Welcoming new signs of progress in reducing child and maternal mortality

Joint Comment: The Partnership and World Health Organization

Dr Flavia Bustreo, Assistant Director-General, World Health Organization

Dr Carole Presern, Director, The Partnership for Maternal, Newborn & Child Health

20 SEPTEMBER 2011 | NEW YORK, GENEVA - This month, we welcome new estimates confirming continued progress in the march towards reaching Millennium Development Goals 4 and 5, relating to the reduction of child and maternal mortality.

The under-five child mortality estimates produced by the UN and the Institute for Health Metrics and Evaluation (IHME) each point to steady progress, with the UN estimating 7.6 million deaths per year (2010) and IHME estimating 7.2 million (2011), declining from more than 12 million deaths per year in 1990. The rate of reduction has been picking up pace, as well, especially in sub-Saharan Africa, where the pace of change has doubled since 1990, averaging a 2.4% decline in child deaths per year during 2000-2010.

That’s news to cheer, and an important marker of progress in the dedicated effort to save the lives of millions of young children each year.

We’re on the right track, yet we’re not moving nearly fast enough. Only nine countries from the developing world are on track to meet both MDGs 4 and 5 by 2015. Meanwhile, the global burden is increasingly lopsided. Sub-Saharan Africa now bears 49% of all under-five deaths – up from 33% in 1990.

That’s why the many financial, policy and service-delivery commitments made to advance the Global Strategy for Women’s and Children’s Health are so important, especially those made by governments of high-burden countries themselves. As of now, 44 of the world’s 49 poorest countries have pledged to address maternal and child mortality in support of the goals set out by the Global Strategy. The new PMNCH 2011 report, published this week, shows that these commitments address a broad range of needs, from removing user fees to allow access to care to increasing midwifery training and investment in health clinics.

Yet commitments must be followed by implementation and results for women and children. Evidence of progress is essential if we are to continue to mobilize effectively for change, and to ensure accountability on the part of us all.

Strong health information systems are critical to tracking progress and keeping promises, as the Commission on Information and Accountability for Women’s and Children’s Health underlines. In its final report, delivered this week at the UN, the Commission recommends that by 2015, all countries should take “significant steps to establish a system for registration of births, deaths and causes of deaths, and have well-functioning health information systems that combine data from facilities, administrative sources and surveys”. The Commission will be followed by an independent Expert Review Group to report regularly from 2012 to 2015 to the UN Secretary-General.

Moving forward, real-time data will reduce the need to rely on estimates, and will guide us more effectively in improving our policies and programmes, and in honouring our commitments to the Global Strategy. Innovative technologies and management approaches will be essential in helping that happen.

Women and children are beginning to receive the attention they have so long deserved. With 2015 now clearly in sight, reliable data on progress is essential to driving us ever faster forward.

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