WHO Study Finds Structured Infection Control Cuts Maternal Deaths by 30% in Africa

A major new study published in the New England Journal of Medicine has found that a structured, sustainable approach to infection prevention and control can reduce severe maternal infections and maternal deaths by 30%. The research, conducted by the World Health Organization (WHO), the UN’s Special Programme in Human Reproduction (HRP) and the University of Liverpool, provides some of the strongest evidence to date on how systematic infection-prevention practices can save mothers’ lives, particularly in resource-limited settings.

Maternal infection and sepsis remain among the leading causes of maternal mortality worldwide. Sepsis occurs when the body’s response to infection damages its own tissues and organs, often during or after pregnancy. Despite being preventable, many health facilities struggle with inconsistent application of basic, evidence-based practices such as hand hygiene, early infection detection and timely treatment.

To address these gaps, researchers developed the Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) programme. The initiative supports health workers to follow WHO’s “five moments for hand hygiene,” apply WHO’s clinical guidance for infection prevention and treatment, and use the FAST-M bundle—a structured set of interventions including fluids, antibiotics, source control, transfer when needed, and continuous monitoring for early recognition of sepsis.

The findings are based on a large clinical trial across 59 hospitals in Malawi and Uganda, involving 431,394 women who gave birth during the study period. Hospitals that implemented the APT-Sepsis approach recorded a 32% reduction in infection-related maternal deaths and severe complications. They also saw marked improvements in hand hygiene compliance, antibiotic prophylaxis during caesarean sections, and routine monitoring of vital signs.

According to WHO, the programme’s success lies in its systems-based design, which ensures that antibiotics are used appropriately and only when necessary, while strengthening other vital practices such as antiseptic preparation before surgery, early detection of infection, and structured sepsis treatment.

“These results show what can be achieved when science, policy and frontline care come together,” said Jeremy Farrar, WHO Assistant Director-General. “Reducing maternal infections and deaths by over 30% is not just a clinical success – it’s a call to action for global health systems to prioritize infection prevention in maternal care. We must ensure these life-saving practices are scaled and sustained across all settings.”

Following the study, WHO, HRP and global partners are working with governments to adapt and integrate the APT-Sepsis model into national health systems to improve quality of care.

To mark the study’s publication, WHO, HRP and the University of Liverpool will host a webinar titled “Preventing and Managing Maternal Sepsis – New Results of the APT-Sepsis Trial” on 24 November 2025, aimed at policymakers and health-care workers worldwide.