Women who develop maternal sepsis in sub-Saharan Africa are almost 150 times more likely to die than mothers in Britain, Europe and North America, according to new research – with a lack of clean water and sanitation contributing to 36 deaths a day.
The analysis by WaterAid finds that the infection – one of the most dangerous complications of pregnancy and childbirth – is vastly more lethal in parts of Africa where maternity wards frequently lack clean water, toilets or basic hygiene facilities. These dangers made worse by devastating overseas aid cuts by the US and UK impacting swathes of the continent.
Across sub-Saharan Africa, an estimated 4.7 million women develop maternal sepsis each year, equivalent to around one in every nine births. The condition occurs when the body develops a life-threatening reaction to infection, often caused by bacteria entering the bloodstream during or after childbirth.
Globally, about one in 1,100 cases of maternal sepsis results in death. In Africa, however, the fatality rate is dramatically higher with one death for every 350 cases. By comparison, mothers in Western Europe and North America face a vastly lower risk.
Health experts say the disparity reflects the stark reality of maternity wards where even the most basic elements of safe childbirth are missing. WaterAid’s research suggests that three out of four births in healthcare facilities in sub-Saharan Africa take place in environments without adequate water, sanitation or hygiene – conditions that dramatically increase the risk of infection for both mothers and newborns.
The charity’s new report, “Born Without Water: the crisis in our delivery rooms”, examined maternity services across 16 countries in Africa and Asia, including Nigeria, Malawi, Tanzania and Bangladesh. The findings show that many clinics lack even the most fundamental infrastructure required for safe deliveries.
Across maternity wards studied in Africa, 78 per cent lacked a functioning toilet, two-thirds did not have clean water and soap for staff to wash their hands and 65 per cent did not meet basic standards for environmental cleaning.
The findings come as the charity launches a new global campaign, Time to Deliver, in Westminster today, calling for greater international investment in water, sanitation and hygiene in healthcare facilities.
Supporters of the campaign include the actors Sir Mark Rylance, Myleene Klass, Sir Stephen Fry and Beverley Knight who are backing WaterAid’s global petition which urges world leaders to prioritise clean water in maternity care ahead of the United Nations Water Conference later this year.
Amaka Godfrey, WaterAid’s executive director of international programmes, said no woman should face the risk of dying in childbirth simply because clinics lack basic sanitation.
She continued: “In the UK, maternal sepsis remains one of the most feared complications of pregnancy and childbirth. Yet millions of women elsewhere are forced to give birth in facilities without clean water, toilets or soap.”
She said improving hygiene in maternity wards could dramatically reduce infections and deaths. The WaterAid report suggests investing in and delivering water, sanitation and hygiene across healthcare facilities could prevent 10 million cases of maternal sepsis and 8,580 deaths worldwide every year – at a cost of less than $1 per person (£75p).
Beverley Knight added: “No woman should face danger or indignity during childbirth… Clean water in every health centre is not a luxury — it is a right.”
Sir Mark Rylance said: “A few years ago, I played Dr Semmelweis, a 19th century Hungarian doctor whose groundbreaking medical practice of washing hands with a chlorinated solution dramatically reduced the number of women dying in maternity wards.
“In Dr Semmelweis’ day, we did not understand the science, today there is no such excuse. It is unacceptable that women are still exposed to these conditions.”
Sir Stephen Fry added: “Aside from its urgency and importance, this campaign is so worth getting behind because its aims are achievable, they truly are, and when achieved will have the most dazzlingly marvellous impact all around the world.”
Campaigners also warned that progress is being undermined by shrinking aid budgets. UK government spending on water, sanitation and hygiene programmes overseas has fallen from £206.5 million in 2018 to £80 million in 2024, with further reductions expected.
WaterAid said restoring investment and improving basic infrastructure in maternity wards could save thousands of lives each year – at a cost of just roughly 75p per person – in the world’s poorest countries.
Ms Godfrey said: “Every woman has the right to give birth safely and with dignity. Clean water in delivery rooms is not a luxury – it is the foundation of safe maternal care.”
Sign the WaterAid Time to Deliver petition here
This article has been produced as part of The Independent’s Rethinking Global Aid project
About the Author
