nurses in the Neonatal Intensive Care Unit (NICU) at Gatot Soebroto Army Hospital, Jakarta, Indonesia. As one of the SMART recommendations for mortality review. Photo credit: WHO/IndoXplore}

WHO and European Union supported the Ministry of Health and partners to conduct crucial research on the impact of COVID-19 on maternal and newborn health and to better understand disruptions to essential health services, with the aim of building a stronger, more resilient health system.

Researchers analyzed the medical records of 4 945 pregnant women and their newborns and interviewed programme managers and health workers from eight selected hospitals in four provinces of Java Island.

WHO and the Ministry of Health will use the findings to inform the development of national guidelines aimed at strengthening the health system's capacity to better respond to acute public health events and minimize disruptions to essential services, including for maternal and newborn health.

Read the full story on how WHO, Ministry of Health and partners analysed the impact of COVID-19 on maternal and newborn health

Maternal care services strengthened in Port au Prince, Haiti

^{The maternity ward at the Eliazar Germain Hospital. Photo credit: PAHO/WHO}

The United Nations Population Fund (UNFPA) and PAHO/WHO are jointly supporting 3 hospitals in the Port-au-Prince metropolitan area to provide maternal health services. This is to support the emergency response of the Ministry of Health and Population and improve access to health care, made increasingly difficult by the current security situation.

Support includes the supply of essential medical equipment and products, and the installation of a reliable power supply system, ensuring constant availability of electricity. Support beyond maternity services responds to urgent needs in sexual and reproductive health. Kits for the management of abortion complications and kits for the management of sexual violence have been distributed for this purpose.

Since the partnership was set up, 62 physiological deliveries and 45 caesarean sections have been recorded in the 3 beneficiary hospitals. These activities were made possible with the financial support of the European Commission Humanitarian Aid (ECHO), the Central Emergency Response Fund (UN CERF) and WHO's Contingency Fund for Emergencies.

Find out more about PAHO/WHO and UNFPA joint support to Haitian health authorities.

Saving lives in flood- and drought-affected areas in Somalia

^{WHO Representative to Somalia Dr Reinhilde Van de Weerdt (left) met with H.E. Mr OKANIWA Ken, Ambassador of Japan to Somalia, to express appreciation for Japan's support. Photo credit: WHO Somalia/M. Saydahmat}

A 12-month project led by the WHO Country Office in Somalia over the course of 2023 reached over 3 million people affected by drought or flood. The Government of Japan supported the project with a grant of over US$ 700 000. Working with the Ministry of Health and Human Services, WHO aims to mitigate the health impacts of recurrent climate shocks, food insecurity and disease outbreaks, especially cholera, while strengthening health system resilience.

Thanks to Japan's funding, WHO was able to deploy 369 community health workers and 121 mobile outreach teams in drought-affected areas. These provided essential health and immunization services to local population with a special focus on children and pregnant and lactating women. The project aims to provide help to about 900 000 flood- and drought-affected people in Somalia.

Read more about Japan and WHO's new project on the WHO Somalia.

Meeting the health needs of Malians displaced by security crisis

^{Meeting the health needs of Malians displaced by security crisis. Photo credit: WHO AFRO}

In 2023, more than 72 500 people were displaced in Mali because of clashes between rival armed groups, inter-community conflicts and military operations by the Malian armed forces against non-state armed groups.

To help Mali maintain delivery of quality health services in areas impacted by insecurity, WHO, supported by UN CERF is providing medicines and other consumables to the Health Ministry, and helping to upskill health workers on the ground. WHO is also supporting mobile clinics to reach isolated populations in the centre of Menaka and the two districts worst impacted by the insecurity, Tidermane and Anderamboukane.

Thanks to the mobile clinics, Aissata, a displaced person in Ménaka city centre, was able to receive the care she needed. She was monitored throughout her pregnancy, which saved her life and that of her baby. "If it wasn't for the free consultation that day, I don't know what I would have done," the young mother says.

Read more about WHO support for meeting the health needs of Malians displaced by security crisis.

WHO urges expansion of lifesaving midwifery care for women and babies

^{Shakila, midwife, measuring height of the fundus on a pregnant woman at the mobile clinic organized by WHO at the Garm Abak of Waras district in Bamiyan, Afghanistan. Photo credit: WHO/Rada Akbar}

Strengthening midwives' role in maternity and newborn care services would save millions of lives each year while significantly enhancing women's overall experience of care, according to a new publication released by WHO and partners.

The publication, transitioning to midwifery models of care: A global position paper, outlines the benefits and key components of midwifery care models, where midwives serve, within broader teams, as the main healthcare provider for women and babies during pregnancy, childbirth and the postnatal period.

Recent modelling shows that universal access to midwifery care could avert more than 60% of all maternal and newborn deaths and stillbirths - amounting to 4.3 million lives saved annually by 2035.

The position paper on midwifery models of care was prepared by WHO together with a coalition of leading health professional associations, UN agencies, non-governmental organizations and women's group, including the Burnet Institute, Collectif interassociatif autour de la naissance, the Council of International Neonatal Nurses, the International Confederation of Midwives (ICM), the International Pediatric Association, Jhpiego, the UNFPA, and the United Nations Children's Fund (UNICEF), with financial assistance from the Bill & Melinda Gates Foundation.

Listen to WHO Director-General's message on Linkedin thanking everyone who contributed for the development of the position paper.

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WHO's work is made possible through all contributions of our Member States and partners. WHO thanks all donor countries, governments, organizations and individuals who are contributing to the Organization's work, with special appreciation for those who provide fully flexible contributions to maintain a strong, independent WHO.

This feature reveals support of partners and donors from Burnet Institute (Collectif intersasociatif autour de la naissance), Bill & Melinda Gates Foundation, Canada, CERF, the Council of International Neonatal Nurses, the European Union, International Confederation of Midwives (ICM), the International Pediatric Association, Japan, Jhpiego, French MUSKOKA, Norway, Sweden, the UNFPA, and UNICEF.

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