How the Bill and Melinda Gates Foundation hopes to turn the tide on maternal mortality

The Bill and Melinda Gates Foundation is on a mission to help reduce maternal mortality rates worldwide.

The foundation’s annual Goalkeeper’s report, released on Tuesday, reveals that progress on reducing maternal mortality rates has stalled in many countries, with deaths on the rise in some places.

“Everyone agrees that a mother should not die in childbirth and that a child should not die of a preventable disease,” Mark Suzman, chief executive of the foundation, told The National.

According to statistics provided in the report, from 2000 to 2015, maternal mortality rates steadily dropped.

But progress ground to a halt in 2016 and rates have remained stubbornly unmoved since.

Maternal mortality is when a woman dies from pregnancy-related causes or within 42 days of the end of the pregnancy termination.

The Covid-19 pandemic, during which there was a massive international effort to develop and distribute vaccines, did not help matters.

The pandemic and the war in Ukraine have taken attention and money away from dozens of other critical issues facing the world, including maternal mortality.

According to Mr Suzman, aid to Africa dropped 8 per cent in 2022.

He said “it is difficult to stay focused” on other issues “when you've got a big crisis like Covid”.

In 2015, the UN adopted a set of Sustainable Development Goals that included 17 interconnected objectives, designed to create a “shared blueprint for peace and prosperity for people and the planet”.

Among the many objectives was reducing maternal mortality rates to fewer than 70 out of every 100,000 births and to end all preventable child deaths by 2030.

As of 2021, maternal mortality rates hovered close to 159 for every 100,000 births, a number that has a cascading effect on the health and well-being of infants and families.

The chance of an infant surviving to its first birthday plummets to just 37 per cent if the mother dies during childbirth.

The report illustrates just how far off the world is from its sustainable development objectives concerning maternal mortality.

“Sadly, we are significantly off track for most of these,” Mr Suzman said.

But he said it was not too late to reverse the tide.

“It is possible for not all the goals, but many of them to get back on [track] even within the seven years,” Mr Suzman said.

The report highlights three relatively easy and affordable innovations that could go a long way in helping to make it safer for mothers to give birth around the world, including in lower and middle-income countries.

The innovations include treating post-partum haemorrhaging with a simple V-shaped plastic bag, known as a drape, that would allow doctors or nurses to easily identify whether a woman is haemorrhaging or not.

Anaemia is a leading cause of post-partum haemorrhage. The report highlights the work of a Nigerian obstetrician, who has shown that a 15-minute intravenous infusion of iron during or after pregnancy could have a life-saving effect.

Another solution the report highlights is providing azithromycin, an antibiotic that treats sepsis, which is also a leading cause of maternal mortality.

In the US, which has a high maternal mortality rate, especially among black and indigenous women compared to other high-income countries, sepsis is especially deadly.

Azithromycin could be a “game-changer” in the US, the report said.

“The United States has some of the most abysmal – and most inequitable – maternal mortality rates among high-income countries,” Melinda Gates said in the report.

“American women are more than three times more likely to die from childbirth than women in almost every other wealthy country.”

Mr Suzman added that “there are tools and innovations that can help bend that curve, but it's going to be challenging."

While the solutions may exist, it is up to the international community to heed the clarion call.

“This is the most visceral human achievement there is, preventing avoidable deaths of mothers and children,” Mr Suzman said.

“And it's absolutely doable at relatively low cost2. It just requires this combination of political time and energy.”