The number of mothers and newborns dying each year is staggering by any standard. Though child deaths dropped below 5 million annually for the first time ever in 2022, progress in maternal and newborn health has plateaued over the past decade. In 2020, 202,000 mothers died in childbirth in sub-Saharan Africa alone—that’s a mother dying every two minutes.
These deaths are preventable. We have lifesaving innovations that already exist and more in the pipeline to be delivered soon. Having worked as a maternal, newborn, and child health (MNCH) advocate in Uganda, as well as the broader Africa region, I’ve seen firsthand what is possible when there is the political will and investment to do so.
An urgent need
The causes of maternal and child mortality, as well as the tools and services available to help save more lives, are well documented. In particular, a recent report by the World Health Organization (WHO) noted that progress could be made to reduce preventable deaths among children aged 1-59 months faster by scaling up low-cost, high-impact interventions—such as routine childhood vaccinations and breastfeeding support—and strengthening primary health care systems to provide care at birth as well as early diagnosis and treatment of childhood diseases.
Similarly, when it comes to mothers and newborns, the first joint Every Newborn Action Plan/Ending Preventable Maternal Mortality progress report found that an alarming number of mothers and infants are still dying, particularly in Africa. Providing essential health services, including at least four antenatal care contacts, a skilled attendant at birth, and postnatal care within two days of delivery, make a crucial difference in saving lives.
What more needs to be done to gain traction in maternal and newborn health? We know what works, yet inequities in access to quality and affordable MNCH services continue to slow progress. Advocacy is key to ensuring that these lifesaving interventions reach mothers and children so that they may survive and thrive.
Accelerate actions now
The 2030 deadline for the ambitious global MNCH targets is rapidly approaching, so we must develop a sense of urgency. Fortunately, we’ve seen promising signs recently of growing political will. Last year, government officials, academics, local and international NGOs, civil society members, and private-sector representatives—including researchers, donors, and multilateral partners—converged at the International Maternal Newborn Health Conference organized by AlignMNH and the Government of South Africa to agree upon steps to regain lost ground.
As a result of these collaborations, at least 29 countries have drafted and submitted plans and targets to accelerate improving maternal and newborn health at the country level. And just last month, a resolution led by Somalia was adopted during the 77th World Health Assembly addressing the need to accelerate progress in reducing maternal, newborn, and child mortality and reaching global health targets.
All these efforts point to the urgency needed to deliver results for mothers, newborns, and children in Africa across all levels, from local communities to the entire continent. MNCH advocates can help ensure health decision-makers and policymakers remain focused and held accountable to these commitments.
In 2024, PATH launched a regional MNCH advocacy dialogue series to catalyze advocacy actions in Africa and move the needle on MNCH targets. The appetite is huge and the demand for action is palpable. As we speak with and work alongside advocates throughout Africa on what action is needed to change the status quo, we have identified four key themes central to this movement to strengthen MNCH advocacy:
- Champion stronger policies and ensure robust implementation.
Strong policies are essential for achieving better health outcomes, yet action often stalls after policy development and adoption. Without robust policy implementation, inequities in access to health services will continue to be a barrier to progress.
We need the concerted effort of civil society advocates, from the community to the global level, to ensure commitments are transformed into actionable, fully implemented policies.
PATH has developed a tool to support advocates and decision-makers working together to push for and implement equitable policies to improve maternal, newborn, and child health. - Break down silos among advocates at all levels.
The policy process needs to be more inclusive of all stakeholders, including civil society organizations (CSOs), to ensure voices from the community, such as parent groups, women, and girls, are heard at the policy table and that leaders are held accountable. Despite good intentions, there remains weak coordination among CSOs engaged in MNCH advocacy and between CSOs and decision-makers in many countries.
To make progress, we cannot work in isolation. Technical teams at ministries of health and at the global level need to intentionally include civil society advocates in decision-making spaces. For example, next year’s World Health Assembly should include more than just the WHO and ministers of health at the meeting. This involves bringing in parents’ groups, health care workers, CSOs, and other decision-makers who work on the ground and directly experience struggles with access to equipment and data.
The same goes for connections between the African Union and subregional and national entities. Collaboration helps advocates from the countries to work toward a joint agenda, leverage the latest evidence, share lessons learned—including successes and, importantly, failures—and understand the clear guidelines required to reduce mortality. With CSOs involved, we can better advocate for policies and finances in a way that will work best for each community. Having a global coordinating body would greatly streamline these efforts. - Invest at the local level.
We must not just localize the commitment but also the investment. This means investing in advocacy efforts at the grassroots level while continuing to strengthen the connections between national, regional, and global initiatives. It is essential that we deepen social accountability efforts so that community members are involved and engaged in the decisions that affect them. The voices of people who experience challenges with MNCH services daily should be heard and considered in decision-making conversations. - Deepen data use for advocacy.
There is an abundance of useful data at the global level, but it is unclear if that evidence is reaching or gaining the trust of the governments and individuals making decisions in their own communities. At the subnational and national level, data is generated through various mechanisms, but it isn’t often delivered in a way that can clearly and efficiently inform policy actions. Advocates should leverage this data to inform their priorities and translate this evidence into easily understood, accessible, and usable information for decision-makers at all levels.
What's next?
Focusing on MNCH is essential and urgent. It is possible to achieve lasting improvements in the health of women and children across Africa. But this work urgently calls for coordinated and collaborative advocacy at subnational to global levels to support resource mobilization, exert strong policies, mobilize communities, and drive demand for innovative and effective MNCH services and products.
PATH will continue partnering throughout the year to bring advocacy partners working across Africa together to share lessons learned, successes, and effective tools; ensure acceleration of advocacy plans; and drive the agenda forward. Ongoing dialogue is crucial to ensure that the learnings we’ve gained can be applied in a meaningful way to help women and children in sub-Saharan Africa. By creating a space for advocates to connect with the necessary tools and strategies, PATH’s regional MNCH advocacy dialogue series seeks to support advocates in driving meaningful change and holding stakeholders accountable for their commitments.
Our next regional MNCH advocacy dialogue session will be held in two parts on June 27 and July 3, focusing on tools to inform and enhance effective advocacy and accountability initiatives to advance MNCH outcomes.
