Africa’s Progress Against Maternal and Infant Mortality Has ‘Flatlined’
Millions of African women don’t have access to skilled birth attendants.

In the past decade, Africa’s progress against maternal and infant mortality has flatlined, and it will need to reduce maternal deaths by a massive 86%, and more than halve the deaths of babies to reach global targets by 2030.

This is according to the Atlas of African Health Statistics 2022  released by the World Health Organization’s (WHO) Africa region on Thursday.

The atlas assessed the nine targets related to the Sustainable Development Goal (SDG) on health, and estimates that 390 women will die in childbirth for every 100 000 live births by 2030 in sub-Saharan Africa, based on the current rate of progress.

This is over five times higher than the 2030 SDG target of fewer than 70 maternal deaths per 100 000 live births, and exponentially higher than the average of 13 deaths per 100 000 live births witnessed in Europe in 2017. 

The region’s infant mortality rate is 72 per 1000 live births, with a slow annual decline of 3.1%. At this rate, there will be 54 deaths per 1000 live births by 2030, more than double the target of fewer than 25 per 1000.

WHO Africa official Dr Humphrey Karamagi described the slowdown in progress as “drastic”, with the likelihood of Africa reaching global targets being unlikely.

Incomplete abortions

The main cause of maternal death is haemorrhaging, followed by sepsis, said Dr Benjamin Tsofa, Principal Research Officer at Kenya Medical Research Institute (KEMRI), who also addressed the briefing.

Some of this bleeding was caused by “incomplete abortions” – abortion is illegal in most African countries – but Karamagi said that it was impossible to calculate what percentage this was.

“There are different policies in different countries around safe abortion, and the pattern will differ really on a country-by-country basis,” said Karamagi. 

“What we do know is that the major cause of maternal deaths at present is bleeding, particularly during labour, [whether] it’s due to unsafe abortion or it’s due to lack of appropriate care and so on. I think it’s important that we unpack what is driving that in the different countries and address it.”

Karamagi added that millions of women in the region did not have access to antenatal care – access ranged from 30-90% across countries – despite the evidence that it plays a major role in reducing maternal and neonatal mortality.

Pandemic’s effect

However, between 2000 and 2010, Africa made progress on a number of health issues: under-5 mortality fell by 35%, neonatal death rates dropped by 21%, and maternal mortality declined by 28%. 

Since then, however, “advances in all three targets have flatlined” – and more recently, the COVID-19 pandemic has undermined progress.

“Crucial health services such as postnatal care for women and newborns, neonatal intensive care units, and antenatal care services, immunisation services were disrupted during the pandemic,” notes the report.

“Since 2021, Africa has also faced a resurgence in vaccine-preventable disease outbreaks. Measles cases rose by 400% between January and March 2022 compared with the same period the year before.”

Dr Matshidiso Moeti, WHO Regional Director for Africa., warned: “It is crucial that governments make a radical course correction, surmount the challenges and speed up the pace towards the health goals. These goals aren’t mere milestones, but the very foundations of healthier life and well-being for millions of people.”

Image Credits: Elizabeth Poll/MMV.

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