Unsafe abortions and no antenatal care: aid cuts hit women hardest in one of Africa’s poorest countries

Ablue, burgundy and white patterned wrapper hides the swell of Joanna Banda’s belly. Eight months pregnant, she has had just three of the five antenatal appointments she should have had. She is unlikely to attend her final three either, as she still has to save 3,000 kwacha (£1.28) for a bicycle to take her six miles on rutted dirt tracks to the nearest health centre when she goes into labour.

In remote villages in Malawi, pregnant women such as 22-year-old Banda, who has one child after losing her first soon after giving birth, are struggling to get the medical care they need.

In January, US aid cuts abruptly ended a rural healthcare outreach programme that was starting to reduce the number of local women dying in childbirth.

Momentum Tikweze Umoyo, a five-year $28m (£20m) programme aimed at cutting maternal and infant mortality rates in five of Malawi’s 28 districts, was meant to last until 2027.

It is just one of the many casualties of Donald Trump’s decision to suspend foreign aid just hours after taking office in January, risking the lives of some of the world’s poorest, most vulnerable people. In July, Congress approved $9bn in cuts to aid and public broadcasting. Last month, the US president said he would be cancelling $4.9bn in aid already approved by Congress.

Kafulatira, where Banda lives, was once regularly visited by a mobile clinic, but villagers now have to walk 11 miles to the nearest health centre. 

A mobile clinic used to visit the community every month or so, providing a private space for women to get screening for cervical and other cancers, HIV tests and treatment, and vaccinations for children. It also provided antenatal checkups and family-planning services, including contraception.

“The outreach clinics were helping a lot, because we could access services right here in the village,” Mulirani Gerard says through a translator. “Since last year, we had been waiting for the team to come, so we were just wondering what had happened.” No one told villagers why their healthcare had been cut.

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Source: The Guardian, 25 September 2025