Investing in primary health care supports mothers and babies in Africa. Here's how.

Over the past 20 years, the world has seen remarkable progress in maternal, newborn, and child health (MNCH). Globally, maternal deaths have dropped by nearly 40 percent, and child mortality has been cut by more than half since 2000. These gains are the result of effective, relatively low-cost interventions that have saved millions of lives.

Yet the story is far from finished.

Preventable deaths continue to claim lives every day. A woman dies every two minutes from pregnancy or childbirth complications, while sub‑Saharan Africa remains the hardest hit, accounting for 70 percent of global maternal deaths and nearly half of global newborn deaths.

Despite progress, reductions are too slow to meet the Sustainable Development Goals by 2030, and inequities remain stark. Poorer households face higher risks, with gaps in antenatal care and limited access to emergency obstetric services even as institutional births rise.

This fragile progress is now threatened by a changing financing environment. Development assistance is declining sharply, with official development assistance dropping by 21 percent between 2024 and 2025.

PATH’s recently released official development assistance study across ten African countries revealed a troubling picture: Governments spend only 4.9 percent of their budgets—or 1 percent of their gross domestic product—on health. Domestic financing covers just 21 percent of maternal, newborn, and child health needs, while households shoulder 33 percent of out-of-pocket costs.

Donor funding is projected to fall even further. Countries such as Kenya, South Sudan, and Uganda are among the most exposed. These reductions threaten vaccine supply chains, health workforce capacity, and data systems, raising the risk of backsliding after two decades of hard-won gains. Rising debt burdens add another layer of constraint, limiting fiscal flexibility and leaving health systems vulnerable.

Despite these challenges, African countries are showing resilience. Governments are expanding domestic budgets, integrating donor programs into national systems, and exploring innovative financing models. Primary health care (PHC) is emerging as the cornerstone of survival, providing antenatal care, skilled birth attendance, newborn care, immunization, nutrition, and community health services.

Strong PHC systems save lives across the continuum of care, but financing them effectively requires strategic prioritization amid tightening fiscal space.

To advance the conversation on investing in PHC for mothers and children, PATH’s Center for Advocacy and Policy hosted “Financing the continuum: Investing in primary health care systems to improve maternal health and child survival in sub‑Saharan Africa” at the International Maternal Newborn Health Conference (IMNHC) 2026.

The session underscored the urgency of scaling proven lifesaving interventions, strengthening domestic resource mobilization, and moving from high‑level commitments to country‑led implementation backed by accountability.

The discussion brought together leaders and practitioners from across the region and global health institutions, including Dr. Nanthalile Mugala (PATH), Dr. Landry Dongmo Tsague (Africa CDC), Supriya Madhavan (Global Financing Facility), Margaret Odera (Community Health Promoter, Kenya), Sis. Jane Francis Acam (Ministry of Health, Uganda), Dr. Mike Mulongo (Tunu Consulting, Kenya), Dr. Milka Choge (Global Financing Facility), Dr. Gregory Ganda (Kisumu County), Soleine Scotney (Financing Alliance for Health), and PATH Center for Advocacy and Policy colleagues Rachel Ndirangu, Esther Nasikye, and Melissa Wanda.

Drawing on their diverse expertise—from policy and financing to frontline service delivery, these experts thoroughly explored how strategic investment in PHC can safeguard maternal and child health gains and build resilient systems for the future.

This discussion made clear that:

• PHC financing delivers the highest MNCH impact by integrating prevention, early intervention, and continuity of care, reducing fragmentation and costs while ensuring sustainable, equitable gains.
• Financing the full continuum of care strengthens systems by supporting frontline workers, essential commodities, and referral networks, moving countries away from siloed funding toward resilient, shock‑responsive health systems.
• PHC‑centered MNCH financing is the smartest path to equity and universal health care, closing gaps through community‑level delivery, gender‑responsive financing, and accountable governance, while generating long‑term social and economic dividends.

The global MNCH community stands at an inflection point. Progress is undeniable, but it is fragile. Declining aid and tightening fiscal space threaten to reverse hard-won gains. Yet opportunities for innovation, domestic leadership, and resilient PHC systems are expanding.

Bold, strategic investment in PHC is the best defense against rising maternal and newborn deaths—and the surest way to ensure that every woman, every newborn, and every child survives and thrives.

PATH remains committed to working alongside governments, civil society, and global partners to protect essential services, strengthen PHC systems, and ensure resources reach the front lines. Together, through collective action and resilient financing, we can hold the line against preventable deaths and secure a healthier future for Africa’s mothers and children.