Maternal deaths have declined worldwide over the past two decades and are down by more than a third due to affordable, quality health care services. Not all countries, however, have benefited from advancements in technology and care. 

Each year about 303,000 women die from complications related to pregnancy or childbirth. Where a person lives shouldn’t determine if they die, yet almost all of the maternal deaths (99%) occur in developing countries.

The majority of maternal deaths, approximately 85% in 2017, occurred in sub-Saharan Africa and South Asia, especially in regions with low numbers of skilled health care workers. Sub-Saharan Africa alone accounted for roughly two-thirds of maternal deaths in the world.

Why Maternal Mortality Is So High in Sub-Saharan Africa

If all countries had access to available technology and medical knowledge, maternal mortality rates could be reduced to zero. Many women who experience maternal death in sub-Saharan Africa live in poverty and do not receive adequate care in time to address complications. Other contributing factors include high rates of child marriage and unintended pregnancies. 

3 Things to Know About Maternal Mortality in Sub-Saharan Africa

  • Sub-Saharan Africa alone accounted for roughly two-thirds of maternal deaths in the world in 2017.
  • The likelihood of a woman dying of pregnancy-related causes is about 1 in 37 in Africa. 
  • Women living in poverty are the least likely to receive adequate health care and experience maternal death. 

What Is Considered a High Maternal Mortality Rate?

Maternal mortality is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. 

India and Nigeria account for one-third of maternal deaths across the world. Other countries with high mortality rates across the African continent range from 119 deaths per 100,000 live births in South Africa, to much higher in countries like Sierra Leone (1,360 deaths per 100,000 live births), South Sudan (800 deaths per 100,000 live births), and Democratic Republic of Congo (473 deaths per 100,000 live births).

Maternal death rates may even be inaccurate in sub-Saharan Africa due to deaths that occur in lower-level facilities and outside hospital settings going unrecorded, incomplete or misclassified. 

The lifetime risk of maternal death in high-income countries is 1 in 4,500 compared to 1 in 45 in low-income countries. The huge disparities found across regions and between the richest and poorest countries are proof that almost all maternal deaths can be prevented.

Who Is Most Affected by Maternal Mortality in Sub-Saharan Africa, and Why?

Women living in poverty are the least likely to receive adequate health care and experience maternal death. The likelihood of a woman dying of pregnancy-related causes is about 1 in 37 in Africa. 

At least 50% or more of women will have started childbearing by the age of 19 in many countries of Sub-Saharan Africa and be at risk. Adolescent girls who experience early pregnancy account for a significant portion of maternal mortality in sub-Saharan Africa, and those under 15 have a much higher risk of maternal mortality. Pregnancy-related complications are the leading cause of death in girls in developing countries due to health, social and economic disadvantages. High child marriage rates also tend to correlate with higher maternal mortality rates. Young women’s bodies are still developing and child brides are more likely to experience early and frequent pregnancies, complications during pregnancy and childbirth, lack the agency to advocate for safe sexual practices and family planning, and often live in isolated areas without access to maternal health care. 

Women who experience unintended pregnancies are also at an increased risk for maternal morbidity.

How Many Women Suffer Maternal Death in Sub-Saharan Africa?

Women in sub-Saharan Africa suffer from the highest maternal mortality rate: 533 maternal deaths per 100,000 live births or 200,000 maternal deaths a year.

What Impact Is Maternal Mortality Having on Sub-Saharan African Communities?

Maternal deaths can lead to the long-term social and economic breakdown of a mother’s immediate family and the wider community in developing countries. A mother’s death can devastate the livelihoods, quality of life, and survival chances of those she leaves behind. Households that experience a maternal death spend approximately a third of their income to access pregnancy and child care, and funeral costs only add to financial hardship. Without a mother’s income, a family can be left without basic needs like food, shelter, and health care. 

Older children who survive a mother’s death are also more likely to leave school and daughters are more likely to enter an early marriage or motherhood continuing cycles of poverty. Maternal mortality also impacts infant mortality and newborns whose mothers die are less likely to reach their first birthday.

What Are the Main Causes of Maternal Morbidity?

Gaps in access to health care workers mean that pregnant women do not receive antenatal care, delivery care, and newborn care, which increases the risk of death from severe bleeding, infections, or other complications. There are currently 985 people for every nurse-midwife and 3,324 people for every medical doctor in Africa. 

Hemorrhage is the leading cause of maternal mortality and accounts for over one-quarter of deaths. A similar proportion of maternal deaths were caused indirectly by pre-existing medical conditions worsened by the pregnancy. Hypertensive pregnancy disorders, especially eclampsia, as well as sepsis, embolism, and complications from unsafe abortion also lead to a significant number of deaths.

Most maternal deaths can be prevented if mothers receive adequate health care and can be attended to in an emergency when complications are present.  

How Does Maternal Mortality Relate to Extreme Poverty and Its Systemic Causes?

Women living in developing countries often only receive prenatal care once during their pregnancy instead of the recommended four visits, which means there are missed opportunities to identify problems and receive appropriate care and treatment. Preventable pregnancy complications such as preeclampsia or anemia and several medical issues such as HIV/AIDS transmission can go untreated.

When women living in poverty do not receive adequate maternal health, it negatively impacts infant health and, in turn, affects a family’s ability to seek education and meet their full potential. When a mother dies from pregnancy-related complications, her children are in unsupportive environments. An estimated 1 million children are left motherless annually and have little chance of receiving proper health care, attending school and are more likely to live in poverty for the rest of their lives. 

Former UN Secretary-General Ban Ki-moon launched the Global Strategy for Women’s, Children’s and Adolescents’ Health, during the United Nations General Assembly 2015 in New York as part of the Global Goals to end all preventable deaths of women, children, and adolescents and foster an environment in which they all thrive, and see their environments, health and wellbeing transformed. Global Goal 3 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 births, with no country having a maternal mortality rate of more than twice the global average to end extreme poverty.

Who Are the Key Players in Tackling Maternal Mortality?

The US-based non-profit organization and Global Citizen partner Pathfinder International promotes maternal health in more than 15 low- and middle-income countries in Africa and South Asia. Pathfinder works to ensure that women can access care at every stage of pregnancy, mobilize communities to identify pregnancy danger signs, provide every woman with access to health care and information, equip providers with training for safe pregnancy and childbirth, and prevent HIV transmission from mother to child.  

The World Health Organization (WHO) is also improving maternal health by increasing research, providing clinical and programmatic guidance, setting global standards, and offering technical support to UN member states. The WHO is urging partners to address inequalities in access to quality reproductive, maternal, and newborn health care services and strengthen health systems while prioritizing women and girls.

In response to the COVID-19 pandemic, the African Population and Health Research Center is encouraging African governments to ramp up efforts to create awareness around which maternal health services are available during lockdowns and curfews, strengthen media coverage to motivate mothers to access services, make maternity rooms available, and learn from previous crises to minimize the impact on maternal and newborn health. 

What Action Can We All Take Against Maternal Mortality?

Global Citizens can urge world leaders to empower women and girls in sub-Saharan Africa by providing access to sexual, reproductive, and maternal health care. When every woman can make their own decisions about reproductive health through family planning they prolong their life and their families lives. 

Ensuring that everyone can rely on strong health systems, preventing child marriage, early pregnancy, and unsafe abortions, and promoting sexual health are all key to achieving gender equality. Learn more about bodily autonomy in sub-Saharan Africa here

You can join the Global Citizen Live campaign to defeat poverty and defend the planet by taking action here, and become part of a movement powered by citizens around the world who are taking action together with governments, corporations, and philanthropists to make change.

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Why Maternal Mortality Is So High in Sub-Saharan Africa

By Leah Rodriguez