A new study by the World Health Organization (WHO), the UN’s Special Programme in Human Reproduction (HRP), and the University of Liverpool, published in the New England Journal of Medicine, demonstrates that a structured and sustainable approach to infection prevention and control can save women’s lives. The Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) programme reduced severe maternal infections and deaths by 30% compared to usual care, showing that targeted interventions can make a critical difference in maternal health outcomes.
Maternal infection and sepsis, which occur when the body’s response to infection harms its own tissues and organs during or after pregnancy, remain leading causes of maternal mortality worldwide. Many health facilities inconsistently apply simple, evidence-based practices such as hand hygiene, early infection detection, and timely treatment. The APT-Sepsis programme addresses these gaps by supporting health workers to follow WHO’s “five moments for hand hygiene,” adhere to maternal infection prevention and treatment guidance, and use the FAST-M bundle, which includes fluids, antibiotics, source control, transfer if required, and monitoring for early recognition and response to sepsis.
The trial, conducted in 59 hospitals across Malawi and Uganda and involving 431,394 women giving birth, showed a 32% reduction in infection-related maternal mortality and severe morbidity in hospitals implementing APT-Sepsis. Participating facilities also reported improvements in hand hygiene compliance, antibiotic prophylaxis during caesarean sections, and routine vital sign monitoring.
APT-Sepsis promotes a systems-based approach, ensuring evidence-based WHO recommendations are applied consistently. This includes appropriate use of antibiotics, proper hand hygiene, antiseptic preparation before surgery, early detection of infection, and structured use of the FAST-M treatment bundle. The results underscore that structured and sustainable practices can transform maternal care, even in resource-limited settings, saving thousands of lives annually.
WHO Assistant Director-General Jeremy Farrar highlighted that reducing maternal infections and deaths by over 30% is not only a clinical success but also a call for global health systems to prioritize infection prevention in maternal care. WHO, HRP, and partners are now working with countries to adapt and scale the APT-Sepsis approach within national health systems to strengthen infection prevention and maternal care worldwide.
To mark the study’s publication, WHO, HRP, and the University of Liverpool will host a webinar titled Preventing and managing maternal sepsis – New results of the APT-Sepsis trial on 24 November 2025, presenting key findings and discussing implications for healthcare workers and policy-makers.
