What's the challenge?

Globally, maternal mortality remains unacceptably high. Efforts to reduce maternal and newborn mortality in Sub-Saharan Africa have been successful since 2000, with a continuous downward trend in most countries, but the rate is still almost double that of other regions. About 287,000 women died during and following pregnancy and childbirth in 2020 with 95% occurring in low and lower middle-income countries. Most could have been prevented. Sub-Saharan Africa alone accounted for around 70% of maternal deaths (202,000)

In 2019, 47% of all under-5 deaths occurred in the newborn period with about one third dying on the day of birth and close to three quarters dying within the first week of life. Sub-Saharan Africa had the highest neonatal mortality rate in 2019 at 27 deaths per 1,000 live births. A child born in sub-Saharan Africa is 15 times more likely to die in the first 5 years than a child born in Europe or North America.


Our Mother and Baby Programme began in 2015. St John currently have 26 staff and 380 trained St John volunteers using the nationally recognised maternal and newborn health packages.

2023 in Numbers

26 staff

380 trained St John volunteers

570,000 additional community members have been reached with health education

425,000 people have been provided with primary health consultations in Malawi, Uganda and Zimbabwe

Integrating St John Mother and Baby Programme and the "Three Delays Model"

In all project countries, maternal and infant mortality ratios are unacceptably high and urgent preventative action is required to save lives. Drivers of maternal mortality and morbidity vary, but can be effectively evaluated at the local level using the “Three Delays” model developed by Thaddeus and Maine (1994) This is the most common framework used to evaluate the circumstances surrounding a maternal death.

What does our response look like in action?

Where do we work?

MalawiUgandaZambia and Zimbabwe

Malawi has a high MMR currently estimated at 349 maternal deaths per 100,000 live births. According to the World Bank (2021), out of every 1,000 children born in Malawi, 31 of them will not reach their first birthday (UK and Canada infant mortality ratio is 4/1000).

Uganda is yet to achieve real progress in reducing neonatal and maternal deaths. MMR is currently estimated at 375 maternal deaths per 100,000 live births, with at least one in 4 girls aged 15 to 19 years already bearing children. Children born in rural areas, to the poorest families, and with uneducated mothers are most likely to die before the age of five.

Zambia has made progress in reducing child mortality, but challenges remain in maternal and neonatal mortality. MM is currently estimated at 213 maternal deaths per 100,000 live births. World Bank (2021) states that 40 of every 1,000 children will not reach their first birthday.

Zimbabwe has high maternal mortality rates at 363 per 100,000 live births. World Bank (2021) states that 36 of every 1,000 children born in Zimbabwe will not reach their first birthday.


What’s next?

As the programme continues to save lives, St John International will continue with the transitioning of the Mother and Baby programme towards establishment oversight while delivering current output. In 2023-24, the programme will enrol 46,000 direct beneficiaries and 160,000 indirect beneficiaries reached through community programmes.

We will use evidence-based approach for decision making within the programme to support learning, programme improvement and future programming. The Success Model and Nurture database developed to deliver and manage the programme will serve as a template for the sustainable delivery of future multi-country programmes.

Discussions about longer term funding ongoing, with some of the solutions dependant on Middle East, Africa (EMEA) region uptake, and/or local fundraising capacity. Recently, St John International have had engagement with St John Canada, St John Wales, and St John Papua New Guinea about working together in expending or starting new initiative in country depending on new developments and strategic direction.

You can read more about our Mother and Baby Programme through our case studies below:

Mother and Baby Programme Stories

Mother and Baby Programme Stories