Email: communications@africacdc.org
1. Executive Summary
For African Heads of State and Government, Ministers of Health and of Finance, and the United Nations General Assembly.
This summary reports the findings of an evidence review commissioned by the African Union Champion for Maternal and Child Health. It states the burden, the methods used, what the evidence shows, and what follows from it. Sources for every figure are given at the point of use in the body of the report.
Background
Maternal and newborn mortality remain concentrated in a minority of African Union Member States. In 2023 an estimated 260,000 women died worldwide from causes related to pregnancy and childbirth, of whom approximately 178,600, some 69%, died in Member States of the Union. The maternal mortality ratio across Member States was 388 deaths per 100,000 live births, against a global average of 197. Member States also account for approximately 1.18 million newborn deaths a year, 51% of the world total.
The fifty-five Member States of the African Union are not a single epidemiological grouping. Maternal mortality ranges from 17 deaths per 100,000 live births to 993, and the burden is concentrated by region. West Africa records 682 deaths per 100,000 live births and accounts for 55% of all maternal deaths in the Africa continent; Central Africa records 439 per 100,000 live births, East Africa 260 per 100,000 live births, Southern Africa 162 per
100,000 live births and North Africa 50 per 100,000 live births. Four of the five regions together carry 99% of the maternal deaths in Africa. Continental aggregates should be read with that concentration in mind.
Maternal mortality across Member States fell by 42% between 2000 and 2023, from 666 to 388 deaths per 100,000 live births. At the observed annual rate of reduction of 2.4%,
Member States will record approximately 330 deaths per 100,000 live births in 2030, close to five times the Sustainable Development Goal target. Meeting that target would require the rate of decline to increase roughly ten-fold. The slowdown in progress began after 2016, several years before the recent contraction in development assistance.
Methods
Five bodies of evidence were combined. First, a structured review of 199 national maternal and perinatal death review reports and related documents covering 62% (34) of Member States, from which 78 records were extracted covering causes of death, contributory delays, avoidability, and whether each report tracks progress against its own previous recommendations. Second, a continental assessment of sexual and reproductive health policy, coordination, financing, monitoring and service delivery for 2021 to 2025, completed by all 55 Member States and validated by them at two regional workshops. Third, country exemplars of high-impact interventions and projects nominated by Member States and graded by strength of evidence. Fourth, the peer-reviewed literature on maternal and perinatal death surveillance and response. Fifth, published global estimates of maternal and newborn mortality.
Cause distributions taken from national death reviews are not comparable between countries, because denominators, classification systems and review coverage differ. They are reported here as patterns, and are not used to rank Member States.
