A Legacy of Safer Births

ribbon

By turning surgical safety into everyday practice, EngenderHealth strengthened the foundations of maternal healthcare, leaving a global legacy of safer birth and a proven model for ending the suffering caused by fistula once and for all.

Why safe surgery matters for childbirth

Safe surgery can mean the difference between life and loss in childbirth. Yet in many low-resource settings, gaps in blood safety, anesthesia care, infection prevention, and follow-up leave women and newborns at unnecessary risk. When surgical systems are weak, preventable deaths and injuries such as obstetric fistula persist.

Fistula survivor Justine after her fistula repair surgery. Photo by: Carielle Doe

Understanding obstetric fistula

An obstetric fistula is a childbirth injury caused by prolonged, obstructed labor without timely medical care. It can leave women incontinent and facing stigma, isolation, and loss of income and support.

An estimated half a million women are living with fistula worldwide, many waiting years for care that could transform their lives. Yet this injury is both preventable and treatable with access to safe, timely surgery.

For women living with fistula, surgery is more than a medical procedure. It is a chance to heal, regain dignity, and move forward with their lives.

Fistula survivor Justine shares her experiences to raise awareness about safe birthing practices and fistula repair. Photo by: Carielle Doe

Strengthening surgical systems for safer births

Through the USAID-funded MOMENTUM Safe Surgery initiative, EngenderHealth expanded access to high-quality, person-centered surgical care. Using evidence-based approaches and global collaboration, we strengthened the full surgical ecosystem, from safer cesarean delivery and fistula prevention and repair to voluntary family planning services.

Across Benin, Burundi, the Democratic Republic of the Congo (DRC), Guinea, India, Madagascar, Mali, Mozambique, Nigeria, Rwanda, and Senegal, we worked with partners to improve blood systems, anesthesia safety, infection prevention, maternal and perinatal death surveillance, and provider capacity so that safety became standard practice.

Fistula survivor Justine with a friend. Photo by: Carielle Doe

What this work made possible

The results speak for themselves:

Because of EngenderHealth and our partners, hundreds of thousands of women received safer cesarean care, thousands healed from fistula, and maternal deaths dropped by 65% at supported facilities. Surgical teams were equipped to carry that progress forward, ensuring safer births and stronger systems for years to come.

MOMENTUM Safe Surgery-trained providers at Nampula Central Hospital in Mozambique. Photo by: Karen Levin

“We built a framework for strengthening surgical ecosystems to support people in seeking, reaching, and receiving appropriate care. The innovations created provide a foundation for partners to continue expanding access to quality surgical care across the life course.” – Dr. Vandana Tripathi, MOMENTUM Safe Surgery Program Director 

The future of safer births

Although the program ended earlier than planned due to USAID’s closure, its impact endures. Thousands of trained providers continue to act in stronger surgical ecosystems now embedded within national health services. 

Sustaining that progress also means protecting the knowledge behind it.

When USAID project websites were taken offline, years of technical expertise risked being lost overnight. EngenderHealth acted quickly to preserve that knowledge by launching a dedicated MOMENTUM Safe Surgery legacy page. By hosting over 60 open-source resources, we ensured that the tools, guidance, and learning behind this progress remain accessible to providers, partners, and health systems working to deliver safer care. remain accessible to providers, partners, and health systems working to deliver safer care.

This is what long-term change looks like: not only stronger systems, but the knowledge to sustain them. Because of this work, more mothers and newborns will survive, more traumatic injuries will be prevented and treated, and health systems are better equipped to protect women and babies for years to come.

The impact of MOMENTUM Safe Surgery continues to save lives, and with sustained support, it can reach more women and newborns for years to come.

Learn more about our global work advancing reproductive health and rights, and use the MOMENTUM Safe Surgery legacy resources to help provide safer care for women and newborns.