Pregnancy and childbirth are the biggest threats to the lives of women and girls in sub-Saharan Africa. We work with women, girls and entire communities to ensure that more women can give birth safely and with dignity - ensuring that every child has the best possible start in life.
Empowering women living with obstetric fistula through treatment, psycho-social support, and livelihoods opportunities.
Every two minutes, a woman dies from preventable causes related to pregnancy and childbirth: that’s around 800 women every day.
For every woman who loses her life, a further 20 to 30 women experience injuries, infections, or disabilities that can affect them for the rest of their lives.
Most of these deaths and injuries are preventable when women have access to the right care and support prior to, during, and following childbirth.
Africa experiences the highest rates of maternal, newborn, and child mortality of any region. Of the hundreds of thousands of women who die while pregnant or giving birth every year, two thirds live in sub-Saharan Africa. The lifetime risk of an African woman dying from pregnancy-related complications is The ten countries with the worst maternal mortality rates are all in Africa.
Why do women die during pregnancy and childbirth?
Like other health challenges, the high number of maternal deaths in some parts of Africa is a reflection of inequitable access to high-quality care. Most of the women who die during pregnancy and childbirth live in low-income countries and in rural areas where healthcare is limited and / or difficult to access.
The most common causes of maternal death include bleeding, infection, high blood pressure, obstructed labour, and unsafe abortions. When a skilled health worker is present during pregnancy and labour – and when that health worker has access to adequate equipment – any complications can be identified and quickly addressed. But when resources are scarce, pregnant women often end up delivering their babies at home without medical assistance.
Who is most at risk?
Pregnancy can be particularly risky when a woman is living with a pre-existing condition like heart disease or diabetes that requires specialist care and monitoring.
The risk of maternal mortality is highest for adolescent girls under 15 years old. That’s why sexual and reproductive rights education is a vital component of maternal health programming: with reliable information and access to family planning options, girls and women are in a better position to decide if, when, and how they want to have children.
Have things improved at all?
We know progress is possible. According to the United Nations, global maternal mortality declined by 38% between 2000 and 2017, from 342 deaths to 211 deaths per 100,000 live births. During the same period, maternal mortality in sub-Saharan Africa fell by 39%. But the world is a long way off achieving the Sustainable Development Goal of fewer than 70 deaths per 100,000 live births.Learn More
The Impact of Covid-19
The COVID-19 pandemic has caused progress to stall and in some cases reverse. As resources – staff, in particular – were diverted away from routine services to support the emergency response, the support available to pregnant women and new mothers across Africa was further reduced. In addition, many women were reluctant to travel to facilities for fear of contracting the virus; others simply couldn’t leave their homes due to strict lockdown rules.
Meet Jemimah Makau
“As a mother I know how important it is to have someone next to you, someone you can rely on, share your fear and insecurities, who guides you before, during and after your pregnancy, who’s monitoring your new-born and you as a mother.
I really hope I that I can be that person for girls and women in my community when they expect a baby. Because of that, it’s such a big privilege, to be on the threshold of life.”
What is Amref Health Africa doing to help?
Improving maternal health is at the heart of Amref Health Africa’s work. We aim to ensure that women across the continent can give birth safely and with dignity. Crucially, we also support women to make informed choices about their reproductive health.
- Train and support midwives through face-to-face and online learning – meaning they have the option to upskill without having to take time off from their vital work. Our training covers technical skills and – just as importantly – patient care. Amref-trained midwives can ensure women have a positive experience of birth and feel respected and listened to throughout the process.
- Train Community Health Workers who are a vital source of reliable information to the communities they serve. Community Health Workers can advise women on what kind of support is available, and how to access it.
- Worked with partners to develop Wheels 4 Life, a helpline for pregnant women in Nairobi who struggled to access ante-natal care during lockdown. By phoning a toll-free number, they could get advice from a doctor or request an ambulance or taxi to take them to hospital. The initiative has since been expanded to five more counties in Kenya.
- Include sexual and reproductive health in our maternal health programmes so that women are equipped to make informed choices about family planning and contraception.
- Support girls and young women so they grow up knowing what their rights are when it comes to sexual and reproductive health – and so they feel confident claiming those rights.
- Support women living with obstetric fistula, an abnormal opening between a woman’s genital tract and her urinary tract or rectum resulting in the leakage of urine, faeces, or both. Fistula is a debilitating condition that has long-term physical and psychological consequences for survivors. It’s something we don’t often hear about in the UK because it’s so rare: but worldwide, an estimated two million women around the world are living with an untreated fistula.
- Advocate at the highest levels for additional investments in maternal healthcare – including a significant increase in the number of trained midwives and nurses available to support women throughout their pregnancies.
Meet Vivian: obstetric fistula survivor
Vivian Nandi developed obstetric fistula during the birth of the youngest of her five children. She credits her husband Mussa, her Christian faith, and her support network for giving her the strength to recover. But it’s clear that she’s a pretty extraordinary woman in her own right.
Meet Scholastica Daudi: entrepeneur
Fistula survivor Scholastica is running her own business, supporting her growing family, and helping other women recovering from this physically and psychologically painful condition.
Meet Violet Boonabana: Midwife
Violet Boonabana was raised by her aunt, a midwife, in Kampala. "My aunt made me love and respect the profession," says Violet. "She showed me how rewarding it is to watch a mother leave the hospital with a healthy, happy baby."
Violet is now a registered nurse and midwife herself, working on one of Kampala's busiest maternity wards at Mengo Hospital.
[Photo credits: Nakayiwa Jane, sixteen year victim of Sexual Gender Based Violence, receiving counselling, immunization for her baby and family planning services (c) Watanda Ambrose; Lydia Kuria Maternal Health Worker, Kenya (c) Steve Kaja; Maternal Health, Uganda (c) Chilo Oostergetel; Betty Nagudi and her daughter Victoria - Elearning Midwife At Jinja School Of Nursing (c) Sam Vox; Jemimah Makau, Amref trained and supported midwife (c) Gregg Telusa].