Surviving Birth: Closing the Maternal and Newborn Mortality Gap
Each year hundreds of thousands of women and millions of newborns die from largely preventable causes around childbirth, overwhelmingly in low- and lower-middle-income countries. This founding report documents the burden, surveys the cheap and proven interventions, and frankly assesses why — despite high tractability — this comparatively crowded area still leaves a meaningful gap to close.
Surviving Birth: Closing the Maternal and Newborn Mortality Gap
Executive Summary
Childbirth remains one of the most dangerous events in human life for both mother and child in much of the world. About 260,000 women and 2.3 million newborns die each year from causes that are largely preventable with known, inexpensive interventions. The tractability is high and the moral urgency clear; the limiting factor is that this is a comparatively crowded field where the binding constraint is often implementation capacity rather than money.
The Scale of the Problem
The WHO reports about 260,000 maternal deaths in 2023 — over 700 women every day — alongside roughly 2.3 million neonatal deaths annually. The deaths are starkly concentrated: sub-Saharan Africa and South Asia account for the overwhelming majority. The global maternal mortality ratio stands around 197 per 100,000 live births, with enormous disparities between rich and poor countries.
Why This Is Tractable
Proven, low-cost interventions exist, with cost-effectiveness often in the range of $500–$6,000 per life saved:
- Skilled birth attendance and access to emergency obstetric care.
- Participatory women's groups (PLA) that have reduced neonatal mortality in trials.
- Community and facility-based newborn care, including kangaroo mother care.
- Tetanus elimination, clean delivery practices, and management of hemorrhage and pre-eclampsia.
The maternal mortality ratio has already fallen roughly 40% since 2000, demonstrating that progress is achievable.
The Neglectedness Reality
This area is heavily funded by WHO, UNICEF, UNFPA, the Gates Foundation, GiveWell-directed giving, and national governments. GiveWell and others note it is "not as neglected as before," and the binding constraint is frequently finding effective implementation partners rather than a shortage of money. This low neglectedness is precisely what pulls the score under 20 despite high importance and tractability.
Recommendations
- Fund proven, cost-effective delivery in the highest-burden settings.
- Strengthen implementation capacity — the genuine bottleneck — rather than only adding funds.
- Support participatory community approaches with demonstrated trial evidence.
- Target equity gaps within and between countries.
Further Reading
- WHO, Maternal Mortality Fact Sheet (2023); UN MMEIG estimates
- Every Newborn Action Plan (WHO/UNICEF)
- GiveWell, intervention reports on maternal and neonatal health
- Lancet Maternal Survival and Every Newborn series