ABA Editorial · Jan 14, 2026 · 14 min read
Sub-Saharan Africa accounts for approximately 70 percent of global maternal deaths despite having a smaller share of global births. Technology-based interventions targeting maternal and child health include community health worker digital support tools, mobile messaging programs, and diagnostic equipment deployment. This report maps the category and the operators working in it.
Sub-Saharan Africa accounts for approximately 70 percent of global maternal deaths despite having a smaller share of global births, according to World Health Organization estimates. The maternal mortality ratio across the region has declined meaningfully over the last two decades as a result of improvements in skilled birth attendance, emergency obstetric care access, and prevention of specific complications, but the gap between African rates and those in high-income countries remains large. Child mortality similarly remains elevated compared to global averages, with under-five mortality rates that reflect a combination of infectious diseases, malnutrition, and preventable perinatal complications. Maternal and child health (MCH) is therefore one of the most important components of African healthcare by both burden and potential for improvement, and it has been a priority area for both donor financing and technology-based interventions. This report maps the maternal and child health technology landscape and the operators working in it.
African maternal mortality is driven by a recognizable set of causes that collectively account for the majority of deaths: postpartum hemorrhage, hypertensive disorders (including preeclampsia and eclampsia), sepsis, obstructed labor, and complications from unsafe abortion. Each of these causes is medically addressable with interventions that are well-established in higher-resource health systems. The reason they continue to kill African women in large numbers is that the interventions are not reliably available to women who need them, either because the women do not reach facilities in time, or because the facilities they reach lack the capacity to respond appropriately, or because the health workforce lacks the training or equipment required to implement appropriate care.
Child mortality follows a different but related pattern. Neonatal deaths (in the first 28 days of life) are concentrated around birth complications, prematurity, and infection. Deaths between one month and five years are concentrated around pneumonia, diarrheal disease, malaria, malnutrition, and HIV. Each category has known interventions with established effectiveness, and the gap between actual outcomes and achievable outcomes reflects the implementation gap rather than the absence of medical knowledge.
Community health workers (CHWs) are the frontline of maternal and child health service delivery in most African countries. CHWs are typically community members with basic training who provide health education, facilitate referrals to clinics, and in some programs deliver specific preventive interventions directly. They are the interface between formal health systems and households that may otherwise have limited contact with healthcare. A growing category of digital tools supports CHW work through mobile applications that provide clinical guidance, enable patient registration and follow-up, and generate reporting data for supervisors.
Living Goods, Last Mile Health, and similar operators have built CHW digital support programs that combine technology with recruitment, training, and ongoing supervision of CHW networks. The digital tools are important because they improve the quality and consistency of CHW work, but they are not substitutes for the human element of the CHW role. The successful programs invest in both the technology and the workforce development, and they operate in partnership with ministries of health that can integrate the CHW networks into broader health system operations.
Mobile messaging programs that send health information directly to expecting mothers and caregivers of young children have been deployed at scale across several African countries. Operators including MomConnect in South Africa (a government-led program) and MAMA (Mobile Alliance for Maternal Action) in multiple countries have reached millions of women with stage-appropriate health messaging delivered via SMS or mobile messaging apps. The messages cover topics including nutrition during pregnancy, recognition of danger signs that should prompt urgent facility visits, infant feeding, immunization schedules, and child development milestones.
The evidence on the impact of mobile messaging programs on actual health outcomes is mixed. Some studies have shown improvements in specific behaviors (clinic attendance, recognition of complications, breastfeeding practices) while others have found more modest effects. The interventions are inexpensive per participant, which makes even modest impacts cost-effective, and they can operate at much larger scale than interventions requiring direct service delivery. This has made mobile messaging a persistent component of MCH programming even as the evidence on specific outcomes continues to evolve.
Diagnostic equipment deployment is particularly important for maternal and child health because many of the conditions driving mortality depend on diagnosis that peripheral facilities cannot currently provide. Ultrasound is valuable for prenatal care but requires equipment and trained operators that most rural facilities lack. Ilara Health's affordable diagnostic deployment model has included ultrasound equipment at some facilities, extending access to this modality in contexts where it would otherwise be unavailable. Point-of-care tests for infectious diseases relevant to MCH (malaria, HIV, syphilis during pregnancy) have been widely deployed and have improved diagnostic capacity at peripheral levels.
The broader opportunity includes expanding the diagnostic categories available at facility level, improving the linkage between diagnostic results and clinical decision-making, and ensuring that diagnostic capacity is matched by treatment capacity. A facility that can diagnose a pregnancy complication but cannot manage it creates the expectation of care without the capability, which can worsen outcomes rather than improve them.
African MCH is funded heavily by international donors including Gavi (vaccines), the Global Financing Facility (health systems strengthening), UNICEF, USAID, bilateral programs, and foundation funders. These donor programs have delivered significant health gains over the last two decades and continue to finance a substantial portion of specific interventions including vaccines, antenatal care, and emergency obstetric care. The donor-financed ecosystem is both a strength (it delivers interventions that domestic health systems could not fund alone) and a constraint (it creates dependency on external decisions about priorities and funding levels that domestic institutions cannot control).
Recent concerns about donor fatigue, shifts in donor priorities, and the broader contraction of some international health financing have raised questions about the sustainability of current MCH programming levels. Transitioning financing responsibility from donors to domestic health systems is a long-term policy project that most African countries have committed to but few have executed at scale.
Three indicators will shape African maternal and child health technology. First, whether community health worker programs continue to expand and integrate digital tools effectively, reaching more households with higher-quality care. Second, whether diagnostic equipment deployment extends to peripheral facilities at levels that would support meaningful improvements in maternal and child clinical capacity. Third, whether the donor financing environment remains stable or contracts in ways that threaten current programming levels. Maternal and child health is both one of the largest components of African healthcare burden and one of the most politically important, and its trajectory over the next several years will shape whether the gains of the last two decades are sustained and extended or whether progress stalls.