Funding Pullback, Births Turn Deadly

As Washington slashes foreign aid, pregnant Sudanese refugees in a remote corner of Central African Republic are now giving birth with almost no medical help, in a crisis our own government helped create.

Story Snapshot

Sharp cuts to United States and international aid are stripping already fragile clinics in Central African Republic of basic maternal care for Sudanese refugees.
Women in Central African Republic are about 40 times more likely to die in pregnancy or childbirth than women in the United States, and that risk is rising as funding dries up.^[3]
United Nations data show humanitarian plans for Central African Republic were less than 40% funded in 2025, with only 17% of the needed 2026 money in hand.^[2]^[5]
New research links sudden United States Agency for International Development (USAID) withdrawals in the region to a projected 45% jump in maternal deaths among vulnerable populations.^[1]

Maternal care in Central African Republic was already on the brink

Women in Central African Republic entered this crisis from a position of extreme vulnerability, long before the most recent aid cuts and the influx of refugees from Sudan.^[3]^[5] United Nations figures show that for every 100,000 births in Central African Republic, about 829 women die, making a woman there roughly 40 times more likely to die in pregnancy or childbirth than a woman in the United States.^[3] The World Health Organization’s regional analysis describes a protracted emergency driven by conflict, displacement, attacks on health facilities, and chronic underinvestment.^[5]

The same World Health Organization public health situation report notes that about 2.4 million people—around 38 percent of Central African Republic’s population—need humanitarian assistance, yet coverage remains critically low.^[5] In health alone, only 364,000 of the 666,000 people targeted had been reached, leaving nearly half without basic services.^[5] This is the fragile system Sudanese refugee mothers are walking into: distant clinics, short-staffed facilities, and frequent shortages of medicines and supplies that are essential for safe deliveries.

Sudan’s war drives refugees into an underfunded system

The armed conflict that erupted in Sudan in 2023 has devastated that country’s maternal health services, forcing tens of thousands to flee into neighboring states like Central African Republic.^[2]^[4] A United Nations Population Fund (UNFPA) brief on Sudan describes how war has destroyed hospitals, disrupted supplies, and pushed maternal mortality above 200 deaths per 100,000 live births, with many of these deaths considered preventable.^[4] As families escape the fighting, border towns and camps in places such as Birao suddenly shoulder the burden for prenatal care, emergency obstetrics, and newborn services.

UN media coverage of the Birao refugee camp shows how one small health facility now provides a wide range of reproductive and maternal health services for Sudanese refugees as well as local residents. That clinic is tasked with antenatal visits, safe deliveries, and postnatal care in a setting where roads are poor, security is fragile, and referral hospitals are far away.^[5] When international partners lack funds for staff, fuel, and supplies, the practical result is fewer functioning beds, fewer skilled birth attendants, and delayed transfers for complicated pregnancies.

Funding cuts are tightening the vise on pregnant refugees

Humanitarian appeals for Central African Republic are now badly underfunded, amplifying the danger for mothers and babies in refugee-hosting areas.^[2]^[5] The United Nations humanitarian office reports that the 2025 response plan for Central African Republic was less than 40 percent funded, a sharp drop from years when appeals were roughly 95 percent covered.^[2] By early 2026, only 17 percent of the 268 million dollars requested had been received, forcing aid groups to scale back or close programs that provide food, healthcare, and protection.^[2]

The World Health Organization’s public health analysis confirms that this shortfall translated into fewer people reached across sectors, with the number of beneficiaries in early 2025 down about 50 percent compared with the same period in 2024.^[5] Health projects were hit directly: of 1.8 million people targeted for assistance, only about 365,000 received any help in the first quarter of 2025.^[5] In practice, that means more pregnant women turned away from clinics, more stockouts of life‑saving drugs like oxytocin and antibiotics, and more high‑risk deliveries happening at home or on the road to distant facilities.

U.S. aid pullbacks add fuel to an already burning fire

New research now quantifies how United States aid decisions have intensified maternal health risks across Central African Republic and neighboring countries.^[1] A 2026 study in a peer‑reviewed global health journal estimated the impact of the January 2025 suspension and termination of most United States Agency for International Development (USAID) programs in six vulnerable West and Central African nations, including Central African Republic and Chad.^[1] Using regional data on how health spending affects maternal mortality, the authors projected how sudden donor withdrawal would affect deaths in humanitarian settings.^[1]

The model found that aid cuts could drive a roughly 45 percent average increase in maternal deaths among populations in need, translating to about 1,000 additional maternal deaths in 2025 above an already grim baseline.^[1] While the biggest absolute increases were projected for larger countries, Central African Republic and Chad were among those where fragile systems made mothers particularly sensitive to funding shocks.^[1] These findings echo warnings from humanitarian groups that United States foreign assistance reductions leave “patients around the world scrambling to understand how they can continue treatment” while providers struggle to keep essential services running.^[4]^[6]

Multiple crises converge on Sudanese mothers in Birao

Doctors on the ground describe how conflict, displacement, and resource gaps combine to create deadly conditions for pregnant women in Sudan and the wider region.^[6] In South Darfur, Doctors Without Borders reported a “shocking number” of preventable maternal and child deaths, driven by overcrowded camps, long travel distances, transportation costs, and insecurity that delays care.^[6] United Nations reporting from Sudan recounts health workers watching patients die because facilities lacked basic surgical supplies, antibiotics, sutures, gloves, or the capacity to handle overwhelmed caseloads.

UNFPA’s own strategy for maternal health emphasizes that reducing maternal deaths requires more than just money; it depends on mobile health teams, community health workers, emergency obstetric care, training, essential medicines, and broader health‑system strengthening.^[4] Yet every one of those components relies on predictable funding and secure logistics. When appeals for Central African Republic are only partially met, and when a major donor like the United States cuts or pauses programs, the weakest places—border camps like Birao—feel the effects first and hardest.^[2]^[5] For Sudanese refugee mothers there, the result is a narrowing path to safe childbirth.