Women, newborns, children, and adolescents: life-saving momentum after a slow start

Moving forward: supremely ambitious targets

In 2012, encouraged by the substantial reduction in mortality for young children, the international community, spearheaded by the governments of Ethiopia, India and the USA, in collaboration with WHO, UNICEF and others, put forward a vision of ending preventable child deaths. That vision was later echoed in new targets for maternal mortality. Preparatory work for revising the maternal health component of the global strategy included a series of technical consultations convened by WHO. After broad discussions that tapped the views of country programme managers, scientists, donors and other partner agencies, consensus was reached on the bold vision of ending preventable maternal mortality. Based on five years of remarkable progress, the vision was considered both realistic and feasible.

Prevention of mother to child of hepatitis B, Peru

The resulting report on Strategies toward ending preventable maternal mortality set out the conviction that a “grand convergence” is within reach, in which the highest levels of maternal death can be reduced to rates now observed in the best-performing middle-income countries. Doing so required a firm emphasis on the ability to count every maternal and newborn death, equality in the provision of both quality clinical care and the reduction of risk factors in the wider social environment, and an understanding that maternal mortality is not solely a health and development issue, but also a sign of discrimination against women.

The strategy was further adjusted to address the “obstetric transition”, in which the primary causes of maternal death shift towards indirect causes as fertility and mortality decline. It called for a shift from an approach focused on emergency care for a minority of women to care focused on wellness for all. To help set realistic targets in line with each country’s unique situation, the strategy proposed a methodology for tracking progress based on the achievement of milestone values adjusted to reflect the country’s initial burden of maternal mortality as the starting point.

"The world has all the knowledge and technology needed to end preventable deaths among all women, children, and adolescents and to greatly improve their health and well-being."

Dr Chan, WHO Director-General

When the UN General Assembly approved the 2030 Agenda for Sustainable Development in September 2015, the updated Global Strategy for Women’s, Children’s and Adolescents’ health was simultaneously launched as a showcase platform for implementation of the Agenda’s ambitious targets and goals. Because the determinants of women’s and children’s health are so broad, the updated Global Strategy translated the holistic approach of the SDGs into a series of precise actions, ranging over multiple sectors and supported by an accountability framework, designed to meet the targets set for ending preventable deaths of newborns and young children and substantially reducing maternal mortality. Other targets that called for ending discrimination and violence against women and girls reflected areas where WHO studies had brought international attention to the related health harms, including the 2013 report of Global and regional estimates of violence against women and its subsequent health systems strategy for addressing interpersonal violence.

The strategy is supremely ambitious: the world has all the knowledge and technology needed to end preventable deaths among all women, children, and adolescents and to greatly improve their health and well-being , allowing them to realize their full human potential as a cornerstone of development. The effects of doing so will ripple throughout societies, contributing substantially to a more prosperous and sustainable future for all.

After a decade of sluggish then dramatic progress, women and children now have an agenda which makes their health needs a high priority and looks after them in a comprehensive and sustainable way. The political will to address the tragedy of millions of avoidable deaths each year has now fully arrived.