A new international study shows that applying structured infection-prevention protocols in maternal care reduced severe infections and deaths by nearly one-third, highlighting a scalable strategy to address persistent gaps in global and national maternal health outcomes. The findings come as maternal mortality trends show uneven progress and widening disparities, raising concerns about stalled global goals and the disproportionate risks faced by marginalized women.
Researchers from the World Health Organization (WHO), the UN Special Programme in Human Reproduction (HRP) and the University of Liverpool reported that the Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) program reduced infection-related maternal mortality and severe morbidity by 32% in a trial conducted across 59 hospitals in Malawi and Uganda. The results, published in the New England Journal of Medicine, demonstrate that adherence to standardized practices, including WHO’s hand-hygiene protocol and the FAST-M bundle for early sepsis management, can substantially improve outcomes in resource-constrained settings. “The APT-Sepsis programme is a testament to what can be achieved when science, policy, and frontline care come together,” said Jeremy Farrar, Assistant Director General, WHO, calling the reduction “a call to action for global health systems.”
The study’s release comes as global indicators show maternal mortality declining more slowly than expected. A UN report issued earlier this year found that maternal deaths fell 40% between 2000 and 2023, but progress has stagnated since 2016. In 2023, an estimated 260,000 women died from complications related to pregnancy or childbirth, or one every two minutes. WHO identifies severe hemorrhage and hypertensive disorders as leading causes of maternal death, contributing to roughly 130,000 deaths combined in 2020. Sepsis remains a major but preventable contributor, particularly in facilities where basic infection-control practices are inconsistently applied.
The WHO and HRP note that the APT-Sepsis results reinforce the role of structured, evidence-based routines in improving maternal safety. The program supports consistent use of hygiene standards, early infection detection and appropriate antibiotic stewardship, areas where implementation gaps are common. Hospitals participating in the trial recorded higher compliance with hand-washing, increased use of antibiotic prophylaxis during caesarean sections, and more routine vital-sign monitoring. WHO, HRP and partner institutions are now working with governments to adapt and scale the model within national systems.
Maternal health risks remain high in low-income settings, conflict zones, and among women facing intersecting inequalities. A recent analysis from Mexico’s National Institute of Public Health (INSP) shows that indigenous women experience lower levels of effective maternal health coverage compared to non-indigenous women, 18.3% versus 25.3% between 2009 and 2023. Coverage peaked prior to the transition from Seguro Popular to the Institute of Health for Well-Being (INSABI) but fell sharply during and after the COVID-19 pandemic, with remote communities experiencing the greatest disruption.
INSP attributes these disparities to structural discrimination, limited health infrastructure, and the compounding effects of gender, ethnicity and poverty. The institute stresses that maternal mortality often reflects inequities in access to quality services, echoing WHO findings that equitable care reduces preventable complications such as hemorrhage, infections and hypertensive disorders.
Mexico’s maternal mortality trends mirror this broader challenge. The Ministry of Health reported 534 maternal deaths in 2024 and 88 in early 2025, with significant shares linked to both direct obstetric causes and underlying infectious and chronic diseases. Women aged 45 to 49 recorded the highest maternal mortality ratio. To improve access and cultural safety, Mexican authorities have introduced NOM-020-SSA-2025, a regulation that formally incorporates both professional and traditional midwives into the health system, and supports the creation of midwifery houses and low-risk birthing units.
These national trends intersect with wider gender-equity concerns. UN Women’s 2025 SDG Gender Snapshot warns that none of the global targets for gender equality are on track for 2030. Poverty, violence, restricted political representation and gaps in economic participation continue to impede progress. The report states that nearly 700 million women lived near active conflict in 2024, while 25% less gender data is available due to funding cuts, weakening policymaking capacity. Still, some indicators show improvement: maternal mortality has dropped significantly since 2000, and digital inclusion could lift millions out of poverty if access gaps are closed.
Experts also emphasize the economic implications of inadequate women’s health. The Mexican Association of Pharmaceutical Research Industries (AMIIF) estimates that closing the women’s health gap could add up to US$1 trillion to the global economy by 2040. PAHO specialists note that chronic conditions increasingly shape women’s health trajectories, often diagnosed later in life and exacerbated by social roles, labor inequities and barriers to care. Persistent gaps in preventive care, nutrition, and early-life health strategies deepen these vulnerabilities.
The APT-Sepsis findings offer a focused example of how standardized, evidence-based care can deliver measurable improvements. WHO and partners plan to support countries in adapting the model and integrating it into broader maternal-health and infection-prevention strategies.