While maternal deaths have fallen by 45% in the last 20 years, over the past two decades, 800 women - and 190 adolescents - still die every day - from complications during and following pregnancy and childbirth.

These complications arise when women and adolescent girls cannot choose when, if, and how many children to have, or cannot choose to have safe pregnancy, childbirth, and postpartum experiences.

Haemorrhage, hypertensive disorders, infection, and obstructed labour account for nearly three quarters of all maternal deaths. Most of these complications develop during pregnancy and sadly, could be prevented or treated if women were able to get the healthcare they need.

Around 95% of maternal deaths occur in low and lower middle-income countries, reflecting the harsh inequalities in access to quality healthcare around the world.

In low and lower-middle income countries, women living in rural and remote communities face barriers to accessing necessary care.

“When I had my first child, I didn’t have anyone to support me during my labour. I stayed at home; I had no way to get to the health facility. There wasn’t any transport to get me there - it would have been over 2 hours walk,” says Birkinesh, a young mother from Ethiopia who was just one of millions of women facing challenges accessing quality care during labour.

Long distances to health facilities are not the only barrier women face. Poverty, lack of information, cultural beliefs and inadequate services all create a complex landscape that limits their freedom to make informed choices, putting their lives at risk.

Our work supports women to find solutions to overcome these barriers. When communities do this, they can go on to survive and thrive.

Birkinesh says, “Our community together had built a road. The government provided us with an ambulance, so I had a way to get to the health centre to give birth to my second child. I was given lots of support during my labour. My baby was vaccinated, and health professionals gave me care after the birth.”

Read Birkinesh’s story here>.

Our community health group approach, brings people together, encouraging communities to take collective, local action to address their biggest health problems, such as maternal and newborn mortality. This approach has been endorsed by the World Health Organization.

Communities form health groups, made up of people who share concerns around their most important health challenges. Trained, local facilitators guide the groups through structured meetings where they come up with their own solutions to the barriers they face in their

communities. They organise their communities to implement these solutions and evaluate their success.

So far, this approach has saved thousands of lives.If scaled up in countries with the highest rates of maternal and newborn mortality, our approach could save over 350,000 maternal and newborn lives per year.

Sustainable Development Goal (SDG) 3 sets a target of reducing the global maternal deaths to less than 70 per 100,000 and newborn deaths to less than 12 per 1000 live births by 2030.

Progress in most lower income countries is too slow to achieve this.

Health groups are predominantly made up of those who are most affected by maternal health issues such as pregnant women or new mothers. However, those who are involved in conception, antenatal, childbirth, postnatal and childcare decision-making, such as older women, men, and local leaders, can also join the groups.

These community members have important roles to play and are encouraged to engage with the groups. Men are partners, husbands, fathers, and brothers, so are also often concerned about maternal and newborn health and have a vital role to play in the health and wellbeing of their families.

Our experience is that male membership may start low, but often grows over time as they are motivated to act on their concerns and better understand their roles and responsibilities in relation to maternal health.

On one of our projects in Bangladesh, for example, health groups discussed the importance of male engagement with religious leaders who then promoted male membership during their calls to prayer.