Bissau – In an important step to reduce maternal mortality, Guinea-Bissau has launched its first-ever national guidelines for maternal health, focused on improving care before, during and after childbirth.  

The Ministry of Health, with support from World Health Organization (WHO) and partners, led the development of this new national framework to guide maternal health services. The goal is to curb maternal deaths, estimated to be about 500 per 100 000 live births. Under the Sustainable Development Goals maternal mortality reduction targets, countries should aim to lower maternal deaths to under 70 per 100 000 live births.  

Guinea-Bissau has not had standard clinical protocols for maternal care. This made it difficult to provide consistent, high-quality services and contributed to avoidable deaths among mothers and newborns.  

“One of the major gaps in our health system has been the absence of standardized norms for maternal and child care. Each region, facility and health worker has been providing care in their own way,” says Dr Elizio Junior Baldé Ferreira, Gynecologist-Obstetrician and Director of Sexual and Reproductive Health Service at the Ministry of Public Health (MINSAP), Guinea-Bissau.  

“For the first time, we now have national standards for prenatal, intrapartum and postpartum care that will guide all maternity care providers and will certainly facilitate the monitoring of quality of care throughout the national territory,” adds Dr Baldé.  

In Guinea-Bissau, around 81% of pregnant women attend at least four antenatal care visits, but only around 50% of all births are assisted by skilled health workers. Skilled support is critical to detect risks early, manage complications and ensure safe delivery. Without it, common issues like heavy bleeding, infections or high blood pressure can quickly become life-threatening. Yet, many women still face barriers to accessing the care they need throughout pregnancy and childbirth.

WHO recommends eight antenatal visits to better protect the health of mothers and newborns. The country is working to meet this target and increase the number of births that take place in health facilities under professional care.

Health experts, nurses, government agencies and partners worked together to develop and validate the new guidelines. The document defines essential medicines, clinical procedures and key service indicators for maternal care. It also lays the foundation for training health workers, strengthening supervision and improving service delivery across the country.  

The Ministry of Health approved the new approach following the launch of its National Health Strategy Plan 2023–2028. The plan also calls for more policies for expanding and integrating reproductive, maternal, newborn child and adolescent health services across the country.

WHO supported the Ministry of Health throughout the process, providing technical expertise to align the guidelines with global best practices. The Organization coordinated partner engagement, facilitated validation and led advocacy efforts to promote national ownership and long-term impact.

“The assessment tool developed by WHO provided a clear picture of how existing practices on the ground align with WHO recommendations," said Dr Daisy Trovoada, specialist in reproductive, maternal, newborn, child and adolescent from WHO Regional Office for Africa. "It also helped identify priority actions for the national guidelines for improving antenatal, intrapartum and postnatal care.”  

Health authorities have begun using the new standards in the regions of Bolama in the southwest, Farim in the north-central region, and Gabu in the east. In the next months, they will train and supervise health workers to improve care, help more women attend the recommended eight antenatal visits and support safer births in health facilities.  

This new framework is also helping partners better plan and provide the medical equipment needed for quality care and support training, supervision and better health services.

“By setting clear health standards and strengthening services, Guinea-Bissau is working to lower the number of maternal deaths and improving life expectancy across the population,” says Dr Walter Kazadi Mulombo, Acting WHO Representative in Guinea-Bissau. “We are proud to stand with the Ministry of Health in building a stronger, more equitable health system for all.”

These efforts directly support the Sustainable Development Goals, by helping reduce maternal and newborn deaths and moving closer to universal access to quality health care. As Guinea-Bissau continues rolling out the new standards, sustained investment, coordination and training will be essential to improve outcomes and ensure that more women and babies receive the care they need ‒ before, during and after birth.