A chronic lack of clean water and hygiene services in delivery rooms is contributing to one in nine mothers in Sub-Saharan Africa developing sepsis, with around 13,000 women dying from maternal sepsis each year, new research from WaterAid reveals.
That is equivalent to 36 mothers lost every day, making women in Sub-Saharan Africa 144 times more likely to die from sepsis than those in Western Europe and North America, WaterAid’s new “Born without water” report reveals.
The new research exposes the shocking reality inside some of the world’s most under-resourced maternity wards and reveals stark global inequalities in maternal sepsis, a life-threatening condition linked to unhygienic childbirth conditions and the third leading cause of maternal mortality worldwide.
Deep diving into the state of maternity wards across 10 Sub-Saharan African countries, including Nigeria, Rwanda and Zambia, the research finds that 76% of births (around 3 in 4 births) occur in “unsafe” delivery rooms – defined by the lack of basic essentials:
- 65% of births take place in healthcare facilities which lack proper cleaning
- 66% are without handwashing facilities and soap
- 78% without any decent toilets
This means mothers are often giving birth in blood-stained rooms and forced to walk to unclean rivers to wash with open wounds post-birth, while babies are delivered by healthcare workers and midwives who have no choice but to provide care with unclean hands and equipment.
Global aid cuts are stalling – or even reversing – progress in reducing maternal and infant deaths. Yet simple, affordable essentials like clean water, toilets and handwashing could cut maternal infections and deaths by at least 50%, WaterAid reveals.
The report discovers that investing in and delivering universal 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*, much cheaper than the cost of treating sepsis. These basic essentials produce life-saving benefits that ripple beyond health to families, communities and wider society – including poverty reduction, education and gender equality.
This research marks the launch of WaterAid’s global Time to Deliver campaign, bringing together sixteen countries in a collective call for urgent action on maternal health. By putting women’s voices and demands at its centre, the campaign calls on governments and global institutions to meet their commitments and invest in clean water, safe sanitation and hygiene services – fundamental systems that underpin safe pregnancy and childbirth worldwide.
WaterAid is calling on people to show their support for the campaign by signing a global petition to world leaders, ahead of the UN Water Conference in December.
Dr Helen Pankhurst, women’s rights activist and great-granddaughter of Emmeline Pankhurst and granddaughter of Sylvia Pankhurst, leaders in the British suffragette movement, authors the report’s foreword:
Behind the statistics in the report are the women, families and health workers facing huge risks, that can be avoided. Governments and world leaders have… a chance to hear what women are demanding, and recognise the simple, affordable solution that sits in front of them.
WaterAid Zambia’s country director, Yankho Mataya, said:
No woman should fear losing her life in childbirth because clean water is missing. No midwife should watch a joyful moment become a tragedy caused by an infection that clean hands could have prevented.
Every two seconds, a woman gives birth in a healthcare facility without clean water, safe toilets or adequate hygiene. That absence puts both her life and her baby’s life at risk.
This new research makes one thing unmistakably clear: the solution is simple, affordable, and long overdue. Clean water saves lives.
Alongside today’s new research, WaterAid’s ‘Born without water’ report includes a new survey by maternal health NGO White Ribbon Alliance, capturing voices from women and frontline health workers on the state and impact of basic essential in healthcare facilities.
With 1,000 participants across four regions in Uganda and 800 participants across 25 facilities in five districts in Malawi, 80% of women’s water, sanitation and hygiene demands centred on just three essentials: clean water, dignified toilets, and functional handwashing facilities in healthcare centres – the foundations of safe and respectful childbirth.
Women in both countries spoke of:
- Frequent and prolonged water outages, dependence on unprotected boreholes, long queues at single taps, all of which impacted cleaning and increased risks of infection.
- Having no choice but to use the toilets in nearby homes or nearby bushes, as there are often no usable toilets
- Issues around waste management as a symbol of neglect, including overflowing pits, blocked drains, stagnant wastewater, and bloody water in drains outside maternity wings.
WaterAid Zambia’s country director, Yankho Mataya, added:
Globally, 1 in 5 health care facilities lacks basic water, sanitation and hygiene services, compromising infection prevention, safe childbirth, and dignity in care with women bearing the greatest burden.
Women across the world are calling for change. Together, we can ensure leaders listen and act. It’s time to deliver clean water for every woman, at every birth. Change starts with water.
Guy Hutton, development economist and lead researcher, said:
We know there are life-saving interventions for at least 17,000 women and over half a million babies who die every year due to sepsis during childbirth.
These interventions are simple and cheap at less than US$1 per capita, but they are not invested in due to lack of knowledge and low political priority given to water, sanitation and hygiene services and infection prevention.
Indeed, spending on basic essentials like toilets and handwashing facilities in healthcare facilities will be more than paid for by the medical cost savings from not having to treat millions of prevented sepsis cases per year.