Africa

David Etor grew up in poverty in Nigeria, but now teaches engineering at the University of Bristol

Ouattara, senior midwife and head of the maternity unit at the Ayaou-Sokpa Health Centre in Côte d'Ivoire, consults with Awa, a pregnant woman, during a routine antenatal visit. Credit: UNFPA Côte d'Ivoire/Miléquêm Diarassouba

By Diene Keita and Jean Kaseya
NEW YORK / ADDIS ABABA, Sep 7 2026 (IPS)

Tonight, thousands of women across Africa will give birth. Whether they survive to see daylight will largely depend on where they live, how quickly they reach care, and whether the health system around them is ready to respond.

Maternal deaths in Africa have dropped 40 percent since 2000, but progress is now stalling. Africa still accounts for more than 70 percent of all maternal deaths worldwide. A woman facing pregnancy complications on the continent is around 130 times more likely to die than a woman in Europe or North America.

Most of these deaths are preventable. Postpartum hemorrhage remains the leading direct cause of maternal death, while indirect causes such as HIV, malaria, and anemia also account for a substantial share. What connects them is delay: delay in seeking care, delay in reaching a health facility, and delay in providing the best treatment to save a woman’s life. The fact that so many maternal deaths occur within health facilities is telling: the problem is not only the absence of care but also weaknesses in facility readiness, referral systems, teamwork, and emergency response.

Throughout the continuum of maternal care, a well-educated midwife can recognize danger signs before they become emergencies: managing complications, including coordinating timely referrals; and delivering respectful and high-quality care. Midwives already deliver up to 90 percent of essential sexual, reproductive, maternal, and newborn health services, often in communities where health systems are weakest. But midwives cannot do this alone and their impact depends on the strength of the health system: functioning primary health care, community referral and transportation systems, reliable medicines and blood supplies, and access to emergency obstetrical and neonatal care when complications arise. Despite this indispensable role, midwives remain one of Africa’s most overlooked and underfunded health workers.

Based on the latest comparable WHO and UNFPA data, only four of 51 reporting African countries meet the WHO needs-based benchmark of 9.23 midwifery personnel per 10,000 population. Forty-seven remain below the benchmark. But the numerical shortage is only part of the story. Even where midwives are educated, roughly 34 percent of midwifery personnel in reporting countries are unemployed. The challenge, in other words, is not simply to educate more midwives—it is to integrate those already educated and deploy and retain them where needs are greatest.

Ending preventable maternal mortality by 2030 has become one of the continent’s greatest tests of leadership, equity, and health sovereignty.

With the appointment of H.E. Dr. Samia Suluhu Hassan, President of the United Republic of Tanzania, as the AU Champion on Maternal and Child Health, our collective quest to end maternal deaths is elevated with the highest level of political support. In a recent op-ed, President Hassan called on African leaders and partners to rally around a simple yet powerful roadmap: the Three Zeros framework. It includes achieving zero home deliveries where women are cut off from skilled care and emergency referrals; zero preventable maternal and newborn deaths by shifting from access alone to quality, respectful, and emergency-ready care; and zero unvaccinated children by placing zero-dose children at the center of primary health care and last-mile delivery. Investing in midwives is fundamental to achieving these Three Zeros.

The case for investment is not just moral — it is economic. The UNFPA midwifery investment case reveals that investing in midwives can generate as much as a ten-fold return through combined social and economic gains. In Sierra Leone, modeling shows that universal care provided by midwives could save 2,278 maternal lives, save 19,029 newborn lives, prevent 39,970 stillbirths, and avert almost 860,000 unintended pregnancies by 2035. Beyond these clinical and economic gains, midwifery is also a powerful engine for women’s economic empowerment. Since the vast majority of midwives are female, expanding this workforce translates directly into thousands of stable, skilled, and dignified formal-sector jobs for women—particularly in rural and underserved communities where employment opportunities are often scarce. Converting informal, unpaid caregiving into salaried careers saves lives and builds financial independence for women, while strengthening Africa’s broader economic development.

Investing in midwives alongside multi-skilled community health workers creates a stronger continuum of care—from the household and community to the primary health facility and referral hospital. Community health workers can support early identification of pregnancy risks, promote antenatal care attendance, encourage skilled birth attendance, strengthen immunization uptake, and facilitate timely referrals, while midwives provide the skilled clinical care required to prevent maternal and newborn deaths. Together, this workforce forms the backbone of a people-centered primary health care system capable of delivering the AU’s vision of health sovereignty.

Africa has already shown political leadership in achieving a strong health workforce. In 2016, Africa committed to train and deploy two million community health workers as part of addressing the chronic health workforce gap—a target already half met. Under the leadership of H.E. Bola Ahmed Tinubu, President of the Federal Republic of Nigeria and AU Champion for Human Resources for Health and Community Health Delivery Partnership (CHDP), the continent is committed to accelerating progress towards the target of two million multi-skilled community health workers by 2030.

Midwifery deserves the same political ambition, together with a clear continental target to close the midwifery gap.

Any midwifery target must sit within a broader health workforce agenda. Accelerating the reduction of maternal deaths depends on a wider multidisciplinary workforce, including nurses, doctors, anesthesia providers, laboratory personnel, pharmacists, blood service staff, and emergency transport teams. This model promotes integrated community health systems where trained, supported, and professional community health workers deliver a comprehensive package of essential services, including health promotion for maternal and child health, disease prevention, immunization, early identification of pregnancy risks, referrals, and links to health facilities.

Just as Africa united around scaling up community health workers, leaders should now rally around a target to educate, deploy and retain the midwives needed to end preventable maternal and newborn deaths on the continent and enhance the health outcomes.

The following priorities, supported by the evidence-driven global initiative The Midwifery Accelerator, offer a practical roadmap:

First, increase and institutionalize financing for the health workforce, including midwives, as a strategic investment for health security and sovereignty.

This means accelerating the Lusaka Agenda and Accra Reset and prioritizing domestic funding for workforce compacts to strengthen primary health care systems in high-burden countries for maternal and child deaths. Establishing dedicated workforce budget lines, and improving the efficiency of workforce financial management through digitalization will require strengthened public finance management capacity and capabilities and cross-ministerial coordination. Aligning partner contributions strategically with national health workforce development plans will improve efficiency and address issues linked to the transition from donor support.

Second, expand equitable access to skilled maternal and newborn care by deploying midwives strategically to underserved high-burden and rural areas.

We must educate, deploy, and retain enough midwives to improve the quality, continuity, and responsiveness of maternal and newborn care. This will require ensuring quality midwifery education aligned to international and national standards, financing new posts and absorbing unemployed midwives, educating more only where the needs are unmet. Retention is equally critical as poor conditions; limited career growth, low pay and migration continue to drain skilled midwives from many African countries. Building a resilient workforce requires investing in decent work, professional recognition, and supportive, accountable workplaces.

Third, we must advocate and empower midwives, building midwifery leadership, strengthening coalitions, and amplifying the voices of women and communities.

Midwives should play a central role in designing models of care, not just delivering them. Professional associations must be seated at policy and financing tables, the Chief Midwifery Officer Network should be formalized, and communities need a stronger say in holding health systems accountable.

Fourth, maternal survival must be addressed as a whole-of-government responsibility.

Backed by political and financial commitments, this requires engagement beyond health ministries, including the finance, education, gender, and planning portfolios, alongside local government and civil society partners.

Through the AU Champion Roadmap on Maternal and Child Health, the AU Commission is collaborating with Member States, Africa CDC, UNFPA, and other partners to strengthen accountability, data systems and peer-to-peer learning. Accountability must drive this agenda: every maternal death should be counted, reviewed, and used to strengthen health systems. What gets measured gets prioritized, and what gets prioritized gets funded.

The AU Champion Roadmap calls for sustained, African-led domestic financing for maternal, newborn and child health. Investing in midwives is an investment in maternal and newborn survival, women’s economic empowerment, resilient primary health care systems, and Africa’s future prosperity. Preventing maternal deaths protects families, creates decent jobs, strengthens trust in public institutions, and safeguards the continent’s greatest asset—its people.

Africa has shown that shared ambition can drive transformative change. That same ambition must be matched with sustained resolve and support to ensure that no woman or newborn’s life is cut short for reasons we can prevent. A strong and resilient midwifery health workforce is within our collective reach – let us use it to secure Africa’s health sovereignty, sustainable development, and future prosperity.

Dr. Diene Keita, Executive Director, United Nations Population Fund (UNFPA), and
Dr. Jean Kaseya, Director General, Africa Centres for Disease Control and Prevention (Africa CDC)

IPS UN Bureau

 

 

 

 

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First Lady of Sierra Leone, Dr. Fatima Maade Bio (center), and Bhuwan Ribhu of Just Rights for Children (left), outside the UN General Assembly. Credit: Naureen Hossain/IPS

By Naureen Hossain
UNITED NATIONS, Sep 4 2026 (IPS)

As the 80th session of the UN General Assembly draws to a close, one of the final items in its agenda was to establish an annual observance for the elimination of child marriage, raising the global profile of a pervasive social issue.

On Friday, the General Assembly unanimously adopted resolution A/80/L.99, which establishes 27 November as the International Day for the Elimination of Child, Early, and Forced Marriage, an effort initiated by Bhuwan Ribhu, founder of Just Rights for Children, and championed by Sierra Leone’s First Lady, Dr. Fatima Maada Bio.

The resolution was brought forward by Sierra Leone and co-sponsored by at least 66 other countries, including Cabo Verde, Morocco, Costa Rica, Namibia, India, Rwanda, Sudan, and Afghanistan.

The resolution calls for governments, UN organizations, civil society groups, and other parties to observe the day through public awareness campaigns, advocacy, and education efforts. It also encourages Member States to implement holistic and multi-sectoral national strategies to abolish early marriage. The observance of this day will further accelerate progress towards the Sustainable Development Goals and create a dedicated global platform to strengthen efforts for the health, education, and protection of all children, especially girls.

Bio addressed the General Assembly, calling the resolution a “call to action” and a reminder to the international community of its “collective responsibility to protect childhood and defend the dignity and rights of every girl.”

“Behind every statistic, a child, early and forced marriage is not merely a number. There is a child, there is a name, there is a dream, and there is a future. A girl who should be learning may instead be preparing for marriage. A girl who should be discovering her potential may instead be carrying responsibilities far beyond her years,” said Bio.

Ribhu, a child activist, first called for the establishment of an international day in March this year, during the Commission for the Status of Women (CSW).

The reason he recommended 27 November, Ribhu explained to the Inter Press Service, was that it is the same date as when 250 million Indians pledged to end child marriage in 2024. According to him, this was the largest mobilization on an issue in human history.

“Today marks the tipping point showing that the end of the crime of child marriage is inevitable and imminent. Now is the time for governments to provide decisive leadership to end child marriage by 2030 and ensure education, protection, and development of every child to realize their full potential,” said Ribhu, who was present at the General Assembly, the only civil society representative invited to attend.

Now that the global community has adopted this resolution, this should signal a collective movement by countries to “promote whatever decisions we have made as a global village,” Bio told Inter Press Service (IPS).

“An international day itself cannot by itself end child marriage, but political attention can, strong laws can, effective institutions can, education can… and above all, sustained political will can.”

“I think every country has to be honest and more action-oriented. When you pass a law, that is one thing, but implementing it should be the agenda… There are a lot of problems around the world, but I believe the problem of early marriage is also at the top of the global agenda.”

She elaborated on the efforts in her own country.

“In Sierra Leone, we have gone beyond just talk. We have passed the law. It’s now an act, and because it’s now an act, it’s been implemented 100 percent. We push every boundary and every barrier that will stop the act from not being what we want. So if every country decides to implement [the law] like Sierra Leone, then what we had here today would be the greatest success in the world.”

For those individuals and groups that have advocated for the abolition of early marriage, the adoption of this resolution is a milestone in the growing recognition that early marriage is a form of child sexual abuse.

This universal condemnation of child marriage is further enshrined in many national laws and global agreements like the Conventions for the Rights of the Child, which outlaw it. Yet this does not reflect the reality.

According to the UN Population Fund (UNFPA), since 2024, one in five women were married or put in an informal union before turning 18, and an estimated 640 million women alive today were married in childhood. Early marriage affects women and girls disproportionately, for they are more likely to be married off younger than men and boys. According to the World Bank, between 2015 and 2024, 19 percent of the global population of women had been married before age 18, compared to 3 percent of men who were married before age 18.

Efforts from countries like Sierra Leone further amplified the momentum in the anti-child marriage movement. Bio has been advocating for the abolition of child marriage for years, and it was through these efforts that in 2024, Sierra Leone passed a law to make child marriage illegal.

“Today, the world has spoken with one voice: child, early and forced marriage has no place in our societies,” Bio said. “This resolution is far more than symbolic—it is a global mandate for action. As mothers, leaders, and advocates, we have a duty to ensure that every girl is free to dream, to learn, and to thrive, unburdened by the chains of forced union. Sierra Leone is profoundly proud to stand at the forefront of this movement, and we look forward to the tangible progress this day will inspire.”

At the end of the session, both Bio and Ribhu spoke to reporters outside the General Assembly Hall. They acknowledged the work done before to advance this agenda and congratulated both civil society and governments for their collective efforts and solidarity. Ribhu remarked that governments need to take “decisive action” through measures like implementing budgeted action plans and responsive, accountable institutions that will enforce anti-child marriage laws and dismantle the current ecosystem that perpetuates child marriage.

“This is the beginning where the world has spoken,” said Ribhu. “Now is the time for action. So we should act. From 27th November, the action begins.”

Ribhu touted India’s example, where the joint efforts of civil society and governments resulted in a decline in child marriages by over 10 percent in the last few years, and at least 550,000 marriages were prevented through legal action.

“Child marriage has no place in the civilized world, and the end of child marriage is not only possible, but it is going to be imminent.”

IPS UN Bureau Report

 

 

 

 

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Healthy rangelands are built through long-term commitment, local leadership and sustained investment. Credit: Shutterstock

By Samson Kuraru
NAIROBI, Kenya, Sep 4 2026 (IPS)

Across the Kenya-Tanzania rangelands, communities have long understood a reality that the global community is increasingly recognising: healthy rangelands support livelihoods, wildlife, water resources and local economies. They are among Africa’s most important natural assets and a foundation for resilience in a changing climate.

That lesson is especially relevant today. As East Africa prepares for the potential impacts of a strengthening El Niño, the focus should not be on rainfall totals alone. Forecasts point to an increased likelihood of wetter-than-normal conditions across much of the region, although the timing and distribution of rainfall may vary significantly.

Increased rainfall can improve pasture and water availability, but it can also increase flood risks and disrupt livelihoods, infrastructure and ecosystems. These conditions underscore the importance of healthy rangelands, reliable water sources and strong community-led approaches that help people prepare for and adapt to climate shocks.

One of the strongest messages to emerge from COP17 was the recognition of Indigenous Peoples, local communities and pastoralists as essential partners in restoring land and building resilience. Across Africa, communities are not simply beneficiaries of conservation and restoration efforts; they are often the people leading them

It was against this backdrop that governments, communities and development partners gathered in Ulaanbaatar, Mongolia, for UNCCD COP17.

The conference highlighted a growing global understanding that drought, land degradation, biodiversity loss, climate change, water security and livelihoods are closely linked challenges that must be addressed together. It also signalled a stronger focus on turning commitments into action through new partnerships, investments and initiatives aimed at strengthening resilience on the ground.

For Africa, this attention could not be more timely.

Rangelands cover nearly half of the continent’s land surface and support hundreds of millions of people. They underpin pastoral and livestock-based economies, sustain biodiversity and tourism, contribute to water security, and help communities adapt to a changing climate. Yet many of these landscapes face increasing pressure from recurring droughts, land degradation and growing climate risks.

The Kenya-Tanzania rangelands illustrate both the scale of the challenge and the opportunity. Stretching across some of East Africa’s most important wildlife and livestock landscapes, they support people, livestock and wildlife across interconnected ecosystems. Their future depends on how effectively land and water resources are managed today.

One of the strongest messages to emerge from COP17 was the recognition of Indigenous Peoples, local communities and pastoralists as essential partners in restoring land and building resilience. Across Africa, communities are not simply beneficiaries of conservation and restoration efforts; they are often the people leading them.

Across Kenya’s rangelands, community conservancies demonstrate what can be achieved when local knowledge is matched with investment and long-term partnerships.

A community conservancy is a locally governed institution through which landowners voluntarily work together to manage land, wildlife and other natural resources for shared social, economic and environmental benefits. These conservancies help protect wildlife while supporting livelihoods and improving the management of land and water resources.

A good example can be found in northern Kenya, where community conservancies operate across connected landscapes that support both pastoral livelihoods and wildlife. In these drylands, healthy grass is not simply an environmental asset; it underpins household income, livestock production and food security.

Community-led grazing systems help manage when and where livestock graze, protecting critical grazing areas during dry periods and allowing grasslands time to recover. Together with improved water management and restoration efforts, these approaches strengthen drought preparedness while supporting wildlife, livestock and local economies. They show that conservation and development do not have to compete. When communities are supported to lead, both people and nature can thrive.

These experiences point to an important lesson: while restoring degraded land remains essential, preventing degradation in the first place is often more effective and less costly. Healthy rangelands are built through long-term commitment, local leadership and sustained investment.

COP17 also elevated the importance of sustainable rangeland management through the Steppe Action Agenda and the Rangelands Flagship Initiative.

Together, these efforts seek to advance the conservation, sustainable management and restoration of rangelands while increasing investment and coordinated action to strengthen the resilience of pastoral and rangeland-dependent communities. They reflect growing recognition that healthy rangelands are essential for resilient communities, thriving biodiversity, water security and adaptation to climate risks.

Importantly, the conference also underscored that restoring land is not a financial burden. It is a strategic investment in resilience, livelihoods and prosperity.

This was reflected in the launch of the Drought Resilience Investment Facility (DRIF), which aims to help countries move from responding to drought crises to preparing for them. COP17 also announced approximately US$1.3 billion in new and pipeline financing for land restoration and drought resilience across 23 countries. Together, these commitments signal a growing shift towards proactive resilience-building rather than repeated emergency responses.

The challenge now is ensuring that investment reaches the communities doing the work on the ground. Success will depend not only on the amount of funding available, but also on strengthening the institutions, conservancies and partnerships that help manage land and water resources over the long term.

As governments, development partners, philanthropies and the private sector look to scale solutions across Africa, rangelands deserve far greater attention. They are among the continent’s most valuable assets for food security, biodiversity conservation, economic development and climate resilience.

COP17 highlighted what communities across Africa’s rangelands have known for generations: healthy land supports healthy communities. The task now is to turn that recognition into action through sustained investment, stronger partnerships and greater support for the people already managing these landscapes for the benefit of current and future generations.

Samson Kuraru is Northern Kenya Conservation Coordinator, The Nature Conservancy

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