Pregnant women and newborns are dying at alarming rates in crisis-affected countries. Every day, an estimated​ 3,000 newborns die​ before reaching one month of age; and an estimated​ 500 women and girls​ die from complications during pregnancy and childbirth. Although only a quarter of global births happen in crisis-affected countries, this accounts for​ almost half of all newborn deaths​ and more than​ 60% of all maternal deaths worldwide. Life-saving solutions that could prevent more than half of these deaths exist, yet fail to reach the most vulnerable women and babies, who are unable to travel the long, sometimes dangerous paths to access care at health facilities.

The COVID-19 pandemic will exacerbate the dangers women and babies face, as facilities become overstretched and as women decide not to seek formal health services due to increased exposure and risk. Recent estimates suggest that a 10% decline in pregnancy-related and newborn care during COVID-19 will likely result in nearly 200,000 additional deaths.

Our simple but radical solution is to deinstitutionalize these services and bring care directly to women in their communities. In partnership with the affected women themselves and frontline health workers, we are placing three big bets, with a clear vision of developing, testing, and delivering effective, women-centered approaches for saving lives and preventing unplanned pregnancies:

• Delivering care at the community level. We will work with Community Health Workers and other community agents, such as pharmacists, traditional healers, and teachers, to both deliver basic services like skilled birth attendants for home delivery where health facility deliveries are not practical and increase access to health knowledge such as promoting key behaviors like breastfeeding and thermal care for newborns.
• Developing easy-to-use mechanisms for self-care. ​We will develop simplified resources for low-literate women and community-based health providers to empower them to receive/deliver high-quality sexual, reproductive, maternal and newborn services tailored to women’s and girls’ needs that they can use themselves (e.g. self-care around contraception), in areas where there is no reasonable access to health facilities.
• Enhancing the supply chain. We will identify and test solutions that strengthen supply chains for consistent availability of key medications and supplies at the community level, including, for example, chlorhexidine, an antibiotic for newborn’s umbilical cords that can help reduce the chance of neonatal infection and morality, and misoprostol, a shelf-stable pill that can prevent postpartum hemorrhage.

We will focus on Sub-Saharan African countries that face high burdens of maternal and newborn death and unplanned pregnancies, like Nigeria, South Sudan, Somalia, Chad, Sierra Leone and Uganda. Through this work, we will help support women to receive life-saving care around contraception, pregnancy, labor and delivery, and immediate postpartum care.

The IRC has a long track record of deploying evidence-based solutions to delivering life-saving care to women and girls around the world in the hardest-to-reach places. Since 2011, the IRC has delivered contraception to nearly 300,000 women and girls in crisis-affected contexts, and post-abortion care to over 20,000 vulnerable women and girls. We also provide maternal and newborn health services in 19 countries. In 2019, IRC health facilities supported nearly 150,000 births taking place at facilities attended by a skilled health professional​.

We need to accelerate research and innovation on the frontlines of this crisis, generating the insight that proves these new approaches to delivering these services are effective and scalable. We have the potential to transform the lives of millions of women and girls of reproductive age and their newborns around the world.

This is one of three global research and innovation priorities at the IRC. Learn more.