Opinion: Backing bold local leadership — a path to safer birth

Between 2000 and 2023, the world saw a 40% decline in maternal deaths. But behind this achievement, another story has been unfolding. In today’s ever-evolving geopolitical landscape, the sudden loss of development funding is forcing many countries with high maternal mortality rates to make difficult decisions about health care delivery — putting the lives of women at significant risk.

The World Health Organization recently warned that the abrupt withdrawal of development funding has forced many countries to scale back essential services, close clinics, and lay off health workers — disrupting supply chains for lifesaving medicines and supplies. Programs aimed at protecting the lives of pregnant and postpartum women and newborns are now in danger of being discontinued, and vital medicines are struggling to reach the people who need them most.

Progress that’s rooted in partnership

The latest annual data shows that around 260,000 women die during and following pregnancy, primarily due to postpartum haemorrhage, or PPH, pre-eclampsia, and sepsis. These deaths are mostly preventable through effective management, prevention, and treatment — and allowing them to continue is a travesty.

We have the solutions to reverse this worrying trend, but making them accessible to every woman, everywhere, demands catalytic action with collaboration at its heart. As a global community, we must continue advocacy at all levels of government to support health and development. Public-private-philanthropic partnerships, or PPPPs, are a key pathway to pursue better health outcomes, especially in low- and lower-middle-income countries where significant gains have already been made. They are critical in creating links between expertise and funding resources, while giving agency to local partners to drive implementation on the ground.

Successful PPPPs aimed at reducing maternal mortality require joint working at a subnational and community level to drive change. This success starts with listening to and empowering women, community members, and local leaders to inform and design tailor-made solutions that are rooted in the local context and responsive to real needs.

To advance the development of such impactful PPPPs, the World Economic Forum through the Global Alliance for Women’s Health, launched the Global Activators Network on Maternal Health. This network, hosted by WEF and initiated with support from the Gates Foundation and Ferring’s Project Family: Safe Birth initiative, aims to foster and strengthen partnerships in maternal health.

Securing national commitments

While subnational and community-level programs are vital for implementation, progress toward reducing maternal mortality is unlikely to happen without commitment at a national level. Securing that commitment can be challenging given the strains on national budgets. However, in 2024, the passing of the World Health Assembly resolution to accelerate progress toward reducing maternal, newborn, and child mortality, which aligns with Sustainable Development Goals 3.1 and 3.2, demonstrated such commitment. While signatures don’t always lead to action, some are actively advancing the principles outlined in the resolution.

Nigeria — a sponsor of the resolution — is one example of a country taking action at a national and local level. At a national level, their Maternal Mortality Reduction Innovation Initiative, or MAMII, focuses specifically on driving change in the 20% of the country where 55% of maternal deaths occur. To do so, they are leveraging PPPPs, including through the Global Activators Network on Maternal Health, to connect federal and state policymakers with implementing partners and funders.

Efforts are already underway to improve maternal health care around the country, with a specific focus on midwifery training and ensuring access to quality-assured maternal health commodities. A core foundation of this program is working directly with local leaders such as State Health Commissioners to drive tangible progress. This is a powerful example of how targeted action, led by local implementors and backed by national commitment, can save lives and, in turn, be used as a blueprint for others.

Another example of the value of partnerships at the subnational level can be found in Makueni County, Kenya. Since 2023, no maternal deaths due to PPH have been reported in public hospitals. Through PPPPs with Jhpiego, Gates Foundation, Ferring’s Project Family: Safe Birth and MSD for Mothers, the county has adopted innovative health care practices, including the rollout of a comprehensive PPH bundle of care. This involves the combined use of heat-stable carbetocin for PPH prevention and the adoption of the E-MOTIVE protocol.

Delivering tailored solutions to equitable care

There is no silver bullet for ending the maternal health crisis. We need political leadership committing to bold targets, innovative financing, PPPPs, and accountability at global and national levels. The scaling up of evidence-based solutions to create more equitable and quality-driven care cannot be ignored; we must increase access to these interventions to save lives. For example, by increasing midwife-delivered interventions, maternal deaths have the potential to decrease by 67%. There is also an opportunity for technical experts, professional bodies, and researchers to come together to demonstrate the value of these interventions and advocate for greater access.

We also need local leaders to drive tailor-made implementation with support from others at a local, national, and global level. With all these stakeholders at play, action must not be siloed, which is why platforms such as the Global Activators Network on Maternal Health play a key role in connecting efforts. The right resources, knowledge, services, and people in public, private, and philanthropic organizations must be connected — and more data is needed to demonstrate how implementation is driving results. Without this, roadblocks will persist.

For policymakers aiming to build healthier, economically productive populations, maternal and newborn health must remain at the top of the agenda despite funding cuts and increased pressure on health care systems.

For development partners and U.N. agencies, the path forward must involve working with local organizations that understand the challenges and know what realistic solutions look like. Listening, learning, and adapting are key to ensuring solutions are tailor-made.

For funders and investors, it’s essential to support the full spectrum of maternal and newborn health interventions — from foundational services to catalytic innovations — to achieve sustainable impact. Without prioritizing the basics, the foundation for improved maternal and newborn health care and reduced maternal and infant mortality will remain too fragile to support lasting change.

For advocates, it’s time to mobilize to ensure no woman dies while giving birth, that every pregnancy is safe, and that every mother and baby has the chance to thrive. This is our collective responsibility, and the time to act is now.

GL-RMMH-2500168 | September 2025