Citation, abstract and comment from me below.
CITATION: Aid cut, lives lost: estimating the impact of USAID’s withdrawal on maternal mortality in six African countries
Matthew Cummins
Health Policy and Planning, Volume 41, Issue 5, May 2026, Pages 731–737, https://doi.org/10.1093/heapol/czag034
Published: 10 March 2026
ABSTRACT
In January 2025, the US government suspended and subsequently terminated the majority of United States Agency for International Development (USAID) programs. This study estimates the impact of that decision on maternal mortality in six highly vulnerable countries in West and Central Africa: Burkina Faso, Central African Republic, Chad, Mali, Niger, and Nigeria. Using a deterministic model grounded in regional health expenditure elasticities, the analysis projects how the sudden withdrawal of foreign aid affects health spending among populations in humanitarian need, under the assumption that no immediate domestic or external financing substitutes for the lost resources, and the resulting changes in maternal mortality ratios (deaths per 100 000 live births). The results indicate that the funding cuts could cause maternal deaths to increase by 45%, on average, among populations in need. This increase is estimated relative to a baseline of approximately 2900 maternal deaths predicted in 2025, yielding approximately 1000 additional deaths across the countries within a single year. The magnitude of impact varies, with Niger experiencing the largest proportional increase (over 90%) and Nigeria the largest absolute increase (more than 300 additional deaths). Sensitivity analyses confirm that the results are robust to alternative elasticity scenarios. The findings illustrate the degree to which maternal health outcomes in fragile settings are sensitive to financing discontinuities. The results are presented as conditional estimates and are intended to inform ongoing discussions on health financing sustainability, transition planning, and risk mitigation.
KEY IMPLICATIONS
For policymakers: Invest in domestic health financing mechanisms and fiscal reforms to reduce reliance on unpredictable external funding. Establish contingency plans to protect maternal health services during aid disruptions.
For program managers and health planners: Prioritize maintaining essential maternal health interventions (e.g. skilled birth attendance, emergency obstetric care) when external funds contract. Develop strategies to rapidly mobilize alternative resources.
For donors and development partners: Recognize the life-threatening consequences of sudden aid withdrawals. Ensure predictable, sustained funding flows and incorporate transition and exit strategies that minimize disruption to critical health services.
COMMENT (NPW): The way forward is evidence-informed policy and practice:
CITATION: Volume 13, Issue 5e797-e798May 2025Open access
Mothers deserve better: evidence-based strategies to address maternal mortality
Etienne V Langloi, Amy Reid ∙ Rajat Khosla
In 2023, an estimated 712 women died each day due to complications during and after pregnancy and childbirth, totalling approximately 260 000 maternal deaths over the year...
Lifesaving interventions exist, but their impact depends on large-scale implementation to improve access, quality, and equity through evidence-based service delivery models. Since most maternal deaths occur during labour or in the first 24 h after birth, strengthening postnatal care alongside antenatal care and intrapartum care is critical...
Quality of care is a fundamental issue to address, and greater efforts are required to measure care quality and strengthen accountability...
A global, evidence-based approach is essential to accelerate change and confront this ongoing crisis with the urgency it demands...
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org