The Central African Republic continues to face one of the highest maternal mortality rates in the world, with 829 deaths per 100 000 live births recorded in 2023. These figures reflect deep challenges, including women giving birth far from health facilities, long distances to reach care, limited medical resources and cultural beliefs that often hinder access to essential services. Fewer than half of pregnant women attend the recommended antenatal consultations, and nearly one-third still deliver at home, putting both mothers and newborns at serious risk.
To confront this crisis, the government has prioritized universal health coverage, ensuring that all women receive quality maternal care without financial barriers. The national strategy focuses on strengthening antenatal services, increasing skilled attendance at birth and improving the management of complications. This approach aims to prevent avoidable deaths, build trust in the health system and encourage women to seek timely care.
With support from WHO and donor funding, major steps have been taken to improve maternal health, with community midwives at the centre of the effort. Selected by their own communities, these midwives serve as crucial links between families and health facilities. They guide pregnant women from early pregnancy to postpartum care and play a key role in changing behaviours by emphasising the importance of antenatal visits and assisted delivery.
Their work often goes beyond routine duties. Midwives such as Erguine Souhat in Bria accompany women to health facilities even at night, ready to intervene if complications arise. Health authorities highlight maternal mortality as a national emergency and stress the need for stronger provider skills, better-equipped facilities and services closer to rural communities.
More than 1,200 midwives are now active across 32 of the country’s 35 health districts, mainly in remote areas where they have helped reduce home deliveries by about 30% and increased attendance at antenatal consultations. In 2024, WHO supported the equipping of around 30 maternity wards and trained 300 community midwives in essential maternal care, while 64 healthcare providers received training on detecting gynecological risks.
These efforts are already saving lives. Mothers like Albertine Shoura, who previously faced life-threatening complications during a home birth, now receive safe delivery assistance thanks to community midwives. For her, and many others, access to skilled care has transformed childbirth from a dangerous ordeal into a moment of safety and hope.
