EDITORIALS
Women's and children's health: from pledges to action
Flavia BustreoI,*; Julio FrenkII
IPartnership for Maternal, Newborn and Child Health, World Health Organization, 20 avenue Appia, 1211, Geneva, 27, Switzerland
IIHarvard School of Public Health, Boston, United States of America
It has been a landmark year for the health of women and children. The world is making important progress in reducing the number of children dying from preventable causes. After six decades of little progress in reducing under-five mortality to less than 10 million, this past decade has seen a steady decline in child deaths.1,2 The publication of new maternal mortality data confirmed that since 1990 there has been a decline of one-third in the numbers of women dying in childbirth,3,4 showing that progress on Millennium Development Goal 5 is being made.
For the first time - through the Muskoka Initiative led by the Canadian Government - heads of state of the group of 8 countries (G8) committed US$ 5 billion to improving maternal, child and newborn health. The African Union summit focused on "Maternal and Child Health and Development in Africa" and committed to action in their countries through a coordinated campaign to be delivered by the African Union Commission and a new task force that will review progress every year until 2015. The United Nations General Assembly discussed the theme in a special event at which the Secretary-General launched a Global Strategy for Women's and Children's Health, developed with the support and facilitation of the Partnership for Maternal, Newborn and Child Health.5
The main objective of this strategy is to save 16 million lives by 2015 by integrating service delivery and funding platforms, involving a wide range of stakeholders, research and innovation, and tracking progress through an accountability framework.
Planned outcomes include: 43 million new users having access to comprehensive family planning and 19 million more women giving birth attended by a skilled health worker with access to necessary infrastructure, drugs, equipment and regulations. The strategy is designed to ensure that 2.2 million additional neonatal infections are treated, 21.9 million additional infants are breastfed, 15.2 million more children are fully immunized in the first year of life and that 117 million more children aged less than five years receive vitamin A supplements. To deliver these interventions, 85 000 more health facilities and up to 3.5 million additional health workers are needed.
Success will mean saving the lives of more than 15 million children aged less than five years and of 570 000 women endangered by complications of pregnancy and childbirth, including unsafe abortion. The strategy will prevent 33 million unwanted pregnancies, protect 88 million children aged less than five years from stunting and protect 120 million children from pneumonia.
To reach these objectives, governments from developing and developed countries, foundations, civil society organizations, academics, health-care professionals and the private sector pledged more than US$ 40 billion and made policy and service delivery commitments at the United Nations special event.
To begin the process of transforming pledges to action, all these groups will participate in this month's Forum of The Partnership for Maternal, Newborn and Child Health, hosted by the Government of India.
The lives of women and children depend on the choices that are available to them to determine their health and to realize their rights. Only if women are fully empowered with the knowledge and means to take action for themselves and their children will this transformation succeed. At the global level, these actions depend on the availability of effective, efficient and equitable mechanisms for funding and service delivery.
One of the key outcomes of the Forum will be agreement on the principles and actions required to ensure mutual accountability for realizing the results to which all stakeholders committed themselves in the Global Strategy. Tracking commitments and ensuring accountability will require actions at many different levels - community, national, agency and international. The World Health Organization has been tasked to chair a process to determine the most effective arrangements for global reporting, oversight and accountability on women's and children's health.5 The Partnership for Maternal, Newborn and Child Health brings together many of the key global institutions and actors - governments, United Nations organizations, donor agencies, professional associations, academics and civil society - who will need to carry out the work.
We see the Forum as an opportunity for all partners to take inspiration from the landmark events of 2010 for women's and children's health. We then need to reinvigorate our efforts and hold each other accountable if we are to realize our shared global commitments to health, development and human rights.
Acknowledgements
We thank Dr Shyama Kuruvilla for her valuable inputs and comments.
References
1. Levels and trends in child mortality; report 2010. New York: United Nations Children's Fund; 2010.
2. Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Levin-Rector A, Dwyer L et al. Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970-2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet 2010;375:1988-2008. doi:10.1016/S0140-6736(10)60703-9 PMID:20546887
3. Trends in maternal mortality: 1990 to 2008. Geneva: World Health Organization; 2010.
4. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010;375:1609-23. doi:10.1016/S0140-6736(10)60518-1 PMID:20382417
5. Global Strategy for Women's and Children's Health. New York; United Nations; 2010. Available from: http://www.who.int/pmnch/activities/jointactionplan/en/index.html [accessed 11 October 2010] .
* Correspondence to Flavia Bustreo (e-mail: bustreof@who.int).