As the humanitarian landscape shifts under the weight of slashed aid budgets, the consequences for maternal health are stark. A new report reveals alarming declines in the availability of essential supplements like folic acid, critical in preventing stillbirths and maternal deaths. In Afghanistan, health professionals are witnessing the devastating effects of these shortages firsthand, with rising cases of complications during childbirth linked directly to a lack of nutritional support.
Dwindling Supplies: The Human Cost
In the maternity ward of a provincial hospital in Ghazni, Afghanistan, midwife Farida, 30, stands watch over expectant mothers. The atmosphere is tense; each delivery a potential crisis. One particular case shook her deeply—a woman, pale and weary, whose iron levels had plummeted. What should have been a straightforward delivery spiralled into tragedy as both of her twins were stillborn.
A maternal health worker, who spoke on condition of anonymity due to the sensitive political climate under the Taliban regime, emphasises the gravity of the situation: “We thought the main issue for her complications in birth was the iron, folic acid, and other nutritional items… the scarcity, the malnutrition of the mother.” They have witnessed a worrying spike in such cases over the past year, as funding cuts from national governments, including the US and UK, have severely hampered the procurement of vital supplements.
In Afghanistan, where the health system leans heavily on international aid, the impact of these cuts is felt acutely. The health worker explains, “Providing quality medicines needs a lot of money. The health system in Afghanistan is fragile, and shortages have worsened following the aid cuts.”
A Global Crisis in Maternal Health
The plight of mothers in Afghanistan mirrors a broader, distressing trend worldwide. Iron and folic acid supplements, which can cost as little as £1 for a month’s supply in the UK, are often overlooked in discussions about global health funding. Yet, their absence can lead to life-threatening complications. A study from the London School of Hygiene and Tropical Medicine revealed a direct correlation between anaemia in pregnant women and increased maternal mortality, highlighting the urgent need for preventative measures.
Recent data from the United Nations Population Fund (UNFPA) underscores the scale of the crisis. Between 2024 and 2025, procurement of folic acid plummeted by 62%, from $1.09 million (£816,000) to just $414,000. Shipments of reproductive health kits, which include iron and folic acid tablets, saw a dramatic drop of 53.5%. A spokesperson for UNFPA conceded that this decline is partially linked to shifts in the funding landscape, revealing a troubling trend for low-income and crisis-affected nations.
Fallout from US Aid Cuts
The ramifications of the US government’s decision to halt aid to Afghanistan in January 2025 have been immediate and devastating. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), the number of health facilities closed surged from 188 in February to over 420 by May. This left nearly three million people without access to basic healthcare services.
The health worker in Afghanistan reported that funding for critical supplies had decreased by nearly 50% over the past year, crippling clinics’ ability to provide even the most basic care. Local organisations, like the Afghan Family Guidance Association, rapidly shut down 45 to 50 health facilities within a day of the funding cuts, many of which remain closed.
When resources run low, healthcare providers find themselves in a desperate position, often forced to ration existing supplies or instruct patients to purchase their own medications. Yet, with a staggering 65% to 70% of the population relying on out-of-pocket payments for healthcare, many women are left without options.
The Broader Implications of Maternal Health Declines
The consequences of these funding cuts extend far beyond Afghanistan. In Nigeria, for instance, where maternal mortality rates are among the highest globally, organisations like Médecins Sans Frontières (MSF) have raised alarms about the impact of dwindling support on already strained healthcare systems. Women arrive at hospitals with life-threatening complications, highlighting the urgent need for effective interventions.
According to the latest figures, an estimated 260,000 women died during pregnancy or childbirth in 2023, equating to roughly one death every two minutes. While there has been a 40% reduction in maternal deaths since 2000, progress has stagnated since 2016. The UN recently warned that if the current pace of decline continues, achieving the target of less than 70 maternal deaths per 100,000 live births by 2030 will require an unprecedented reduction rate.
Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation (WHO), stated, “Solutions exist to prevent and treat the complications that cause the vast majority of maternal deaths.” Yet, as the health professional in Afghanistan poignantly articulated, the reality on the ground is grim. “These tablets are very cheap. It’s the difference between life and death for some women, but that’s not happening.”
Why it Matters
The ongoing decline in maternal health resources highlights a critical humanitarian crisis exacerbated by geopolitical decisions. When funding is cut, the most vulnerable populations pay the highest price. The revelations from Afghanistan serve as a chilling reminder of the interconnectedness of health systems worldwide, illustrating how political choices can lead to dire consequences for mothers and children. As global health stakeholders grapple with these challenges, the urgent call for renewed investment in maternal health resources becomes increasingly clear. Without immediate action, the progress made over decades stands to be reversed, endangering countless lives.