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What We Do

Maternal, Newborn & Child Health

Strategy Overview

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A mother and newborn at a health center in the Patna district of Bihar, India.

our goal:

To ensure that women and newborns survive and remain healthy before, during, and after childbirth, including by identifying and addressing underlying vulnerabilities to poor health.

The Challenge
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At A Glance

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In high-burden communities, millions of women and newborns die during childbirth and the first month of life – the majority, due to preventable causes.

We channel our resources to understand and address underlying risks to keep women and their children healthy.

We work to strengthen health care systems to support the sustainable scale up of high-impact interventions, including a focus on improving the quality of care.

We advocate for evidence-based policies and programs and the better coordination of donor and domestic resources for health.

Our Maternal, Newborn & Child Health Program is led by Amy Pollack and is part of the foundation’s Global Development Division.

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While maternal deaths worldwide dropped by 44 percent between 1990 - 2015, roughly 800 women still die every day from preventable causes related to pregnancy and childbirth. Almost all these deaths occur in low- and middle income settings due to conditions that include severe bleeding, infection, high blood pressure, and complications during delivery.

Against this backdrop, we need to make faster progress—particularly if we are to achieve the 6 to 9 percent annual reduction in mortality rate that is required to meet the Sustainable Development Goal targets by 2030. By comparison, during the Millennium Development Goal era, the average annual decline in mortality rate for children under 5 was between 2 percent and 4 percent in Sub-Saharan Africa.

Maternal health is closely linked to newborn survival, as vulnerabilities to illness can pass from mother to child. While great strides have been made in reducing global under-five child mortality, newborns now account for 46 percent of all childhood deaths. Each year, 2.6 million newborns die within their first month of life, and an additional 2.6 million are stillborn. The main causes are complications due to prematurity, complications during delivery, and infection.

Proven, high-impact interventions are still not reaching all of those in need. Although facility births are increasing across regions and income groups, quality of care also remains a challenge. Primary health care systems are often ill-equipped to prevent or address underlying causes of illness or other complications, and links to functional referral level care are often missing. Resourcing for health is often insufficient or fragmented and accountability for policy implementation is lacking in many settings.

The Opportunity
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The development and implementation of proven, cost-effective interventions has led to significant improvements in maternal and newborn health over the past decades.

A home visit with a mother and newborn in the Patna district of Bihar, India.

There is an opportunity to build on this progress by better targeting and addressing the root causes of poor maternal and newborn health through both known and new packages of interventions.

Given increasing competition for finite donor resources, the pathway to impact also requires influencing and supporting country priorities and domestic health financing, including by working more intentionally through national, regional and global levers to accelerate the adoption, adaptation and scale-up of intervention packages.

Our Strategy
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The Bill & Melinda Gates Foundation’s Maternal, Newborn & Child Health program envisions a world in which healthy mothers deliver healthy babies, receiving quality care from skilled and well-equipped health care workers. We invest in efforts to better understand and develop products to address underlying vulnerabilities and promote resilience among women and children. We also prioritize efforts to develop and deploy innovative systems and practices to improve the productivity, quality, and responsiveness of primary health care systems to maximize the efficacy of interventions.

A mother and newborn at Dalocha Health Center in Ethiopia.

We work closely with governments, bilateral agencies, multilateral organizations, civil society, and the private sector, and collaborate with other programs at the foundation, including Maternal, Newborn & Child Health Discovery & Tools, a group comprised of initiatives from Enteric and Diarrheal Diseases, Discovery & Translational Sciences, Pneumonia. Additionally, we work closely with Integrated Delivery, Family Planning, Nutrition, Program Advocacy & Communications and the foundation’s regional offices in Ethiopia, India, and Nigeria.

The Maternal, Newborn & Child Health program supports work at the country level and uses national, regional and global policy and financing levers to increase coverage at scale.

Areas of Focus
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Downstream: Maximizing Investments and Strengthening Systems

A new mother practices kangaroo mother care at Bwaila Hospital in Lilongwe, Malawi.

Looking downstream, we focus on aligning programmatic and advocacy investments to maximize health outcomes and strengthen primary health care systems. This work includes testing new interventions that target maternal and newborn morbidity and mortality; increasing coverage of key interventions through strengthened primary health care systems; and advancing evidence-based recommendations to accelerate the adoption of innovations by global and country decision-makers.

Our partners help gather, assess, and share critical data on maternal and newborn health to inform policies, and we look for opportunities to maximize health financing to support program implementation. We are also helping develop a standardized set of indicators for health targets and measurements to guide planning, monitoring, and decision-making.

Upstream: Developing Innovative Tools to Address Root Causes of Poor Health

A new mother in Katsina, Nigeria, practices kangaroo mother care with her newborn who was born prematurely. © Save the Children

We are investing in non-vaccine tools targeting the time between conception to 2 years of age to shift the mother-fetus and mother-infant trajectory from the vulnerable to the ideal. We focus our investments on three initiatives:

  1. Optimizing birth outcomes for mothers and newborns.
  2. Supporting thriving in the community.
  3. Optimizing prevention and treatment of acute illness.

We use a variety of tools and technologies outside of vaccines, including diagnostics, devices, therapeutics, treatment algorithms and nutritional supplements to support healthy pregnancies and babies. We invest in research and development for vaccines via our other Global Health teams, including Enteric and Diarrheal Diseases; Pneumonia, Malaria, Vaccine Development & Surveillance; and Discovery & Translational Sciences.

In addition to the three initiatives above, our Strategic Data Analysis & Synthesis initiative aggregates all of the data and knowledge generated across our portfolio of investments to inform our priorities and track progress. This initiative helps us understand burden, analyze crosscutting quantitative questions, and model the impact and cost-effectiveness of new tools.

For more about our upstream work, please visit Maternal, Newborn & Child Health Discovery & Tools.
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