How Tanzania dramatically reduced maternal and newborn deaths—and why the world should pay attention

For parents, the day of birth is one of the most joyous occasions. But it can also be one of the most dangerous for a mother and her baby. More than 70% of maternal and neonatal deaths happen around the time of labor and delivery. Tragedy can strike without warning from complications like postpartum hemorrhage and newborn asphyxia.

Without properly equipped facilities and trained, well-supported health workers, these emergencies too often become fatal. This is a reality that, despite hard-won progress in recent years, is reflected in the persistently high maternal and newborn mortality rates in many countries, including in Tanzania.

A new approach

To address this crisis, a coalition of organizations including the Global Financing Facility (GFF), a partnership hosted at the World Bank, developed a low-cost, evidence-based program around a simple idea: equipping frontline workers with the tools, skills and confidence they need to act quickly and effectively on the day of birth.

The innovative program, the Safer Births Bundle of Care (SBBC), provides improved clinical tools and a strong focus on regular, on-site, simulation-based trainings designed to strengthen health workers’ response to emergencies during labor, birth and the critical hours that follow. The program includes health care workers learning to manage postpartum hemorrhage with their hands and to perfect high-quality neonatal resuscitation for babies born not breathing.

The approach of creating a culture of safety and learning for all those working within maternity departments has been critical to the success of the program.

Delivering results

As a recent study published in the New England Journal of Medicine shows, the outcomes of the program have been remarkable, the kind of results rarely seen in maternal and newborn health interventions. Over a three-year period, the program delivered a 75% reduction in maternal deaths and a 40% decline in early newborn deaths.

This study was carried out in 30 busy health facilities in Tanzania, tracking around 300,000 mother-baby pairs. The results show that over a thousand lives were saved within this sample – an incredibly rewarding impact.

What is in the Safer Births Bundle of Care?

These outcomes were achieved without relying on expensive technology. Instead, the program focuses on strengthening basic, lifesaving care during labor and delivery.

The program provides low-cost tools to better monitor heartrate and perform resuscitation. Individual and team simulation-based trainings for health workers complement these tools and allow participants to repeatedly practice emergency interventions in real-time scenarios in a health care setting. All health care workers take part in the training sessions – regardless of seniority – and some of the most important learning happens in the debriefing sessions that follow these simulations.

To ensure that health care workers retain their newly acquired knowledge, we also provide peer coaching and mentorship to reinforce skills, supporting a culture of confidence and continuous improvement. And finally, we ensure facility teams can track outcomes and adjust practices based on real-time training and clinical data that they and their colleagues have collected. This means specific skills and knowledge gaps are targeted, resulting in higher quality care for mothers and newborns.

It takes a village

Achieving this success has required over 10 years of collaboration across Tanzania and beyond — from local researchers and health workers at the Haydom Lutheran Hospital to the Ministry of Health and international experts.

Support from organizations like the Global Financing Facility (GFF), along with Norad, UNICEF, Laerdal Global Health, and the Tanzanian Ministry of Health has been critical. With resources from the World Bank and the GFF, we have been able to move beyond pilot projects and into real-world scale. We have now expanded to over 150 facilities and trained more than 4,000 health workers. The government of Tanzania plans to scale the program to three additional regions this year covering 200 hospitals, and then nationally.

What’s next

The model is adaptable and ready to scale. Many countries across Africa and beyond face similar challenges and can benefit from this proven, practical approach.

Already, there is interest from other countries including Botswana, Ethiopia, Lesotho, and Namibia. We started rolling out the program in Gombe and Borno states in Nigeria in early 2025.

With the right investment and technical support, other countries can implement the SBBC, just as we are doing in Tanzania.

To donors, development partners, and ministries of health: this is a call to action. Maternal and newborn deaths are preventable. The question is no longer whether this works, it's how quickly we can take it where it’s needed most. But to get there, the political will and financial backing will also be needed. Every mother deserves a safe birth. Every newborn deserves a chance to live and thrive. With this program, we can help make safe births a common reality — not just in Tanzania, but around the world.