A recent investigation led 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—reveals that a well-structured and lasting infection prevention strategy can significantly reduce maternal infections and deaths. The study found that this approach led to a 30% decrease in severe infections and fatalities among pregnant women when compared to standard care.

Maternal infections and sepsis—an often life-threatening condition where the body harms itself while fighting infection during or after pregnancy—continue to be a major cause of death among mothers globally. In many healthcare settings, basic but effective practices like handwashing, timely detection of infections, and quick treatment are not consistently followed. To address these gaps, the Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) initiative was created. This program helps healthcare providers implement WHO’s “five moments for hand hygiene,” apply infection prevention and treatment protocols, and use the FAST-M bundle: fluids, antibiotics, source control, transfer when necessary, and close monitoring to catch and manage sepsis early.

The study involved 431,394 childbirths across 59 hospitals in Malawi and Uganda. It demonstrated measurable improvements when the APT-Sepsis program was in place. These hospitals achieved a 32% drop in serious illness and deaths linked to maternal infections. They also saw better hand hygiene practices, more consistent use of preventative antibiotics during cesarean deliveries, and improved monitoring of vital signs during care.

The APT-Sepsis project emphasizes a strategic, system-level method for managing maternal infections. Health practitioners are guided to follow WHO-endorsed procedures, applying antibiotics carefully and only when needed, while also focusing on key actions such as hand cleanliness, antiseptic preparation before surgeries, early infection identification, and implementation of the FAST-M treatment plan.

These results prove that following WHO guidelines through a methodical and durable system can lead to substantial improvements in maternal health, particularly in locations with limited resources. Strengthening infection control methods, hygiene routines, and timely medical responses could save the lives of many mothers around the world.

“The APT-Sepsis initiative shows the power of uniting research, policy, and hands-on healthcare practice,” stated Jeremy Farrar, WHO’s Assistant Director-General. “Achieving a 30% reduction in maternal infections and deaths is more than a health milestone—it’s a vital step forward in securing better maternal care globally. This success should inspire efforts to make these measures universally available and maintainable.”

Moving forward, WHO, HRP, and their collaborators are supporting countries in adjusting and expanding this method within their healthcare systems, with the goal of applying the insights from Malawi and Uganda to enhance maternal infection control strategies around the world.

To highlight the study’s outcomes, WHO, HRP, and the University of Liverpool will hold an online event titled “Preventing and managing maternal sepsis – New results of the APT-Sepsis trial” on 24 November 2025. This discussion will explore the trial's key findings and their relevance for health professionals and policy leaders.

The APT-Sepsis trial received backing from the Joint Global Health Scheme, with financial support from the UK’s Foreign, Commonwealth and Development Office, the UK Medical Research Council (MRC), the UK Department of Health and Social Care via the National Institute of Health Research (NIHR), Wellcome (Grant reference: MRV005782/1), and HRP.