Global Study Shows 30% Drop in Maternal Deaths Through Improved Infection Control

The trial assessed APT-Sepsis implementation in 59 hospitals across Malawi and Uganda, involving a staggering 431,394 women giving birth.

A major new study published in the New England Journal of Medicine has revealed that a structured, evidence-based approach to infection prevention and control can cut severe maternal infections and related deaths by nearly one-third. The research, conducted by the World Health Organization (WHO), the UN’s Special Programme in Human Reproduction (HRP), and the University of Liverpool, demonstrates that systematically applying proven clinical practices can dramatically improve maternal survival—especially in low-resource settings.

Maternal Sepsis: A Persistent Global Threat

Maternal infection and sepsis remain among the leading causes of maternal mortality worldwide. Sepsis is a life-threatening condition triggered when the body’s response to infection harms its own organs and tissues, often occurring during childbirth or the postnatal period. Despite clear guidelines, many health facilities continue to struggle with inconsistent application of infection prevention protocols, including basic hand hygiene, timely diagnosis, and appropriate use of antibiotics.

The consequences are severe: each year, hundreds of thousands of women face preventable, life-threatening complications during pregnancy and childbirth due to infections.

The APT-Sepsis Programme: Closing Critical Gaps

The Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) programme was designed to address precisely these gaps. Developed using WHO’s evidence-based guidance, the programme trains and supports health workers to:

• Follow WHO’s “five moments for hand hygiene”

• Apply infection prevention and treatment protocols consistently

• Use the FAST-M bundle—Fluids, Antibiotics, Source control, Transfer (if needed), and Monitoring—to recognise and respond to sepsis early

This systems-based approach ensures that maternal care teams intervene rapidly and appropriately at the first signs of infection.

A Landmark Trial Across Malawi and Uganda

The trial assessed APT-Sepsis implementation in 59 hospitals across Malawi and Uganda, involving a staggering 431,394 women giving birth. The results have been described as groundbreaking:

• 32% reduction in severe infection-related maternal deaths and complications

• Significant improvements in hand hygiene compliance

• Increased use of antibiotic prophylaxis during caesarean sections

• More consistent monitoring of vital signs during labour and postnatal care

These improvements demonstrate that even in resource-constrained environments, structured systems and consistent clinical practices can save large numbers of lives.

A Model for Transforming Maternal Care

The findings confirm that applying WHO guidelines through a sustainable, organised framework can transform maternal care on a global scale. Importantly, the study shows that life-saving results do not depend on expensive equipment or complex technology but on strengthening clinical systems, training health workers, and ensuring reliable adherence to protocol.

“The APT-Sepsis programme is a testament to 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.”

Scaling the Approach Worldwide

WHO, HRP, and partners are now working closely with countries to integrate the APT-Sepsis model into national maternal health strategies. The aim is to ensure that lessons learned in Malawi and Uganda are applied globally, from rural clinics to urban hospitals, forming the foundation of stronger, more resilient maternal care systems.

Countries adopting this approach will be better positioned to reduce maternal mortality, ensure early detection of complications, and provide safer childbirth experiences for mothers everywhere.

Webinar to Share Findings and Next Steps

To support global knowledge-sharing, 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. The session will highlight the study’s implications for health-care workers, policymakers, and national health systems.

As nations continue striving toward the Sustainable Development Goal of reducing maternal mortality, the APT-Sepsis programme offers a clear pathway forward: with strong systems, consistent practice, and global collaboration, thousands of maternal deaths can be prevented each year.