Advancing Women’s, Children’s and Adolescents’ Health: Key Advocacy Messages for the 39th African Union Summit

Africa is home to 17% of the world’s population, yet it continues to bear a disproportionately high share of global disease and preventable deaths. In 2023 alone, more than 70% of global maternal deaths occurred in Africa, with an estimated 182000 women losing their lives to pregnancy-related complications. Nearly 58% of global under-five deaths and almost half of all newborn deaths occur on the continent, alongside a stillbirth rate of 21.7 per 1000 total births in 2023.

These figures reflect a persistent and systemic challenge: chronic underinvestment in sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH).

Commitments to women’s, children’s and adolescents’ health are not new. African Union Member States have repeatedly affirmed their political will through the SDGs and the Global Strategy for Women’s, Children’s and Adolescents’ Health, the Maputo Protocol and Maputo Plan of Action, the 2010 AU Summit Declaration on Maternal, Newborn and Child Health, the Africa Health Strategy, and related continental frameworks.

The challenge today is not commitment, but implementation and accountability.

Key data points on maternal, newborn and child mortality

• Sub-Saharan Africa alone accounted for approximately 70% of global maternal deaths in 2023, followed by Central and Southern Asia which accounted for almost 17%. (WHO, 2025)
• Maternal mortality is disproportionately high in conflict and fragile settings - classifications that are rising in number with many crises becoming long-term. Conflict and fragility disproportionately affect sub-Saharan Africa, with 18 out of 48 countries classified in these categories. (WHO, 2025)
• Approximately 1 million neonatal deaths occurred in sub-Saharan Africa in 2023.
• In 2023, Sub-Saharan Africa had the highest neonatal mortality rate globally, at 26 deaths per 1,000 live births, 11 times higher than the lowest-mortality region, Australia and New Zealand. There was a 12% decline in neonatal mortality between 2015-2023. (UNIGME, 2025)
• A child born in sub-Saharan Africa is on average 18 times more likely to die before turning 5 than one born in the region of Australia and New Zealand. (UNIGME, 2025)
• Despite a 23% decline in under five mortality between 2015-2023, Sub-Saharan Africa had the highest U5 mortality rate globally, at 69 deaths per 1,000 live births in 2023. (UNIGME, 2025)
• Sub-Saharan Africa has the biggest share of global under-five deaths

Key messaging for the 39th African Union Summit

1. From commitments to measurable delivery

Africa continues to bear a disproportionate burden of preventable deaths, with more than 182,000 maternal deaths recorded in 2023 despite longstanding political commitments through continental and global frameworks.

Accelerating implementation of existing AU and global health commitments will require strong accountability. We call for the institutionalisation of reporting on women’s children’s and adolescent health and regional mechanisms and processes. 

2. Close the financing gap for SRMNCAH

Chronic underinvestment in sexual, reproductive, maternal, newborn, child and adolescent health continues to drive inequities, with sub-Saharan Africa accounting for around 70% of global maternal deaths and nearly 58% of under-five deaths.

Strengthening domestic investment, reinforcing primary health care systems and aligning financing with country priorities can help address systemic gaps and sustain.

3. Prioritize fragile and conflict-affected settings

Maternal and child mortality remains highest in fragile contexts, with 18 out of 48 sub-Saharan African countries affected by conflict or instability, placing essential health services under strain.

Integrating humanitarian and development responses and strengthening community-based health delivery can help maintain continuity of care in complex environments.

4. Accelerate newborn and child survival

Around 1 million neonatal deaths occurred in sub-Saharan Africa in 2023, with neonatal mortality rates at 26 deaths per 1,000 live births, 11 times higher than the lowest-mortality regions. Under-five mortality remains the highest globally despite recent declines.

Scaling proven interventions, improving quality of care at birth and strengthening integrated maternal and child health services can help reduce preventable deaths.

5. Invest in equity and adolescent health

A child born in sub-Saharan Africa is still 18 times more likely to die before age five than one born in Australia or New Zealand, reflecting persistent inequities affecting women, children and adolescents.

Prioritizing inclusive health policies and strengthening access to essential services across the life course can help reduce disparities and support healthier futures.

6. Strengthen accountability through partnership

Despite a 23% decline in under-five mortality between 2015 and 2023, progress remains uneven, highlighting ongoing challenges in implementation and coordination.

Aligning continental commitments with country-led action and reinforcing multi-stakeholder collaboration can help accelerate delivery across the continuum of care.