Maternal, Child and Reproductive Health

An estimated 287,000 women die each year as a result of complications during pregnancy or childbirth. Infectious diseases (sepsis, HIV/AIDS, malaria and tuberculosis) are a significant cause of maternal mortality, which exacerbate risks during pregnancy and postpartum and contribute to one-third of maternal deaths globally. Progress has stagnated since 2015, with most maternal deaths occurring in low- and middle-income countries, particularly in sub-Saharan Africa, which accounts for 70 per cent of global deaths and has a maternal mortality ratio (MMR) estimated at 211 deaths per 100,000 live births, far from the Sustainable Development Goal (SDG) target of less than 70 by 2030.

Cervical cancer, caused by persistent infection with the human papillomavirus (HPV), is the fourth most common cancer in women globally with around 660,000 new cases and around 350,000 deaths in 2022. More than 85 percent of cervical cancer cases and deaths occur in low- and middle-income countries, reflecting major inequities driven by lack of access to effective strategies to prevent cervical cancer such us national HPV vaccination, cervical screening and treatment of pre-cancer lesions.

The global under-five mortality rate has declined by 60% since 1990 (from 93 to 37 deaths per 1,000 live births in 2022). However, significant disparities persist, particularly in sub–Saharan Africa and Southern Asia that account for over 80 percent of these deaths. In 2022, some 4.9 million children under 5 years of age died. Of these, 2.3 million deaths occurred during the neonatal period (the first month of life). Leading causes include infectious diseases and neonatal complications highlighting the need for enhanced healthcare access, vaccinations and nutrition. Without accelerated efforts many countries will miss SDGs targets.

Main Lines of Research

At ISGlobal, our research focuses mainly on the following key areas: 

• Improving and expanding strategies for the control of malaria in pregnant women and young children, including those living with HIV. 
• Evaluating the effectiveness and acceptability of maternal immunisationfor vaccine-preventable diseases. 
• Determining the effectiveness of human papilloma virus (HPV)vaccination programs in adolescent girls to prevent cervical cancer.
• Evaluation of the burden and preventive strategies of emerging infections during pregnancy (e.g. Zika, COVID-19, Lassa fever...).
• Identification of the causes of maternal and child mortality in low-income countries. 

Translation and Impact

As part of the efforts to advance SDG3 on health (targets 1 and 2 on maternal and child health), SDG5 on gender equality (targets 1 and 6) and SDG10 on reducing inequality within and between countries, we work to generate evidence on inequalities in access to quality Reproductive Maternal, Newborn, Child and Adolescent Health services and on the factors contributing to such inequalities in low-resource settings.

We also promote capacity building through short courses, leadership workshops, participation in ISGlobal's Master in Global Health, and collaborations with academic institutions. These activities aim to strengthen technical and leadership skills among health professionals and researchers, with a particular emphasis on those from low- and middle-income countries.

In addition, we engage in evidence-based health policy advocacy, technical assistance, and actively participate in specialized forums, international networks and global initiatives. Through these efforts, we seek to ensure that the knowledge generated translates into action and contributes to advancing the global health agenda for the most vulnerable women and children in low-resource settings.

A major area of work is malaria in pregnancy, a leading cause of maternal and neonatal mortality associated with low birth weight, prematurity, maternal anaemia and placental infection, causing an estimated 10,000 maternal and 200,000 infant deaths annually in Africa. We focus on operational research and technical assistance to improve the coverage of intermittent preventive treatment in pregnancy (IPTp) in endemic countries (TIPTOP), as well as studies on drug resistance, pharmacovigilance, and interactions between antimalarials and antiretrovirals in pregnant women and children (MAMAH, Pyrapreg, HIVDR). Previous studies include: safety and efficacy of alternative treatments to sulfadoxine-piremethamine for IPTp (MIPPAD); epidemiological and clinical characteristics of Plasmodium vivax malaria in pregnancy (PregVax); cost-effectiveness of interventions to control malaria in infants and pregnant women; and intermittent preventive treatment in infants (IPTi) to prevent malaria in the first year of life, which contributed to WHO recommendations for its implementation in endemic areas. 

In childhood malaria, our research evaluates the impact of azithromycin combined with intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTi-SP) administered through the Expanded Programme on Immunization (EPI), on all-cause mortality at 18 months in children living in high-burden settings in sub-Saharan Africa. We also assess implementation barriers to scaling up IPTi-SP through EPI in Sierra Leone (ICARIA) and work to optimize delivery and uptake of IPTi (now PMC) to maximize its effectiveness through scale-up into the second year of life in Sierra Leone, Togo and Mozambique.

ISGlobal is a member of the WHO-Roll Back Malaria Working Group on Malaria in Pregnancy (RBM MiPWG), which aims to align RBM partners on best practices and lessons learned in MiP programming to help achieve higher coverage in MiP interventions globally. As well as the Partnership for Women's, Children's and Adolescents' Health (PMNCH), the world's largest alliance committed to protecting and advocating for the health, well-being and rights of women, children and adolescents, and the United Nations' Every Women Every Child initiative to end all preventable maternal, newborn and child deaths, including stillbirths, by 2030, and to improve their overall health and wellbeing.

Translation activities were led by the Maternal, Child and Reproductive Health Initiative until January 2026, when they were integrated into the programme, further strengthening ISGlobal’s commitment to a comprehensive, results-oriented approach.

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