Maternal Mortality in Sub-Saharan Africa: Challenges, Progress, and the Path Forward

Photo by The Yuri Arcurs Collection from Freepik

In Sub-Saharan Africa, pregnancy and childbirth remain among the most dangerous experiences a woman can face. Despite global progress in maternal health, the region continues to account for nearly 70% of all maternal deaths worldwide. Behind each statistic is a woman who lost her life giving life—a reminder of how much work remains to ensure every mother has access to safe, respectful, and effective care.

Yet there is also reason for hope. Across the continent, healthcare workers, innovators, and communities are reimagining maternal care—using mobile technology, remote monitoring, and community networks to save lives in even the most remote settings.

The Scope of the Challenge

According to the World Health Organization (WHO), the maternal mortality ratio (MMR) in Sub-Saharan Africa was approximately 545 deaths per 100,000 live births in 2020, compared to 13 per 100,000 in high-income countries. This stark contrast highlights systemic inequities in access to quality healthcare.

The leading causes of maternal death remain largely preventable:

• Severe bleeding (postpartum hemorrhage)
• Infections after childbirth
• Hypertensive disorders of pregnancy (such as preeclampsia and eclampsia)
• Complications from unsafe abortions
• Obstructed labor

Many of these deaths occur not because the conditions are untreatable, but because care is delayed—by distance, cost, or lack of skilled providers.

Barriers to Maternal Health

Maternal mortality is rarely due to a single factor. Instead, it reflects overlapping barriers:

• Geographic isolation – Women in rural areas may travel hours or days to reach the nearest clinic, often in labor.
• Shortage of trained personnel – Some countries have fewer than one midwife per 10,000 people.
• Weak referral systems – Even when complications are identified, there may be no ambulance, blood bank, or equipped hospital nearby.
• Socioeconomic and cultural challenges – Poverty, low literacy, and gender inequality can limit women’s ability to seek care.

Together, these factors create what experts call the “three delays”:

1. Delay in deciding to seek care.
2. Delay in reaching a healthcare facility.
3. Delay in receiving adequate treatment once there.

Addressing all three is critical to saving lives.

Signs of Progress

Despite these challenges, Sub-Saharan Africa has made measurable progress. Between 2000 and 2020, the region achieved about a 40% reduction in maternal mortality—a testament to the impact of targeted interventions, community health programs, and technological innovation.

1. Mobile Health (mHealth) Programs

Mobile phones are becoming one of the most powerful tools in maternal health. Programs like MomConnect in South Africa and MatHealth in Uganda send text and voice messages to pregnant women with reminders, health tips, and alerts for danger signs. These tools are especially vital in areas where formal healthcare outreach is limited.

2. Remote Monitoring Tools

Community health workers (CHWs) in countries such as Tanzania and Kenya are using smartphone-based apps to monitor expectant mothers, record vital signs, and detect complications early. Some apps can even alert nearby hospitals in real time when a high-risk pregnancy is detected.

3. Training and Empowering Midwives

Organizations across the continent are investing in midwife education and equipment. Portable ultrasounds and solar-powered delivery kits enable safe childbirth even in clinics without electricity. By strengthening frontline capacity, communities can deliver care closer to home.

4. Community-Based Maternal Care Networks

Grassroots initiatives are combining traditional practices with modern technology. Village mothers’ groups and local health committees are helping spread awareness about prenatal visits, facility deliveries, and postpartum care—bridging the cultural and educational gaps that often hinder access.

Why Technology Alone Isn’t Enough

While technology is transforming maternal care, it cannot operate in isolation. Many digital interventions show improvements in antenatal care attendance and health awareness, but fewer have demonstrated direct reductions in mortality—often because underlying systems remain weak.

Without reliable transportation, electricity, and referral systems, even the most advanced tools can fall short. The path forward must blend innovation with infrastructure, ensuring that data from mobile apps translates into action at clinics and hospitals.

The Road Ahead

To meet the United Nations Sustainable Development Goal of reducing maternal deaths to fewer than 70 per 100,000 live births by 2030, Sub-Saharan Africa will need not only new technologies but also sustained investment in:

• Health system strengthening — reliable power, supply chains, and emergency obstetric care.
• Skilled personnel — training and retaining midwives, nurses, and doctors.
• Equity-focused policies — reaching women in remote, conflict-affected, and marginalized communities.
• Community education — empowering families to recognize danger signs and seek care early.

A Future Where Every Birth Is Safe

Maternal mortality is one of the clearest indicators of inequality—but also one of the most preventable. Each life saved represents the success of collaboration among innovators, health workers, and communities.

At Accessome, we believe accessible healthcare means meeting women where they are—with tools, compassion, and systems that support them before, during, and after childbirth. The solutions exist. What’s needed now is the collective will to ensure that no woman dies giving life simply because of where she lives.