A woman dies every two minutes due to failures in maternal healthcare, according to shocking global data that has prompted stark warnings about the impact of cuts to aid funding by the US and the UK.
A new report from the World Health Organisation (WHO) has revealed that there were 260,000 maternal deaths in 2023, equating to 712 women a day or 30 per hour – with the vast majority in sub-Saharan Africa.
The WHO has warned that the global target for all UN member states to reduce maternal deaths – down to 71 per 100,000 by 2030 – will be missed by more than twice this amount as “the pace of progress has slowed to a near standstill”.
Leading health organisations including the WHO have warned that recent sweeping cuts to international aid by the US government, which amount to more than £595m ($770m) for maternal health and family planning, will risk “a shift backwards” in the progress made on cutting maternal deaths – defined as any death related to or aggravated by pregnancy, or within six weeks of the end of a pregnancy.
Speaking at a press conference, Dr Bruce Aylward, assistant director general of universal health coverage for the WHO, said: “The funding cuts risk not only that progress, but we could have a shift backwards.” He said that cuts were already “affecting access to lifesaving supplies and medicines, and especially treatments for some of the leading causes of maternal death”.
“One of the first things that they’re seeing already is that countries are already laying off staff, or not hiring, or they’re slowing down that healthworker spend… This is a real concern,” he added.
Some 60 countries worldwide are dependent on US-funded maternal care programmes and family planning services, largely concentrated in Africa and South Asia.
These programmes also provide funding for midwives in areas where essential maternal care is lacking. Reports from sources on the ground indicate that cancelling USAID contracts has led to some midwives losing their source of income, leaving women in the area without safe care during pregnancy.
But it’s not just the US: aid cuts are happening around the world. In February, prime minister Sir Keir Starmer announced that the government would slash its aid spending from 0.5 per cent of national income to 0.3 per cent in 2027 – a cut of about £6bn – to pay for increased defence spending.
The announcement came after the government’s International Development Committee (IDC) warned that UK aid cuts have already had a “devastating” impact on women and girls, with young girls in Sudan more likely to die during pregnancy than finish school. Labour MP Sarah Champion, chair of the IDC, told The Independent: “I remain deeply concerned that the cuts to aid will hit women’s health hard and destroy all the hard-won progress around the world.”
She added: “Preventing maternal deaths is not a medical mystery; we can end them with political commitment and financial investments. Realising the right to safe pregnancy and childbirth requires continued efforts to improve the quality of care, which must be backed by adequate financial resources and supportive laws … Weak health systems and new and protracted humanitarian crises have led to stagnating results in several countries, and even reversals in some.”
Sub-Saharan Africa and India suffer highest death rates
The new WHO figures reveal that one in 36 15-year-old girls in west Africa is at risk of maternal death. This compares to 1 in 16,000 across southern Europe.
Since 2000, global maternal mortality rates have declined by 40 per cent, from 328 per 100,000 live births to 197 in 2023. However, the figures reveal inequalities across high- and low-income countries.
Dr Pascale Allotey, director of the Department of Sexual and Reproductive Health at the WHO, warned: “Despite advances since 2000, the pace of progress has slowed to a near standstill. In some regions, we are already sliding backwards. In this context of fragility, complacency is not just dangerous, it is deadly … When women die because of where they live, what they earn, or what rights are denied, it is indefensible, and it is preventable.”
According to the report, half of all maternal deaths in 2023 were recorded in Nigeria, India, the Democratic Republic of the Congo and Pakistan. Nigeria alone accounted for one in three deaths, with around 75,000 deaths in 2023, while 70 per cent of deaths occurred in sub-Saharan Africa.
The world’s key international organisation focused on women’s reproductive health, the United Nations Population Fund (UNFPA), has also warned that recent US funding cuts to aid will risk an increase in maternal death rates.
Estimates by UNFPA show that £71m ($92m) of US aid is distributed in Nigeria, where death rates are highest. UNPFA itself has lost £291m ($377m) in grants following the cuts to USAID.
Julia Bunting, programme director for UNFPA, told The Independent that, while there has been progress in reducing maternal deaths globally, it is “by no means fast enough”. She said: “We know there has been a 40 per cent decline in maternal death rates since 2000, but … the progress is uneven and slowing.”
She added: “These lives can be saved … It’s not just a matter of health. It’s a matter of rights; it’s a matter of justice. We believe every woman should deserve to survive childbirth … We know how to prevent these deaths: with skilled midwives, quality care, and political commitment we can save very many of these lives, but there’s a real urgent need for investment, so we don’t risk reversing the gains that have already been made.”
Although UNFPA has faced cuts to its funding from USAID, Monica Ferro, director of the organisation’s London representation office, confirmed that it has yet to have its funding cut by the UK, which is its second-biggest donor.
However, she warned: “The combination of funding cuts, the increasing frequency of conflicts and the impacts of climate change mean pregnant women can’t access lifesaving care, and gender-based violence is rising. We can’t abandon the women and girls who need us most.”
The Cabinet Office was approached for comment.
A spokesperson for the Foreign Office said: “We are committed to defending and promoting sexual and reproductive health and rights, and we will continue to work with international partners in support of women and girls.
“Aid is only one way in which we support this work, and we will continue to use targeted funding and diplomatic engagement to provide leadership on gender issues and maternal health.
“Protecting our national security is the first duty of any government, and doing so required the difficult but necessary decision to reduce our aid spending.”
A US state department spokesperson said that the US government has provided longstanding support to lifesaving maternal and child health services in lower-income countries where the vast majority – over 90 per cent – of all maternal and child deaths occur.
This report has been produced as part of The Independent’s Rethinking Global Aid project