Making Progress—and Facing Reality—in Maternal and Newborn Health

Every seven seconds, a woman or a baby dies from preventable complications during pregnancy, childbirth or in the first few weeks of life. Neonatal deaths now account for nearly half of all deaths among children under five, with over half occurring in sub-Saharan Africa.

Maternal and newborn survival is one of the clearest reflections of the quality of care that a health system provides. Encouragingly, we also know what works. Over the past two decades, maternal and neonatal mortality has declined by nearly 40% globally, driven largely by progress in countries like China and India. The policies, technologies and practices that save lives are well established.

And yet, many countries in sub-Saharan Africa still have a way to go.

It was against this backdrop that the International Maternal and Newborn Health Conference (IMNHC) convened in Nairobi—bringing together practitioners across policy, programs, and research to share lessons, challenge assumptions, and discuss how to accelerate progress. Given the urgency of this agenda, it is striking that this was only the third time the conference has been held, with the last event in 2023 following a ten-year gap since 2013.

Helmsley Program Officer Mila Nepomnyashchiy with Medicines for Humanity Program Director Kenneth Muko.

For Helmsley, this moment matters. Since 2012, we have invested more than $250 million to improve outcomes for mothers, newborns, and children across sub-Saharan Africa with a focus on Burkina Faso, Ethiopia, Ghana and Zambia. Investments in maternal and newborn health are investments in the community, and our Vulnerable Children in Sub-Saharan Africa Program has focused on strengthening health infrastructure, building health worker capacity and expanding access to essential health commodities. The conference provided a valuable opportunity to connect with grantee partners—including Catholic Relief Services, the Clinton Health Access Initiative, Healing Hands of Joy, Medicines for Humanity and PharmAccess—and to deepen our understanding of emerging evidence and innovations shaping the field.

A few highlights stood out:

1. Palpable optimism in a challenging funding environment.
   Despite significant foreign aid cuts in 2025, the conference was marked by a sense of momentum and optimism. Strong attendance (1,800+ participants), growing political leadership and new funding commitments underscore that maternal and newborn health is beginning to get the attention it deserves.

   Emerging funding opportunities led by funders and coalitions like Unitaid, the Beginnings Fund, and Every Pregnancy attest to renewed financial momentum. Throughout the conference, there were anecdotes of governments stepping in to address financing gaps, demonstrating a growing commitment.

   At the same time, political leadership is unprecedented: The African Union recently appointed President Samia Suluhu Hassan of Tanzania as its inaugural Champion for Maternal and Child Health and Sexual and Reproductive Health and Rights. Meanwhile, parliamentarians from 11 African countries issued a joint statement at the close of the conference, committing to stronger legislative action and accountability.

   At a time of uncertainty, this collective energy matters.

2. Commodities are necessary—but not sufficient.
   A notable shift from previous convenings was the strong focus on life-saving commodities—the essential medicines and services that support maternal and newborn health.

   The conference featured a dedicated commodities track, highlighting growing evidence on scaling interventions such as the EMOTIVE postpartum hemorrhage bundle, which improves early detection, prevention, and treatment of postpartum hemorrhage—the leading cause of maternal death.

   But there was also a clear and consistent message: commodities alone do not save lives. Their impact depends on whether systems can reliably deliver them to patients—at the right time, in the right place, and with skilled providers ready to use them. Stories of commodities expiring in warehouses and stockouts at the point of care highlight the need for coordination between demand generation, reliable supply chains and service delivery.

   Even as more women access health facilities, quality of care remains the defining challenge. And despite the stronger focus on commodities, critical system enablers such as safe blood, medical oxygen and last mile distribution systems received comparatively less attention even though they play essential roles in emergency care and patient survival.

3. Integration is no longer optional.
   If there was one clear consensus across sessions, it was this: the era of fragmented, vertical programming is ending.

   Integration of different services that affect the same patient is increasingly seen as essential to improving outcomes at scale. This was reflected in multiple areas:

   • The Triple Elimination initiative (HIV, hepatitis B, and syphilis)
   • The use of antenatal care as a platform for broader screening and prevention
   • The launch of Every Woman Every Newborn Everywhere (EWENE), a global effort led by WHO, UNICEF, and UNFPA to accelerate progress toward 2030 targets

   The shift toward integrated, people-centered care reflects a growing recognition that health systems must be designed around patients—not diseases.

Three learnings related to Helmsley’s priority areas made a deep impression:

1. Consistency is key. Ethiopia’s dramatic declines in maternal and neonatal mortality over the last 25 years underscore the impact of consistent investments in primary care and emergency maternal services even amid political changes. The country is now on track to meet the United Nation’s Sustainable Development Goals (SDG) within the next five years.
2. Design matters. One of the most compelling insights was that the physical design of health facilities can help improve health outcomes for mothers and babies. A collaboration between the Institute for Healthcare Improvement, MASS Design Group and Jacaranda Health launched the Delivering More toolkit, a set of resources based on human-centered design that reimagines physical care environments to better support mothers, newborns, and health workers. Tested in Ethiopia, Kenya, and Bangladesh, the toolkit lays out considerations for facility layout, workflows, and design.
3. Technology is reshaping what is possible. Point–of–care ultrasounds (POCUS) are emerging as promising tools for improving early detection and rapid response to complications. Multiple sessions, including one led by the Global Women’s Health faculty at University of North Carolina Chapel Hill (UNC), a Helmsley grantee, highlighted the potential of AI-enabled ultrasounds to support frontline health workers, particularly in rural settings where sonographers and obstetricians are notably lacking.

Looking ahead

The convening in Nairobi left a sense of inspiration, energy and challenge. Inspiration came from the strength and commitment of the global movement. Energy was drawn from the progress being made and the partnerships driving it forward. At the same time, there is a clear challenge: despite strong evidence and growing momentum, too many lives are still being lost, and difficult choices remain about where to focus and how to scale impact.

Maternal and newborn health interventions are among the most cost-effective investments in global health. This convening reaffirmed that progress is possible even amid an evolving cascade of political, economic, and societal challenges.

We are proud to be part of a global effort working toward a future where no mother or newborn dies from preventable causes.