Introduction
This policy brief is DIMA Health’s summary of a presentation by Professor Peter Waiswa, a leading expert in maternal and child health in Africa, addressing the critical challenges facing maternal health on the continent. Professor Waiswa identifies major barriers, including poor leadership, inadequate funding, and weak health systems, that are impeding progress in improving maternal health outcomes. With Africa’s rapidly growing and youthful population, the demand for maternal healthcare is expected to rise significantly in the coming years. This brief provides an overview of the current maternal health landscape, underscores the primary challenges, and offers strategic recommendations to enhance maternal health outcomes across Africa.
Main Highlights
- Rapid Population Growth: Africa’s fast-growing population is putting immense pressure on hospitals and clinics, making it difficult to provide adequate care for pregnant women and new mothers.
- Slow Progress in Reducing Maternal Mortality: In sub-Saharan Africa, the decline in maternal deaths during pregnancy or childbirth is not occurring quickly enough to meet global goals.
- Rising Maternal Deaths in Urban Areas: Increasing maternal mortality in cities indicates the need for improved emergency care for pregnant women in urban settings.
- Key Actions Needed:
- Strengthen the entire healthcare system.
- Leverage new technologies to enhance care delivery.
Background
Africa’s population is expanding rapidly and is projected to reach 2.5 billion by 2050. A significant portion of this growth will be among young people, leading to more pregnancies and higher demands on healthcare services. While there has been progress in reducing maternal deaths in sub-Saharan Africa, with a one-third reduction between 2000 and 2020, the decline is insufficient. To meet the global targets for safer childbirth by 2030, maternal mortality rates must decrease by nearly 90%, posing a formidable challenge.
Main Issues
- Overburdened Healthcare Facilities: The growing number of pregnancies due to Africa’s expanding population is overwhelming hospitals and clinics, leading to increased demand for services, including caesarean sections.
- Regional Disparities in Maternal Mortality: Maternal mortality rates vary significantly across Africa. West Africa has the highest rates, with approximately 754 deaths per 100,000 births, while Southern Africa has the lowest, with 157 deaths per 100,000 births. Overall, in sub-Saharan Africa, a woman has a 1 in 40 chance of dying from pregnancy-related complications, compared to the global average of 1 in 210.
- Changing Health Challenges: While child mortality rates have decreased, maternal and newborn mortality remains high due to inadequate emergency care. The leading causes of maternal deaths are haemorrhage, high blood pressure, and infections after childbirth, most of which are preventable with better healthcare.
- Urban Maternal Mortality: Maternal deaths in urban areas are increasing. For instance, Kampala, Uganda’s capital, now has the highest maternal mortality rate in the country, highlighting the challenges city hospitals face in providing adequate emergency care.
Policy Implications
The data underscores the persistent health risks African women face during pregnancy and childbirth unless substantial changes are made. These issues extend beyond the healthcare sector and involve economic, social, and political factors. Addressing them requires a multi-faceted approach that goes beyond the traditional “Three Delays Model” (delays in seeking care, reaching care, and receiving care).
Recommendations
- Strengthen Health Systems: Improve the capacity of hospitals and clinics to handle the increasing number of pregnant women and new mothers by ensuring adequate supplies of medicine, equipment, trained staff, and effective management.
- Target Urban Areas: Develop specific strategies for cities where maternal mortality is rising. This includes enhancing emergency care, improving access to health services, and addressing unique urban challenges.
- Embrace New Technology: Utilize tools like artificial intelligence to improve maternal healthcare delivery and monitoring. These technologies can help analyze data, support community health programs, and implement proven treatment methods.
- Adopt Proven Strategies: Implement successful approaches from different parts of Africa. For example, the Saving Mothers, Giving Life initiative significantly reduced maternal deaths in Uganda and Zambia by strengthening health systems.
- Focus on Prevention: Emphasize preventing health problems before they arise. This includes promoting family planning, supporting women’s rights, ensuring financial stability, and fostering community support—all of which are critical to improving maternal health.
Conclusion
Maternal health in Africa is at a critical juncture. While there have been improvements, significant challenges remain. Achieving meaningful progress requires more than just enhancing healthcare facilities—it necessitates addressing broader factors that impact women’s health, such as education, economic stability, and gender equality. With the right strategies and sufficient investment, Africa can make substantial strides in maternal health, ultimately achieving global targets for safer childbirth. The goal is to ensure that all women in Africa receive the care they need to stay healthy and have healthy babies. This is a significant challenge, but it is achievable if everyone works together and focuses on what truly benefits mothers. Improving maternal health is not just about better healthcare; it’s about improving the overall quality of life for women.
References
- Galal, S. (2024, March 25). Forecast of the population growth rate in Africa from 2025 to 2050. Statista. https://www.statista.com/statistics/1224222/forecast-of-population-growth-in-africa/#statisticContainer
- World Health Organization. (2022). Trends in maternal mortality 2000 to 2020. Retrieved from https://www.who.int
- Onambele, L., et al. (2023). Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach. Epidemiologia, 4(3), 322–351. https://doi.org/10.3390/epidemiologia4030032
- Conlon, C. M., et al. (2019). Saving Mothers, Giving Life: It takes a system to save a mother. Global Health Science and Practice, 7(suppl 1), S6-S26. https://doi.org/10.9745/GHSP-D-18-00427
- Birabwa, C., et al. (2024). Maternal health in cities: analysis of institutional maternal mortality and health system bottlenecks in Kampala City Uganda, 2016-2021. Journal of Global Health Reports, 8, e2024006. http://doi:10.29392/001c.116248