Resolution must put preventable deaths behind us
Many regions continue to experience persistently high rates of maternal and child mortality.
Global progress on improving maternal, newborn and child survival has stalled. Many regions continue to experience persistently high rates of maternal and child mortality and, despite improvements in 2000-2015, progress is stagnating.
The combination of ongoing and new conflicts, climate change and the impact of the Covid-19 pandemic create a perfect storm to drive back any gains made during the Sustainable Development Goal (SDG) era.
The global community is off-track from SDG 3.1, on reducing maternal mortality, and SDG 3.2, on ending preventable deaths of newborns and children under five years. Some 287,000 women died from a maternal cause in 2020, averaging 223 per live birth, while 4-9 million children under five died in 2022, with 2-3 million of them in the first month.
There were 1-9 million stillbirths in 2021. The stark reality is that 46 countries are projected to record more than 140 maternal deaths per 100,000 live births by 2030, when 59 will miss the SDG target for mortality for children under five and 64 miss the neonatal mortality target.
Maternal deaths
Tragically, many of these deaths are preventable. Over 70 per cent of maternal deaths are due to obstetric causes—like hypertension, sepsis, unsafe abortion and embolism. Prematurity is the leading cause of under-five child mortality, the others being birth trauma and asphyxia, acute respiratory infections, malaria, diarrhoea and congenital anomalies.
It is an indictment of the global health community that we know these facts and have done very little about them. There is a myriad approaches that could be tailor-made for each challenge but the political will to do so has been lost. This is why the World Health Assembly Resolution on maternal, newborn and child health is crucial.
Initiated by Somalia, it is co-sponsored by Botswana, Djibouti, Ethiopia, Egypt, Kenya, Lebanon, Nigeria, Paraguay, Sierra Leone, South Africa, and Tanzania. It is going through consultation with growing support from other member states and we, as Health ministers, consider it to be essential to future progress in maternal and child survival.
It aims at tackling the persistent disparities in maternal, newborn and child health and accelerate progress and calls for urgent action on inequities across the life course to create resilient health systems focused on primary healthcare. It is a resounding call for prioritising maternal, newborn and child health in policy, service delivery and financing.
Empowered women
Healthy and empowered women, children and adolescents are central to the transformational change envisioned by the 2030 Agenda. Investing in their wellbeing leads to healthier communities, vibrant economies and more prosperous, peaceful and resilient societies. The entire continuum of care must always be considered, starting with the health and wellbeing of parents before conception and through all stages of life.
Fortunately, what works is known. Successful approaches include high-quality essential health and nutrition services; a multipronged approach to maximise resources and address workforce shortages; stronger primary healthcare delivery; prioritising the hardest-to-reach communities; and universal access to reproductive and sexual healthcare.
Dr Adam is the Minister for Health, Somalia. Dr Daba is the Minister for Health, Ethiopia. *This article was first published in ‘The Lancet’ .
