We know that the strength of a community depends on the strength of its mothers, and the fate of a child is inextricably tied to the health of its mother.
Great progress has been made in reducing the number of women who die in childbirth during the MDG era. Since 1990, the annual number of maternal deaths has decreased by 43%, from approximately 530,000 to 300,000 in 2015. This progress has been driven by several factors, including: an increase in percentage of births attended by skilled health personnel from 59% to 71%; a 17% increase in the proportion of women receiving adequate antenatal care; a decrease in the adolescent birth rate and improved access to contraception and family planning services.
Bringing an end to preventable maternal and newborn deaths is an ambitious but achievable target. To realize this target by 2030, the global maternal mortality ratio must fall to less than 70 per 100,000 live births, and newborn mortality rates must fall to 12 per 1,000 live births in every country.
The health tools and strategies capable of averting these deaths are well-documented, simple and affordable. However, this will require a rapid acceleration in access to antenatal care, institutional deliveries, skilled birth attendants, life-saving maternal health and nutrition commodities and family planning services, including modern methods of contraception to effectively prevent unwanted pregnancies.
Reaching these goals will require more than continuing on the current trajectory. The overall pace of scale-up of essential health and nutrition services will need to accelerate, particularly in areas where progress has been lagging, such as stillbirth prevention and maternal care in humanitarian and conflict “fragile” states – in these settings, a fifteen year old girl has a 3-fold higher risk of dying from a maternal cause, as compared to the global average. Integrated approaches to health and nutrition will be key – reaching adolescent girls and pre-pregnant women with the right interventions, from micronutrient supplementation to diagnosis of infectious disease, will help to ensure that her future children will achieve their full health and development potential.
Throughout the MDG time period, we have seen the impact that the delivery and use of a few affordable interventions can have on mortality, and we will aim to accelerate progress through new and existing funding mechanisms like the World Bank and the Global Financing Facility, UNFPA, USAID, the Micronutrient Initiative, as well as the private sector and foundations such as the Bill & Melinda Gates Foundation, Johnson & Johnson and Merck for Mothers. We also expect to see increased levels of domestic funding from countries that are transitioning from low- to middle-income.
The Office of the Special Envoy is actively engaged with the U.S. Agency for International Development (USAID)’s commitment to the goal of Ending Preventable Child and Maternal Deaths (EPCMD) within a generation through our involvement on the EPCMD Panel, which provides recommendations to USAID to help sharpen their work and achieve their EPCMD goals. In July 2013, USAID embarked on the Award Cost Efficiency Study (ACES), a comprehensive effort led by USAID Administrator Rajiv Shah to review USAID’s EPCMD program designs, funding mechanisms, and cost structures and to outline opportunities for USAID to enhance spending effectiveness and efficiency.
The ACES Blue Ribbon Panel (now called the EPCMD Panel) aided USAID’s Global Health Bureau in its implementation of this cost efficiency study and in focusing USAID’s work toward EPCMD. The Panel recommended the creation of the role of Child & Maternal Survival Coordinator with 3 priority areas:
- Continue to sharpen the Agency’s work toward EPCMD;
- Intensify external outreach and engagement;
- Increase financing for EPCMD.
An important component of USAID’s work was highlighted in the 2014 Acting on the Call: Ending Preventable Child and Maternal Deaths report, outlining an evidence-based plan to accelerate progress in USAID priority countries through 2020. USAID’s 2015 Acting on the Call report reviews progress against these targets and identifies areas where additional effort is needed.
Building on the momentum of the ACES Blue Ribbon Panel and progress, the EPCMD Panel continues to provide USAID with recommendations for each of the three priority areas to help USAID achieve its maternal and child health goals by 2020, and ultimately to end preventable maternal and child deaths within a generation.