Science to transform maternal and newborn survival and stillbirths in sub-Saharan Africa in the SDG era

The Academy of Medical Sciences, in collaboration with the African Academy of Sciences, convened a policy workshop on maternal and newborn survival and stillbirths in sub-Saharan Africa in Nairobi, Kenya on the 4-5 September 2018.

This two day workshop, co-chaired by Professor Joy Lawn FMedSci and Professor Charles Mgone, facilitated discussions on improving maternal and newborn survival and stillbirths in sub-Saharan Africa.

Maternal and child health has long been recognised as an international priority. It is estimated that in 2015 there were almost 6 million deaths of children under the age of five and over 300 thousand maternal deaths globally. The United Nations Sustainable Development Goals (SDGs) set targets for reduction of maternal and child deaths by 2030.

The Millennium Development Goals (MDGs), called for reduction in maternal mortality by three quarters and reduction in the mortality for children under five years by two thirds. These targets provided political and social impetus for change and in 25 years, between 1990 and 2015, the global maternal mortality rate fell by 44% and the child mortality declined by 53%, although with much slower progress for neonatal deaths (first month after birth). Now almost half of child deaths globally (2.6 million) are in the neonatal period, and an equal number of babies die as stillbirths in the last 12 weeks of pregnancy. Building on this remarkable progress and to continue the unfinished agenda of MDGs, the SDGs include a call for reduction of global maternal mortality to less than 70 per 100 000 live births and national targets for under-5 mortality to be at least as low as 25 per 1000 live births by 2030, with for the first time ever, a target for neonatal mortality of 12 or lower These new SDG targets, endorsed by world leaders, show renewed political commitment, and provide a catalyst to accelerate change.

In 2015, the Sub-Saharan region with only 13% of the world’s population had the majority of maternal deaths worldwide (66%), and more than half of under-5 deaths. If current trajectories continue, more than half of the sub-Saharan countries will not meet the SDGs targets for maternal, newborn or child mortality. The transition from MDGs to SDGs marks a change from relative to absolute targets for maternal, newborn and child mortality. This is particularly challenging for a number of sub-Saharan African countries which will need to more than double their current rates of progress. For example, in 2015, the lifetime risk of maternal death was almost 16 times higher in Sierra Leone compared to Botswana. Similar disparities were observed in child health trends, and in 2015 under-5 mortality rates ranged from 14.9 per 1000 livebirths in Botswana to 130.5 per 1000 livebirths in Central African Republic. Yet a large majority of these deaths are preventable with universal health coverage, and science can contribute both to better implementation and to innovations that can be transformative.

In 2009 a group of seven African Science Academies on behalf of US NAM published a report which was launched at Ghana’s Academy’s 50th Anniversary. The report presents an overview of what the then current status of maternal, newborn, and child health in sub-Saharan Africa and reported a new analysis of how many lives could be saved if science translated into action through health systems. The report resulted in positive media coverage in Africa and a series of papers in PloS.

This workshop considered the current status for maternal and newborn survival, and stillbirths in sub-Saharan Africa, with respect to relevant SDG targets and identified tools that could accelerate progress in implementing existing tools identify new innovations that could be disruptive, and reviewed opportunities to support increased research leadership. In addition, the workshop also impacted policy uptake, specifically through the use of science and investment in research and research leadership.

A meeting report was produced and disseminated to relevant stakeholders. This report outlines the proposed next steps to improve maternal and newborn survival in sub-Saharan Africa.

This workshop was funded by the Global Challenges Research Fund that aims to support cutting-edge research that addresses the challenges faced by developing countries. Visit our GCRF webpage to read more about the fund.

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