Tackling Unsafe C-sections In Ethiopia



Working to reduce surgical site infections from C-sections with Lifebox’s Clean Cut Program.

More than 295,000 women die each year from complications that arise during or following pregnancy and childbirth. Of these deaths, 94% occur in low-resource settings and could have been prevented. 

There is no single intervention that can address all the causes of maternal deaths but Lifebox, with its aim to save lives through safer surgery, is focusing its efforts on improving the safety of C-sections – the most common surgical procedure performed in low-and middle-income countries. 

By adapting “Clean Cut’, our successful program shown to reduce surgical site infections (SSIs) by 35%, for C-section use, Lifebox is working to improve the safety of C-sections in Ethiopia. This work is part of the Bill & Melinda Gates Foundation‘s Grand Challenges initiative, funded by UBS Optimus Foundation. Read the release here.

“Surgical site infections from C-sections are a leading cause of harm for mothers in Ethiopia. By supporting Lifebox to adapt ‘Clean Cut’ – a proven program to reduce surgical infections – for C-sections, this grant funded by UBS Optimus Foundation as part of the Bill & Melinda Gates Foundation’s Grand Challenges initiative will enable Lifebox and partners to drive lasting improvements in maternal health across the country and, we hope, beyond.”

Dr. Tihitena Negussie Mammo, Lifebox Global Clinical Director and a surgeon based in Addis Ababa. 

A mother giving birth in Ethiopia is 23 times more likely to die than a mother giving birth in the United States (U.S.). This figure rises to 57 times more likely compared to a mother giving birth in the United Kingdom. The neonatal mortality rate in Ethiopia is over seven times that of the U.S. The majority of C-sections in Ethiopia are considered essential surgical procedures with an overall SSI rate following a C-section estimated at 9% and infections and complications following C-sections estimated to cause 15% of maternal deaths in the country. 

Lifebox is working with partners to adapt Clean Cut specifically to improve the safety of C-sections. The program will implement Clean Cut in ten maternity hospitals across Ethiopia, impacting the safety of 6,000 C-sections. 

“The Ethiopian Society of Obstetricians and Gynecologists is delighted to partner with Lifebox to tackle the morbidity and mortality faced by Ethiopian mothers from complications arising from cesarean sections. We see firsthand the toll this takes on families across our country and we look forward to implementing change.”

Dr. Mekdes Daba, President of The Ethiopian Society of Obstetricians and Gynecologists. 

As with all of Lifebox’s work, our aim is to reach scale, partnering with the Ethiopian Society of Obstetricians and Gynecologists, the Ethiopian Federal Ministry of Health, and Ariadne Labs – a joint center for health systems innovation at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health – to replicate this work across Ethiopia before scaling the approach in other resource-limited settings. 

“Clean Cut was able to leverage teamwork and multidisciplinary action to dramatically improve compliance with essential perioperative infection prevention standards. This improvement in adherence to such critical standards resulted in profound reductions in postoperative infections. This Grand Challenge Initiative allows for a rigorous study of Clean Cut and its impact on the safety of C-sections”

Dr. Thomas Weiser, Program PI, Consulting Medical Officer of Lifebox and an Associate Professor of Surgery at Stanford University.

Thank you to the Bill & Melinda Gates Foundation Grand Challenges initiative and UBS Optimus Foundation for supporting Lifebox’s work to improve the safety of emergency obstetric care in Ethiopia to save mothers’ lives