By Joyce Ojanji
By making seven new innovations accessible to those who need them most, two million additional lives could be saved by 2030, and 6.4 million lives by 2040.
This is according to The Bill & Melinda Gates Foundation’s seventh annual Goalkeepers Report, co-authored by foundation Co-chairs Melinda French Gates and Bill Gates. It highlights new data that shows the potential of scaling up global access to seven innovations and practices that address the leading causes of maternal and newborn deaths.
These innovations include a bundle of interventions that can reduce postpartum hemorrhage (PPH), the leading cause of maternal death, by 60% for less than $1 per package.
The World Health Organization(WHO) estimates that PPH, which means losing more than half a liter of blood within 24 hours of childbirth, affects 14 million women every year—killing 70,000 of them, primarily in low-income countries. Those who survive often face long-term, disabling complications, such as heart or kidney failure.
When PPH is identified, doctors, nurses, and midwives have long relied on a series of five treatments to stop the bleeding: uterine massage, oxytocic drugs, tranexamic acid, IV fluids, and genital tract examination. But those interventions were being delivered sequentially—and far too slowly. So the researchers asked providers to bundle the interventions, administering all five at once.
Bifidobacteria (B. Infantis), a new probiotic supplement that, when given to an infant alongside breast milk, combats malnutrition—one of the leading causes of newborn deaths. B.infatis promotes a healthy gut microbiome and gut environment through high mucus-binding ability in breastfed infants, modulates inflammatory responses and suppresses the production of pro-inflammatory cytokines. Bifidobacteria are different depending on where you’re from. Babies in India have different gut bacteria than babies in the United States, so these probiotics have to be tailored hyper-locally.
Multiple micronutrient supplements (MMS) boost survival rates for babies by helping replete nutrient stores in pregnant women and ensuring those vital nutrients are transferred to the baby. These MMS reduce the risk of stillbirth, reduce the risk of mortality among six-month infants, reduce the risk of low birth weight (2500g), reduce the risk of preterm and reduce the risk of being born small for gestational age.
A new one-time infusion of IV iron for women that replenishes iron reserves during pregnancy, protecting against and treating anemia, a condition that is both a cause and effect of postpartum hemorrhage and affects almost 37% of pregnant women.
Antenatal corticosteroids (ACS), which are given to women who will give birth prematurely to accelerate fetal lung growth, provide several weeks of maturation in just a few days. They can increase the chance of your baby surviving if they are born prematurely and can reduce the risk of them having health problems. It is estimated that ACS could save the lives of 144,000 infants in sub-Saharan Africa and South Asia by 2030 and nearly 400,000 by 2040.
Azithromycin, reduces maternal infections during pregnancy and prevents infections from spiraling into sepsis—the cause of 23% of maternal deaths in the United States—and reduces mortality when given to infants in high-mortality settings.
Also, an AI-enabled portable ultrasound that empowers nurses and midwives to monitor high-risk pregnancies in low-resource settings to ensure that risks are diagnosed and addressed early.
Since 2016, progress in reducing global maternal mortality has stalled, and in some countries—including the United States-death rates have risen steadily. Across the world, nearly 800 women die in childbirth every day.
Though deaths of children under five have continued to decline since the mid-2010s, the first month of a newborn’s life continues to be the most dangerous, accounting for almost half of all under-5 deaths today. An estimated 74% of child deaths happen during a baby’s first year.
In the report, French Gates and Gates acknowledge the global efforts between 2000 and 2015 that significantly improved the health of mothers and babies but point out that progress has stalled since COVID-19 hit. They explain how the discovery of revolutionary information about maternal and child health in the last 10 years led to low-cost and easy-to-implement innovations and practices that prevent and treat deadly childbirth complications such as post-partum hemorrhaging, infections, and maternal anemia.
Therefore, they call for immediate action to help put the world back on track to achieve the global goal of cutting the maternal mortality rate to less than 70 out of 100,000 births and newborn mortality to 12 deaths per 1,000 live births by 2030.
“As is so often the case in global health, innovations aren’t making their way to the people who need them most—women in low-income countries, as well as Black and Indigenous women in high-income countries like the United States, who are dying at three times the rate of white women. That needs to change. We have seen over and over again that when countries actually prioritize and invest in women’s health, they unleash a powerful engine for progress that can reduce poverty, advance gender equality, and build resilient economies,” writes French Gates.
According to Gates, over the past decade, the field of child health has advanced faster and farther than he thought and would see in his lifetime. He says if researchers can continue developing new innovations and skilled health workers can get them to every mother and child who needs them, then more babies will survive those crucial first days.
Halfway to the deadline for the SDGs, the Goalkeepers Report shows that on 18 indicators—from poverty to gender equality, education to food security, health to climate—the world is off track.
The report underscores the urgent need for action, as well as a renewed global commitment to ensure a more equitable and safe future for all by 2030. For mothers and babies, having access to the quality health care they need to live long and healthy lives will require policy changes, political will, and more investment in women’s health and healthcare workers, including midwives.