As the world marks World Water Day on March 22, the findings of a new report from WaterAid highlight an urgent and overlooked crisis in maternal healthcare: millions of women are giving birth in facilities that lack the most basic sanitation and hygiene. This failure to provide safe water, clean toilets, and adequate handwashing facilities is putting the lives of mothers and babies at risk, making preventable infections a leading cause of maternal death.
The report, titled Born Without Water: The Crisis in Our Delivery Rooms, reveals that every two seconds, a woman gives birth in a healthcare facility without clean water or sanitation. This shocking statistic underscores the dire reality many women face, especially in low-income countries across Sub-Saharan Africa and the Asia-Pacific regions.
Women in Sub-Saharan Africa face a 144 times greater chance of dying from maternal sepsis compared to their counterparts in Western Europe and North America
Over 13.5 million women annually give birth in facilities where delivery rooms are deemed unsafe, often due to the absence of essential water, sanitation, and hygiene (WASH) services. The lack of basic hygiene contributes directly to maternal sepsis, a life-threatening infection that continues to claim the lives of thousands of women each year. The report's findings show that a lack of proper WASH facilities is responsible for a significant portion of these deaths, which could be prevented with simple, affordable interventions.
Maternal sepsis, primarily caused by infections acquired during childbirth, remains one of the top killers of mothers globally. In the countries covered by the report, 16 in total, including nations like Ghana, Zambia, and Cambodia, poor hygiene practices are directly linked to higher rates of sepsis. In fact, women in Sub-Saharan Africa face a 144 times greater chance of dying from maternal sepsis compared to their counterparts in Western Europe and North America.
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The lack of WASH facilities doesn’t only affect patients; healthcare workers, too, are at risk. With 70% of health workers being women, the absence of adequate sanitation and water has profound implications for their health and morale. Midwives and other healthcare workers report a daily struggle to provide care without basic resources like clean water and functional toilets. The inability to properly wash hands or sterilize equipment not only jeopardizes the lives of the women they care for but also exposes them to the very infections they are trying to prevent.
The report emphasizes that providing basic WASH services in healthcare facilities is both affordable and crucial for saving lives. At a cost of just $1 per capita, these simple interventions, clean water, decent toilets, and handwashing stations, could prevent up to 3,800 maternal deaths from sepsis annually across the 16 countries studied. This is far less than the cost of treating these infections.
The report emphasizes that providing basic WASH services in healthcare facilities is both affordable and crucial for saving lives
Moreover, improving WASH facilities is one of the most cost-effective ways to achieve broader public health goals, including reducing maternal and child mortality rates and advancing gender equality. Clean water and safe sanitation are not just basic needs—they are a fundamental human right that governments must prioritize.
The report doesn’t just present data; it amplifies the voices of the women who are directly impacted by this crisis. From Liberia to Malawi, women have shared harrowing stories of giving birth in unsanitary conditions. Many describe laboring without water to wash themselves or their newborns, using locked or filthy toilets, and struggling to maintain hygiene in filthy, overcrowded maternity wards.
Women in Uganda, for instance, ranked clean, reliable water as the top priority for safe childbirth, followed by accessible and clean toilets and well-maintained handwashing stations. These demands are not just about comfort, they are about dignity, respect, and ensuring that women receive the care they deserve during one of the most vulnerable moments of their lives.
This crisis is not a distant issue but one that demands immediate action. The report calls on governments to treat WASH in healthcare facilities as a non-negotiable foundation for quality maternal and newborn care. With the evidence in hand, the report urges national leaders to fund and implement the basic infrastructure needed to protect the health of mothers and babies.
