🟠 Moderate Evidence
Pregnant Sudanese women fleeing civil war face a staggering 138-fold higher risk of maternal death when seeking refuge in the Central African Republic compared to the European Union, according to The BMJ. The crisis highlights how conflict displacement compounds existing healthcare vulnerabilities, particularly for reproductive health services.
Key takeaways
- 36,414 Sudanese refugees have fled to CAR amid ongoing civil war
- Women in CAR face 138 times higher maternal mortality risk than EU countries
- Healthcare infrastructure remains severely undermined by international aid cuts
Maternal mortality disparities: CAR vs developed regions
Risk comparison for women in childbirth, 2026
Source: World Health Organization, 2026 | Georgian Medical Journal News
Displacement compounds maternal health vulnerabilities
The Birao District Hospital in the Central African Republic has become a critical refuge for pregnant Sudanese women seeking prenatal care after fleeing their homeland’s civil war. These women represent a fraction of the 36,414 Sudanese refugees who have crossed into CAR, according to UNHCR displacement data.
The journey to safety paradoxically exposes these women to heightened health risks. CAR’s maternal mortality ratio of approximately 829 deaths per 100,000 live births starkly contrasts with the European Union average of 6 deaths per 100,000 births, as reported by the World Health Organization.
Healthcare infrastructure under strain
The Central African Republic’s healthcare system faces multiple pressures that directly impact maternal health outcomes. The country’s medical infrastructure, already fragmented by decades of political instability, struggles to accommodate the influx of refugees requiring emergency obstetric care.
International aid reductions have exacerbated these challenges. Budget cuts from major donor countries including the UK and US have reduced funding for essential maternal health services, according to humanitarian organizations monitoring the region. This creates a perfect storm for women who have already survived the trauma of displacement.
Limited access to skilled birth attendants, essential medicines, and emergency obstetric care contributes to the stark mortality disparities. Many refugee women arrive at facilities like Birao District Hospital after traveling long distances without adequate prenatal monitoring. For more insights on migration and health challenges, our analysis explores similar patterns globally.
Regional context of maternal mortality crisis
The situation in CAR reflects broader patterns of maternal health vulnerability across conflict-affected regions in sub-Saharan Africa. Countries experiencing active conflict consistently show elevated maternal mortality ratios, with displaced populations facing the highest risks.
The Sudanese refugees in CAR represent just one population among millions of women worldwide who face reproductive health challenges during displacement. Their experiences highlight the urgent need for targeted maternal health interventions in humanitarian settings, particularly as conflicts continue to drive displacement across the region.
Women in the Central African Republic are 138 times more likely to die in childbirth compared to women in European Union countries, with refugee populations facing additional vulnerabilities.
— World Health Organization maternal mortality data, 2026
What this means
Frequently asked questions
Why is maternal mortality so high in CAR compared to developed countries?
Multiple factors contribute including limited access to skilled birth attendants, inadequate healthcare infrastructure, and reduced emergency obstetric care availability. Political instability and international aid cuts have further compromised the healthcare system’s capacity to provide safe delivery services.
How do refugee women access maternal healthcare in CAR?
Refugee women typically access care through district hospitals like Birao and health centers supported by humanitarian organizations. However, services are often limited by resource constraints, geographic barriers, and the overall fragility of CAR’s healthcare infrastructure.
What can be done to improve maternal health outcomes for refugee populations?
Solutions include strengthening emergency obstetric care capacity, training more skilled birth attendants, ensuring reliable supply chains for essential medicines, and developing sustainable financing mechanisms that don’t depend solely on volatile international aid flows.
The maternal health crisis facing Sudanese refugee women in CAR underscores the urgent need for comprehensive approaches to reproductive health in humanitarian settings. As conflicts continue to drive displacement across the region, protecting maternal health must remain a priority for both humanitarian responders and long-term development planning. Without sustained investment in healthcare infrastructure and emergency obstetric care, vulnerable populations will continue to face preventable maternal deaths at rates that starkly contrast with global health equity goals.
Source: Victims of war: Women seek refuge to deliver their babies
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.





