Aid Cut, Lives Lost: Estimating the Impact of USAID’s Withdrawal on Maternal Mortality in Six African Countries

In January 2025, the United States government suspended and subsequently terminated the majority of United States Agency for International Development (USAID) programs. This study estimates the impact of that decision on maternal mortality in six highly vulnerable countries in West and Central Africa: Burkina Faso, Central African Republic, Chad, Mali, Niger, and Nigeria. Using a deterministic model grounded in regional health expenditure elasticities, the analysis projects how the sudden withdrawal of foreign aid affects health spending among populations in humanitarian need, under the assumption that no immediate domestic or external financing substitutes for the lost resources, and the resulting changes in maternal mortality ratios (deaths per 100,000 live births). The results indicate that the funding cuts could cause maternal deaths to increase by 45%, on average, among populations in need. This increase is estimated relative to a baseline of approximately 2,900 maternal deaths predicted in 2025, yielding approximately 1,000 additional deaths across the countries within a single year. The magnitude of impact varies, with Niger experiencing the largest proportional increase (over 90%) and Nigeria the largest absolute increase (more than 300 additional deaths). Sensitivity analyses confirm that the results are robust to alternative elasticity scenarios. The findings illustrate the degree to which maternal health outcomes in fragile settings are sensitive to financing discontinuities. The results are presented as conditional estimates and are intended to inform ongoing discussions on health financing sustainability, transition planning, and risk mitigation.

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Publication Details

Journal
Health Policy and Planning
Published
2026-03-07
DOI
https://doi.org/10.1093/heapol/czag034
Primary Topic
Global Health Care Issues
Type
article
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article

Aid Cut, Lives Lost: Estimating the Impact of USAID’s Withdrawal on Maternal Mortality in Six African Countries

Matthew Cummins
Health Policy and Planning
Global Health Care Issues
article

Aid Cut, Lives Lost: Estimating the Impact of USAID’s Withdrawal on Maternal Mortality in Six African Countries

Matthew Cummins
article en

Abstract

In January 2025, the United States government suspended and subsequently terminated the majority of United States Agency for International Development (USAID) programs. This study estimates the impact of that decision on maternal mortality in six highly vulnerable countries in West and Central Africa: Burkina Faso, Central African Republic, Chad, Mali, Niger, and Nigeria. Using a deterministic model grounded in regional health expenditure elasticities, the analysis projects how the sudden withdrawal of foreign aid affects health spending among populations in humanitarian need, under the assumption that no immediate domestic or external financing substitutes for the lost resources, and the resulting changes in maternal mortality ratios (deaths per 100,000 live births). The results indicate that the funding cuts could cause maternal deaths to increase by 45%, on average, among populations in need. This increase is estimated relative to a baseline of approximately 2,900 maternal deaths predicted in 2025, yielding approximately 1,000 additional deaths across the countries within a single year. The magnitude of impact varies, with Niger experiencing the largest proportional increase (over 90%) and Nigeria the largest absolute increase (more than 300 additional deaths). Sensitivity analyses confirm that the results are robust to alternative elasticity scenarios. The findings illustrate the degree to which maternal health outcomes in fragile settings are sensitive to financing discontinuities. The results are presented as conditional estimates and are intended to inform ongoing discussions on health financing sustainability, transition planning, and risk mitigation.

Health Policy and Planning
United Nations Population Fund (US)
Partnerships for the goals
Openalex Percentile: Top 31%
Global Health Care Issues
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