- 12/11/2013 : Teenage pregnancies and contraception access under spotlight at global summit
- 06/11/2013 : More than 7 Million Girls in Poor Countries Give Birth Before 18 Each Year, Finds New UNFPA Report
- 23/10/2013 : New service uses mobile phones to reduce maternal mortality
- 15/10/2013 : India seeks to regulate its booming 'rent-a-womb' industry
- 14/10/13 : Major Announcements Boost the Last Stretch of the Health Millennium Development Goals
- 10/10/2013 : UN: Global Child Deaths Down By Almost Half Since 1990
Reducing the number of teenage pregnancies and ensuring young women have access to contraception will be the focus of the largest global summit on family planning, which opens in Addis Ababa on Tuesday 12 November.
As The Guardian reports, the third international family planning conference aims to build on the momentum of last year's meeting in London, where donors pledged $2.6bn (£1.6bn) in new funding and committed to providing 120 million more women with access to modern contraceptives by 2020.
The Malawian president, Joyce Banda, Thai prime minister, Yingluck Shinawatra, and Melinda Gates are among the thousands of political leaders, philanthropists, medical experts and women's rights activists expected to attend.
"These are exciting times," said Ketchie Obagwu, senior expert on family planning at the UN Population Fund (UNFPA), who wants governments to present clear action plans on how to fulfil their promises.
06/11/2013 : More than 7 Million Girls in Poor Countries Give Birth Before 18 Each Year, Finds New UNFPA Report
LONDON/UNITED NATIONS, New York — More than 7 million girls in poor countries give birth before 18 each year, finds new UNFPA report - 2 million of them are 14 or younger.
Motherhood in childhood is a huge global problem, especially in developing countries, where every year 7.3 million girls under 18 give birth, according to The State of World Population 2013 , released today by UNFPA, the United Nations Population Fund.
For many rural expectant and new mothers, health care providers may be far away, but new technology is bringing them close through the mobile phone, now almost ubiquitous even in the poorest corners of the world.
This could save many of the 800 women a day who die of preventable problems related to pregnancy and childbirth, most of them in developing countries. Growing evidence indicates that many of these deaths could be avoided through better information and access to skilled birth attendants - or urgent care helped by the use of mobile phones and messaging services.
Mobile technology also can assist a new mother by providing information geared to the exact age of her child through its first year of life. This is a way to reduce child mortality which – though much lower than in 1990 – still runs at 18,000 under-five-year-olds a day. Sub-Saharan Africa has shown the least progress in reducing the number of deaths of infants in the first month of life.
Access to information and communications technology (ICT) is not a problem in most of the developing world. Mobile phone networks now cover 96 percent of the world's population, with 77 percent of the subscriptions held by nearly 90 percent of the population in low and middle-income countries. Even in places where electricity is in short supply, mobile phone users charge their phones through batteries, solar power and charging stations at rural stores, and are regular users.
As a result, services offering mobile health care information are proliferating. The newest, Zero Mothers Die, launched its service last week to improve maternal, newborn and child health by providing pregnant women and new mothers with mobile health information.
Dressed in a green surgical gown and cap, British restaurateur Rekha Patel cradled her newborn daughter at the Akanksha clinic in northwestern India as her husband Daniel smiled warmly, peering in through a glass door. "I can't believe we have our own child at last," said Patel, 42, gazing in wonderment at five-day-old Gabrielle. "We are really grateful to our surrogate mother who managed to get pregnant and kept our little daughter healthy. She gave nine months of her life to give us a child."
It is the perfect promotion for India's booming surrogacy industry that sees thousands of infertile couples, many from overseas, hiring the wombs of local women to carry their embryos through to birth.
We often question whether big international meetings achieve enough to justify the expense and trouble. But the news in September from New York suggests that, at the very least, global meetings create peer pressure on donors and a real sense of urgency.
Two major funding announcements have been made, both of which should result in lives saved. They’re particularly welcome because they’re focused on helping poor countries accelerate progress towards the current Millennium Development Goals (MDGs), which only have two years left to run.
The World Bank’s commitment to spend an additional $700m from its IDA fund – which lends or grants money to the poorest countries – on maternal and child health is very welcome.
Although we’ve made huge progress on child survival since the MDGs were signed in 2000 – with a 47% drop in under-five deaths since 1990 – there remains so much more to be done. MDG4 (on child mortality) is off-track both globally and in most countries, and more than 6 million children under five died last year. Rightly the Bank highlights the scandal of lack of access to skilled birth attendance.
Bank President Jim Yong Kim is giving global leadership to the movement for Universal Health Coverage, and this funding helps to build maternal and child health as the core of essential primary care.
5 million lives
Separately, the UK has announced a new pledge to the Global Fund to Fight AIDS, TB & Malaria of £1 billion over three years. MDG 6 on HIV and infectious diseases helped to galvanise the world to create the Global Fund.
While it’s had its fair share of problems, no one disputes that the Global Fund delivers results: more than 5 million people are alive today because they’re on antiretroviral drugs it paid for. The Global Fund’s money has helped 2 million women give birth with treatment that prevents transmission of the virus to their babies.
Britain’s support has been exemplary ever since its crucial role in establishing the Global Fund in 2002. Yesterday’s news – alongside generous commitments from the United States and Nordic countries – is intended to encourage other donors not to turn their backs.
Much more to do
The job is far from done on the MDGs. And we need even greater ambition for the period in the post-2015 framework that will set in place the next set of development goals. But continued financial support for institutions such as the Global Fund and the World Bank’s IDA fund is a key way to help countries wanting to build systems that can deliver universal health coverage – the best way to end the scandal of unnecessary deaths.
Other donors need to do the same as the UK and World Bank. Getting world leaders together appears to focus their minds and heighten their ambition.
Justin Forsyth - Chief Executive Officer, Save the Children UK, September 2013
NEW YORK/GENEVA, 13 September 2013 – In 2012, approximately 6.6 million children worldwide – 18,000 children per day – died before reaching their fifth birthday, according to a new report by UNICEF, the World Health Organization (WHO), the World Bank Group and the United Nations Department of Economic and Social Affairs/Population Division. This is roughly half the number of under-fives who died in 1990, when more than 12 million children died.
“This trend is a positive one. Millions of lives have been saved," said Anthony Lake, UNICEF Executive Director. "And we can do still better. Most of these deaths can be prevented, using simple steps that many countries have already put in place – what we need is a greater sense of urgency.”
The leading causes of death among children aged less than five years include pneumonia, prematurity, birth asphyxia, diarrhoea and malaria. Globally, about 45 per cent of under-five deaths are linked to undernutrition.
About half of under-five deaths occur in only five countries: China, Democratic Republic of the Congo, India, Nigeria, and Pakistan. India (22 per cent) and Nigeria (13 per cent) together account for more than one-third of all deaths of children under the age of five.
Newborn children are at particularly high risk
“Care for mother and baby in the first 24 hours of any child’s life is critical for the health and wellbeing of both,” says Dr. Margaret Chan, Director-General at WHO. “Up to half of all newborn deaths occur within the first day.”
The lives of most of these babies could be saved if they had access to some basic health-care services. These include skilled care during and after childbirth; inexpensive medicines such as antibiotics; and practices such as skin-to-skin contact between mothers and their newborn babies and exclusive breastfeeding for the first six months of life.
While the global average annual rate of reduction in under-five mortality accelerated from 1.2 per cent a year for the period 1990-1995 to 3.9 per cent for 2005-2012, it remains insufficient to reach Millennium Development Goal 4 which aims to reduce the under-five mortality rate by two-thirds between 1990 and 2015.
Sub-Saharan Africa, in particular, faces significant challenges as the region with the highest child mortality rates in the world. With a rate of 98 deaths per 1000 live births, a child born in sub-Saharan Africa faces more than 16 times the risk of dying before his or her fifth birthday than a child born in a high-income country.
However, sub-Saharan Africa has shown remarkable acceleration in its progress, with the annual rate of reduction in deaths increasing from 0.8 per cent in 1990-1995 to 4.1 per cent in 2005-2012. This is the result of sound government policies, prioritized investments and actions to address the key causes of child mortality and reach even the most difficult to reach populations.
Global and national action to improve child health
Both globally and in countries, a series of initiatives are in place aimed at improving access to maternal and child health care, inspired by the United Nations Secretary-General’s widely endorsed Global Strategy for Women’s and Children’s Health, which aims to save 16 million lives by 2015 through a “continuum of care” approach.
As part of this strategy, focus on specific areas is given through:
- A Global Vaccine Action Plan that is working towards universal access to immunization by 2020. Vaccination against preventable diseases is one of most effective country-driven and globally-supported actions, as it currently averts an estimated two to three million deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. In 2012, an estimated 83 per cent (111 million) of infants worldwide were vaccinated with three doses of diphtheria-tetanus-pertussis (DTP3) vaccine.
- Some 176 countries have signed on to A Promise Renewed – the call to action spearheaded by the Governments of Ethiopia, India and the United States, together with UNICEF in a global effort to stop children from dying of causes that are easily prevented.
- The United Nations Commission on Life-Saving Commodities for Women and Children is helping countries improve access to priority medicines such as basic antibiotics and oral rehydration salts.
- Earlier this year, WHO and UNICEF joined other partners in establishing a new Global Action Plan for Pneumonia and Diarrhoea which aims to end preventable child deaths from these two major killers of under-fives by 2025. The plan promotes practices known to protect children from disease, such as creating a healthy home environment, and measures to ensure that every child has access to proven and appropriate preventive and treatment measures.
- Similarly, partners are working on Every Newborn: a global action plan to end preventable deaths. The aim is to launch this global newborn action plan in May 2014 and provide strategic directions to prevent and manage the most common causes of newborn mortality, which account for around 44 per cent of all under-five mortality.
Jeffrey Sachs writes: A special event at the UN General Assembly on Sept 25, 2013 marks a bridge between the Millennium Development Goals (MDGs) to the end of 2015 and the Sustainable Development Goals (SDGs) that presumably will run from 2016 to 2030. The special event will address urgent actions to accelerate progress to the MDGs over their remaining 2 years, while setting a timeline and diplomatic framework for creating the post-2015 development agenda. For many, the UN processes seems convoluted, or even irrelevant, but what is taking shape has the potential to help humanity make an urgent change of course to address the deep and interconnected economic, social, and environmental challenges the world faces.
The MDGs have been the most successful global undertaking in history to coordinate action to fight extreme poverty in all its forms: income, hunger, disease, lack of schooling, and deficient basic infrastructure. Most importantly, they have helped sub-Saharan Africa to enter an era of economic growth and disease reduction by focusing domestic and international policies, expertise, and finance on recalcitrant challenges, such as AIDS, tuberculosis, malaria, low farm yields, and children out of school. The MDGs have mobilised an unprecedented focus on the global poor by promoting the cancellation of unaffordable debts; prompting the establishment of new organisations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria; and encouraging new technologies for diagnostics, medicines, supply chains, microfinance, and infrastructure. They will not be met in full, but the MDGs have made their mark despite the hurdles of wars, the global financial crisis, tax evasion, and debilitating corruption in rich and poor countries alike.
It was in the context of this MDG-inspired progress that member states at the Rio+20 UN Conference on Sustainable Development, in June, 2012, committed to adopt global goals based on a holistic, sustainable development framework addressing the key challenges faced by all countries. On the 20th anniversary of the Rio Earth Summit, world leaders contemplated a dire reality: the gains in fighting poverty, and indeed generations of economic gains, are at serious threat of reversal unless deep structural crises of rising social inequality and rapid environmental degradation are finally addressed. They noted that three climate treaties adopted in 1992 at the Rio Earth Summit—the United Nations Framework Convention on Climate Change, the Convention on Biological Diversity, and the United Nations Convention to Combat Desertification—had failed to translate into transformative action on the ground. They concluded, rightly, that only by committing the world to ending extreme poverty while also placing social and environmental concerns into an expanded set of SDGs would there be the chance to mobilise urgent global action by governments, business, and civil society. Hence came their unanimous call for a new set of SDGs to follow the MDGs.
The complexity of the global negotiations to put the SDGs into practice may seem daunting, even self-defeating. The UN's leadership and its 193 member states have embarked on an unprecedented scale of consultations and negotiations that will last until 2015. Secretary-General Ban Ki-moon received several reports on how best to proceed, including from a High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, and from various international groups, including one that I lead on behalf of the Secretary-General, the Sustainable Development Solutions Network. He has recently issued his own report on the post-2015 development agenda to the UN General Assembly. In parallel, the UN member states created working groups to propose the specific SDGs; to examine financial options to meet them; and to establish a new high-level political forum that will put heads of state and government in the lead to oversee the implementation and monitoring of the SDGs.
Despite the ongoing negotiations, there is already near universal assent on key aspects of the emerging SDGs. The new goals should be centred on sustainable development, meaning the integration of economic, social, and environmental objectives. The highest priority of the new goals should be the end of extreme poverty in all its forms by 2030, completing the work begun by the MDGs. The SDGs should be universal and apply to all countries although placed in local context. This universality is especially relevant for environmental goals, on which rich countries have so far not met their global responsibilities. Yet it is also true of the emerging social goals, given that many rich countries have had a deterioration of social capital and a decline of social mobility in the past generation under the forces of globalisation, rapid technological change, and often-errant politics. The post-2015 agenda should also include the means of implementing the SDGs, including financing, technology, monitoring, and political accountability.
Cynics scoff at this flurry of activity, doubting that the mere statement of new global goals could make much difference in the face of powerful economic and political forces that treaties have been unable to affect. The cynics are wrong. Like the MDGs, the SDGs can provoke a new global awareness of needs and of possibilities on a global scale. Part of the story is generational: millions of young people around the world want to reshape the world for their own survival. The doubters underestimate the power of the SDGs to help harness breakthroughs in information, communications, materials, and biological technologies to solve problems of energy, water, food production, and universal access to health, education, and financial services.
There is the real possibility of a gathering revolution. Strong voices from across the world are coalescing around a new approach: SDGs to help the rising generation to set the global priorities they will need for a safe harbour for their societies and for the planet. The new goals can also mobilise and inspire leaders from business, civil society, and government to work together on solving deep and complex challenges. Time is short, the negotiations are laborious, and significant work remains to build the needed trust and consensus on priorities, yet the meetings taking place this week at the UN have the chance to make a profound positive contribution.
Published in The Lancet 21 September 2013
"Women are not dying because of untreatable diseases. They are dying because societies have yet to make the decision that their lives are worth saving". Mahmoud Fathalla
A recent Article in the Lancet, Ending preventable maternal deaths: the time is now, quotes the challenging statement above from Mahmoud Fathalla, past president of the International Federation of Obstetricians and Gynaecologists and former Chair of the WHO Advisory Committee on Health Research.
The global community is urged to commit to ending preventable maternal deaths and reducing the maternal mortality ratio to less than 50 per 100,000 live births by 2035.
Bustero et al, in the Lancet article, stress the need for new strategies to help achieve rapid reductions in maternal mortality, together with the initial requirement of collection of data regarding the causes and conditions of every maternal death. They also discuss the necessity for strategies that can be adapted to specific local causes of maternal mortality and implementation that responds to changing demographics.
Read Ending preventable maternal deaths: the time is now in full.
A new UN Report says that Sub-Saharan Africa and southern Asia lag behind rest of world, with targets on child and maternal deaths, and sanitation significantly off-target.
Millions of lives have been saved and improved as several millennium development goals (MDGs) have been met or are within reach, but bolder action is needed in many areas.
Although the goal of halving the proportion of people living on $1.25 a day was met five years ahead of schedule, 1.2 billion people still live in extreme poverty. In sub-Saharan Africa, almost half of the population live on less than $1.25 a day. It is the only region in which the number of people living in extreme poverty rose steadily, from 290 million in 1990 to 414 million in 2010, accounting for more than a third of destitute people worldwide.
Though targets on halving the number of people living in extreme poverty and on access to clean drinking water have been met, progress on the eight MDGs, which have a number of sub-targets, has been uneven between regions and countries, and within countries, according to this year's annual progress report. A total of 83% of people without access to drinking water live in rural areas.
The MDGs on which progress is lagging most are education- and health-related. Global targets for infant, under-five and maternal mortality – and, to a lesser extent, access to basic sanitation – are significantly behind.
The mortality rate for children under five dropped by 41% – from 87 deaths per 1,000 live births in 1990 to 51 in 2011, or 14,000 fewer deaths per day. That means 6.9 million children under five died in 2011, mostly from preventable diseases. The report said efforts must be redoubled to meet the target of reducing the under-five mortality rate. India and Nigeria account for more than a third of all deaths of children under five. Only eight of 49 countries in sub-Saharan Africa are expected to achieve the MDG target, if trends continue.
The maternal mortality rate fell by 47% over the past two decades, from 400 maternal deaths per 100,000 live births to 210 between 1990 and 2010. This falls far short of the target of reducing the rate by three-quarters. Southern Asia and sub-Saharan Africa have the highest levels of maternal mortality. In 2011, only 36% of pregnant women in southern Asia and 49% in sub-Saharan Africa received at least four antenatal care visits – the minimum recommended by the World Health Organisation.
Access to reproductive health services is divided along urban-rural lines. In 2011, only 53% of births in rural areas were attended by skilled health workers, compared with 84% in urban areas.
Edited from the Guardian’s article published, 1 July 2013.
- 27/06/2013 : Women and Children First and partners announce 1,000 newborn lives saved
- 17/06/2013 : Countdown 2015 launches 2013 Update on Accountability for Maternal, Newborn & Child Survival
- 13/06/2013 : Investing in women's reproductive health: Closing the deadly gap between what we know and what we do
- 12/06/2013 : Measuring Coverage in Maternal, Newborn and Child Health
- 22/05/2013 : Newborn deaths down by a third in Bangladesh
- 17/05/2013 : New evidence to save mothers’ lives!
- 13/03/2013 : Join us in May at Women Deliver!
- 25/02/2013 : A Manifesto for Maternal Health Post-2015
- 16/01/2013 : In India Preference for Sons Undermines Desire for Smaller Families
- 08/01/2013 : UK Government launches Violence Against Women initiative
BBC Radio 4 Appeal – Sunday 8th DecemberKathy Lette, bestselling author, writer, social commentator and Patron of Women and Children First, presents our BBC Radio 4 Christmas Appeal.
The Appeal will was broadcast on Radio 4 at 07.55 & 21.26 on Sunday 8 December 2013, repeated Thursday 12 December at 15.27. Please listen to the Radio 4 appeal or donate direct to us.