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World Health Day 2025: Healthy Beginnings, Hopeful Futures

Posted: By: Sophie Harris

World Health Day 2025 underlines the critical role anaesthesiologists play in improving maternal and neonatal morbidity and mortality outcomes around the world

The theme for World Health Day 2025, “Healthy Beginnings, Hopeful Futures,” highlights the importance of ensuring safe and healthy starts for mothers and newborns, laying the foundation for lifelong well-being. This theme is particularly relevant to obstetric anaesthesiologists, who play a crucial role in safeguarding maternal and neonatal health during pregnancy and childbirth.

Safe anaesthesia is a cornerstone of quality obstetric care, ensuring that mothers and their newborns receive the best possible outcomes during childbirth. Techniques such as regional anaesthesia (spinal and epidural), general anaesthesia for high-risk cases, and advanced airway management strategies are critical in providing safe and effective care 

Anaesthesiologists are key members of the multidisciplinary team that manages obstetric emergencies, such as obstetric haemorrhage, eclampsia, and sepsis – the leading causes of maternal mortality. Their expertise in administering anaesthesia safely, managing pain, and responding to life-threatening complications during pregnancy, caesarean sections and other emergency procedures is essential for achieving good outcomes. However, the role of the anaesthesiologist starts much earlier, and includes assessment of high-risk pregnant patients and planning anaesthetic care during and after delivery.

Despite advancements in maternal healthcare, preventable maternal and neonatal morbidity and mortality remain unacceptably high, particularly in low-resource settings where access to skilled obstetric anaesthesia is limited.

The evidence and reason for these missed targets is stark – a lack of access to well-trained and adequately equipped anaesthesiologists:

1. Maternal Mortality and Caesarean Section Risks

  • 5–15% of births globally require caesarean section to prevent maternal and neonatal mortality.1 However, in many low-resource settings, the lack of trained anaesthesiologists leads to unsafe anaesthesia practices, contributing to increased maternal mortality.
  • Studies show that 1 in 200 women undergoing caesarean section in low-income countries dies, compared to 1 in 10,000 in high-income countries.2 Poor anaesthesia care is a key contributor to this disparity.

2. Anaesthesia-Related Mortality

  • A Lancet Global Health study found that anaesthesia was a contributing factor in 15% of maternal deaths in low-resource settings.3
  • Women in Africa are three times more likely to experience a complication following caesarean delivery, yet are 50 times more likely to die compared women in high income settings.4

3. Neonatal Mortality 

  • Neonatal mortality rates are significantly higher in settings where emergency obstetric care, including safe anaesthesia, is unavailable. 5
  • Delays in accessing appropriate obstetric and anaesthesia care contribute to approximately 40% of stillbirths and neonatal deaths in low-income settings. 6

4. Human Resource Shortages

  • An estimated additional 136,000 additional anaesthesia professionals are needed globally, with the most acute shortages in sub-Saharan Africa and South Asia. 7
  • In many low-resource countries, there is less than 1 anaesthesia professional per 100,000 population, compared to 20–40 providers per 100,000 in high-income countries.8

5. Access to Safe Surgery

  • The Lancet Commission on Global Surgery found that 5 billion people lack access to safe, timely, and affordable surgical and anaesthesia care, with the majority living in low resource settings.9
  • Without adequate anaesthesia services, essential surgeries such as caesarean sections, emergency laparotomies, and treatment for obstetric complications cannot be safely performed, contributing to preventable maternal and neonatal deaths.

6. WHO and UNFPA Reports

  • WHO and United Nations Population Fund (UNFPA) reports consistently highlight that improving access to safe anaesthesia services in low-resource settings could reduce maternal mortality by 10–15%, particularly in settings with high maternal mortality ratios.10

These statistics underscore the urgent need to strengthen anaesthesia capacity through training, infrastructure, and system-wide improvements to reduce preventable maternal and neonatal deaths worldwide.

Addressing Gaps in Obstetric Anaesthesia Care

One of the major challenges contributing to poor maternal and neonatal outcomes is the shortage of trained obstetric anaesthesiologists, particularly in low resource settings.  The lack of skilled clinicians often leads to delays in care, inadequate pain management, and an increased risk of complications. 

Strengthening the workforce of obstetric anaesthesiologists is vital to ensuring that pregnant women receive timely and high-quality anaesthetic care, especially in settings where the burden of maternal and neonatal morbidity is highest.

WFSA’s role in strengthening Obstetric Care

To improve maternal and neonatal outcomes, we must increase the number of skilled obstetric anaesthesiologists through targeted investment in training, education, and mentorship. At WFSA we are seeking to do this by:

Expanding Access to Training: Scaling up evidence-based training programmes, such as the SAFE Obstetrics Course, which equips anaesthesia professionals with the knowledge and skills needed to manage obstetric emergencies effectively.

Developing Specialist Training Pathways: Establishing formal obstetric anaesthesia fellowships to develop a cadre of experts capable of leading anaesthesia services and driving quality improvements.

Strengthening Mentorship Opportunities: The WFSA’s Global Anaesthesia Mentorship Programme seeks to build sustainable mentorship networks that foster peer learning and professional growth, ensuring that anaesthesiologists stay up-to-date with the latest guidelines and best practices.

Accessible Continuous Professional Development resources: Ensure anaesthesia professionals are able to access and utilise relevant and practical educational resources like Anaesthesia Tutorial of the Week.

What individual anaesthesiologists can do

Global observation days like World Health Day are valuable for highlighting important issues, but their impact extends beyond just a single day. Strengthening obstetric anaesthesia services for the underserved will not happen in one day. That is why we must take a long-term commitment to advocate for long-lasting change. 

Steps you can take to strengthen obstetric anaesthesia
1. Engage in data collection and research for national and international studies

2. Advocate for improved safety and the recognition and expansion of the role of the obstetric anaesthesiologist

3. Engage in teaching / education of anaesthesia providers and the wider multidisciplinary team. 

4. Participate in multidisciplinary training to improve communication, team working and patient safety

5. Participate in local quality improvement initiatives in obstetric anaesthesia

6. Be the voice of/for our patients

7. Participate in morbidity and mortality meetings 

Week in, week out, we must engage with our local and national policy makers and decision makers to get them to recognise that investing in the anaesthesia workforce is an investment in maternal and neonatal health. 

Only by encouraging them to embed anaesthesia policies into the national and local health planning will we see the change that our patients deserve. 

Strengthening obstetric anaesthesia services will not only save lives but will also contribute to achieving universal health coverage and reducing inequalities in maternal healthcare. 

By empowering anaesthesiologists and expanding access to safe anaesthesia, we can make significant strides towards ensuring that no woman or newborn dies needlessly during childbirth.

Footnotes

  1. World Health Organization (WHO) and United Nations Population Fund (UNFPA). State of the World’s Midwifery 2021. ↩︎
  2. Sobhy S, et al. Anaesthesia-related maternal mortality in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet Global Health, 2016. ↩︎
  3. Sobhy S, et al. Anaesthesia-related maternal mortality in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet Global Health, 2016. ↩︎
  4. Bishop D, Dyer RA, Maswime S, Rodseth RN, van Dyk D, Kluyts H-L, et al. Maternal and neonatal outcomes 
    after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort 
    study. Lancet Glob Heal 2019; 7(4):e513–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30879511
    ↩︎
  5. WHO. Making Every Baby Count: Audit and review of stillbirths and neonatal deaths. 2016. ↩︎
  6. Bhutta ZA, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet, 2014. ↩︎
  7. World Federation of Societies of Anaesthesiologists (WFSA). Global Anaesthesia Workforce Survey. 2017. ↩︎
  8. Law, Tyler J., Michael S. Lipnick, Wayne Morriss, Adrian W. Gelb, et al. 2024. “The Global Anesthesia Workforce Survey: Updates and Trends in the Anesthesia Workforce.” Anesthesia & Analgesia, March, 10.1213/ANE.0000000000006836. ↩︎
  9. The Lancet Commission on Global Surgery. Global Surgery 2030: Evidence and Solutions for Achieving Health, Welfare, and Economic Development. The Lancet, 2015. ↩︎
  10. World Health Organization (WHO) and United Nations Population Fund (UNFPA). State of the World’s Midwifery 2021. ↩︎
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