A set of cost-effective measures aimed at enhancing the safety of childbirth could save the lives of approximately 2 million more mothers and infants globally by 2030, according to the Bill & Melinda Gates Foundation. The foundation highlighted the stagnation in global progress toward reducing maternal mortality since 2016, partly attributed to disruptions caused by the COVID-19 pandemic, with some countries, including the US and Venezuela, witnessing increases in maternal death rates.
With nearly 800 women losing their lives during childbirth daily, the foundation called for immediate action to achieve the UN’s sustainable development goal of reducing the maternal mortality rate to below 70 per 100,000 births and newborn mortality to at least as low as 12 per 1,000 births by 2030. The current projection suggests 138 maternal deaths per 100,000 births by that date, nearly double the target.
Bill & Melinda Gates Foundation co-chairs Melinda French Gates and Bill Gates outlined seven “innovations” and practices, many of which are low-cost and deliverable by midwives and birth attendants, that could prevent deaths related to childbirth complications. These measures include increased antibiotic usage and anaemia treatments with micronutrient supplements. They believe that these measures could save an additional 2 million lives by 2030 and 6.4 million lives by 2040.
The report emphasized that policy changes and increased investment in women’s health and healthcare workers, including midwives, would be essential to reduce maternal mortality.
Mark Suzman, the foundation’s CEO, noted that substantial progress had been made in reducing childbirth-related deaths in low- and middle-income countries. Preventable child mortality had decreased by more than half to fewer than 5 million deaths annually between 2000 and 2015. However, progress slowed and ultimately stalled due to the COVID-19 crisis, which disrupted healthcare systems and funding.
The report identified 18 key indicators within the UN’s Sustainable Development Goals that may not be met by the 2030 target. Nevertheless, Suzman expressed optimism that implementing the recommended innovations and increasing the use of vaccines and malaria bed nets could reverse these setbacks and help achieve the SDGs.
Professor Bosede Afolabi, head of obstetrics and gynaecology at Nigeria’s Lagos University, shared that providing micronutrient supplements to anaemic pregnant women reduced stillborn births by approximately 21% and low birth weights by 19%, while also significantly reducing six-month infant mortality. Anaemia affects up to 37% of pregnant women globally, reaching rates as high as 80% in some regions of South Asia.
In a trial across sub-Saharan Africa, the use of the antibiotic azithromycin reduced sepsis cases by a third. Melinda French Gates added that this approach could also be a game-changer in the US, where sepsis accounts for 23% of maternal deaths and has one of the most inequitable maternal mortality rates among high-income countries.
Robert Yates, director of the global health program at Chatham House, emphasized that COVID-19 had exposed the global underinvestment in health. While he welcomed investment in the interventions recommended by the Gates Foundation, he stressed that increased funding for infrastructure, personnel, ambulances, and medical supplies was also crucial. He noted that “big increases in domestic public financing” would make a significant difference in improving maternal mortality rates.
