The Silent Emergency: Maternal and Newborn Deaths in Conflict and Humanitarian Settings

The report argues that women and newborns in humanitarian crises bear a vastly disproportionate share of global deaths because maternal and newborn health services remain underfunded, fragmented and poorly integrated into emergency responses. It calls for sustained financing, stronger national leadership, protection of health workers and the full implementation of global commitments to ensure life-saving care reaches mothers and babies even in conflict and displacement settings.

The report in the Bulletin of the World Health Organization paints a clear and troubling picture: global gains in maternal and newborn health are not reaching women and babies living through humanitarian crises. Written by experts from the World Health Organization, UNICEF, UNFPA, Jhpiego (affiliated with Johns Hopkins University), the International Rescue Committee, the London School of Hygiene & Tropical Medicine, and several WHO regional offices and national ministries of health, the piece draws on field experience and global data. While maternal and neonatal deaths have declined worldwide, this progress has stalled in countries affected by conflict, fragility and displacement. In early 2025, just 29 countries under United Nations humanitarian response plans accounted for less than one third of global births but an estimated 58% of maternal deaths, 41% of stillbirths and 39% of newborn deaths. The authors note that these numbers likely understate the true toll, as data are often missing in the most severe crises.

Why humanitarian settings are falling behind

The article links these outcomes to a worsening global humanitarian environment. A revised Global Humanitarian Overview in mid-2025 reported a decline in foreign aid, an increase in attacks on health and humanitarian workers, and growing political instability. At the same time, needs are increasing. Yet the authors argue that poor outcomes are not inevitable. Evidence from a 2022 United Nations country-level survey shows that even in crisis settings, maternal and newborn health can improve when services are clearly prioritized, properly financed and integrated into national health systems and emergency preparedness plans. The problem, they argue, is not a lack of solutions, but weak coordination, short-term funding and insufficient accountability that allow maternal and newborn care to slip down the priority list during emergencies.

The importance of care from start to finish

A central message of the report is the need for a full continuum of care. In many humanitarian contexts, services are fragmented and underfunded. Antenatal care may receive attention, but postnatal care is often neglected, and stillbirth prevention is rarely included in national plans or monitoring systems. The authors emphasize that effective maternal and newborn healthcare must extend from before pregnancy through childbirth and the postnatal period. Reliable data are essential to make deaths visible and to drive political action. Coordination between humanitarian and development actors is also critical, especially when technical support aligns with national priorities rather than operating separately. Initiatives like Every Woman Every Newborn Everywhere, which supports subnational planning in more than 55 countries, show what is possible, but only if backed by predictable, multi-year financing that can sustain services over time.

From emergency response to system recovery

The report also explains why emergency response and long-term recovery must be linked. During acute crises, the Minimum Initial Service Package for sexual and reproductive health sets basic standards, ensuring access to skilled birth attendance, emergency obstetric and newborn care, prevention of unintended pregnancies, and care for small and sick newborns. Access to essential supplies, including interagency reproductive health kits, is vital. As crises stabilize, services should expand into integrated primary care, including quality antenatal and postnatal care and family planning. This not only reduces health risks but also helps rebuild trust between communities and health systems. However, the authors point to ongoing gaps, such as limited access to safe abortion care where it is legal, weak referral systems, supply-chain disruptions and insufficient funding. While national commitment to these standards has grown, implementation at local levels often lags.

Protecting health workers and turning promises into action

Health workers are another focus of concern. In crisis settings, they face insecurity, heavy workloads and personal danger, making their protection both a humanitarian duty and essential for recovery. International humanitarian law requires the protection of health workers and facilities, yet violations remain common. The authors call for safe working conditions, fair pay, psychosocial support and sustained investment in training and supervision. Practical approaches such as surge staffing, rotational deployments and task-shifting can help maintain services in insecure environments. The report concludes by highlighting World Health Assembly Resolution WHA77.5, adopted in 2024 by all 194 WHO Member States, which calls for faster progress in reducing maternal, newborn and child mortality. Turning this commitment into reality, the authors argue, requires governments to develop funded national and local plans, and donors to better align humanitarian and development financing. Protecting mothers and newborns in crises, they conclude, is not optional but essential for global health equity.