Maternity program linked to 22% fewer early perinatal deaths

A digital birth register became more than a record-keeping tool in 16 maternity units across Benin, Malawi, Tanzania and Uganda. It provided feedback to care teams during the project—and the chance of early perinatal death fell by 22%, according to a study led by Karolinska Institutet and published in Nature Medicine.

The program targeted the work around labor rather than a single piece of equipment. Women, families and health care staff first identified barriers together. Researchers then combined training for midwives and other maternity workers with hospital quality-improvement support and mentoring for maternity managers. The study followed 134,630 women and 139,300 newborns.

The outcome measure included stillbirths and deaths during the first 24 hours of life. Researchers also reported a 19% reduction in oxygen-deprivation-related complications among newborns. Fetal heart rate monitoring improved during the study, while the proportion of cesarean sections rose slightly. The team said that pattern may indicate earlier detection of complications and more timely action.

The scale of the problem remains stark. Around one million children show no signs of life at birth every year in sub-Saharan Africa, and the risk of a child dying during childbirth is around 40 times higher than in Europe, the report says. Claudia Hanson of Karolinska Institutet, the study's principal investigator, said the results show that maternity care can improve even where resources are limited and midwives work under high pressure.

So, concretely, hospitals can use a combination of locally designed training, management support, quality work and live feedback to strengthen care teams—not just buy a new tool. The findings come from a hospital-based trial, and the researchers' next step is to test better ways to interpret fetal distress, potentially including AI-supported decision support and improved guidelines.