Full document: Global Strategy for Women's and Children's health
Working together to accelerate progress
Key elements of the Global Strategy
We know what works. Women and children need an integrated package of essential interventions and services delivered by functioning health systems. Already, many countries are making progress. In Tanzania, for instance, deaths of children under five have fallen by 15-20% because of widespread use of interventions such as immunizations, vitamin A supplements and integrated management of childhood illness. Sri Lanka has reduced maternal mortality by 87% in the past 40 years by ensuring that 99% of pregnant women receive four antenatal visits and give birth in a health facility.
We know what we need to do. In line with the principles of the Paris Declaration, the Accra Agenda for Action and the Monterrey Consensus, all partners must work closely together in the following areas:
Country-led health plans. Partners must support existing, costed national health plans to improve access to services. Such plans cover human resources, financing, and delivery and monitoring of an integrated package of interventions.
A comprehensive, integrated package of essential interventions and services. Partners must ensure that women and children have access to a universal package of guaranteed benefits, including family-planning information and services, antenatal, newborn and postnatal care, emergency obstetric and newborn care, skilled care during childbirth at appropriate facilities, safe abortion services (when abortion is not prohibited by law), and the prevention of HIV and other sexually transmitted infections. Interventions should also include: exclusive breastfeeding for infants up to six months; vaccines and immunization; oral rehydration therapy and zinc supplements to manage diarrhea; treatment for the major childhood illnesses; nutritional supplements (such as vitamin A); and access to appropriate ready-to-eat foods to prevent and treat malnutrition.
Integrated care improves health promotion and helps prevent and treat diseases such as pneumonia, diarrhea, HIV/AIDS, malaria, tuberculosis, and non-communicable diseases. Stronger links must be built between disease-specific programs (such as for HIV/AIDS, malaria and tuberculosis) and services targeting women and children (such as the Expanded Programme on Immunization, sexual and reproductive health and the Integrated Management of Childhood Illness). Partners should coordinate efforts with those working in other sectors to address issues that impact on health, such as sanitation, safe drinking water, malnutrition, gender equality and women’s empowerment.
Health systems strengthening. Partners must support efforts to strengthen health systems to deliver integrated, high-quality services. They should extend the reach of existing services, especially at the community level and to the underserved, and manage scarce resources more effectively. They also need to build more health facilities to give vulnerable people access to medical expertise and drugs.
Health workforce capacity building. Partners must work together to address critical shortages of health workers at all levels. They must provide coordinated and coherent support to help countries develop and implement national health plans that include strategies to train, retain and deploy health workers.
Coordinated research and innovation. Partners must find innovative ways to provide high-quality care and to expand research programs that develop new interventions, such as vaccines, medicines and diagnostic devices. They must develop, fund and implement a prioritized and coordinated global research agenda for women’s and children’s health, and strengthen research institutions and systems in low- and middle-income countries.
The “Global Consensus for Maternal, Newborn and Child Health” (see Figure 1), developed and adopted by a wide range of stakeholders, lays out an approach to speed up progress. It highlights the need to align policies, investment and delivery around a cohesive set of priority interventions across what health professionals call the continuum of care, and offers a framework for stakeholders to take coordinated action.
Figure 1. The global consensus for Maternal, newborn and child health
Women’s and children’s health and the Millennium Development Goals
Eradicate extreme poverty and hunger (MDG 1). Poverty contributes to unintended pregnancies and pregnancy-related mortality and morbidity in adolescent girls and women, and under-nutrition and other nutrition-related factors contribute to 35% of deaths of children under five each year, while also affecting women’s health. Charging people less for health services reduces poverty and makes women and children more willing to seek care. Further efforts at the community level must make nutritional interventions (such as exclusive breastfeeding for six months, use of micronutrient supplements and deworming) a routine part of care
Achieve universal primary education (MDG 2). Gender parity in education is still to be achieved. It is essential because educated girls and women improve prospects for the whole family, helping to break the cycle of poverty. In Africa, for example, children whose mothers have been educated for at least five years are 40% more likely to live beyond the age of five. Schools can serve as a point of contact for women and children, allowing health-related information to be shared, services offered and health literacy promoted.
Promote gender equality and empower women (Mdg 3). Empowerment and gender equality improve the health of women and children by increasing reproductive choices, reducing child marriages and tackling discrimination and gender-based violence. Partners should look for opportunities to coordinate their advocacy and educational programs (including those for men and boys) with organizations focusing on gender equality. Shared programs might include family-planning services, health education services, and systems to identify women at risk of domestic violence.
combat HIV/AIDS, malaria and other diseases (MDG6). Many women and children die needlessly from diseases that we have the tools to prevent and treat. In Africa, reductions in maternal and childhood mortality have been achieved by effectively treating HIV/AIDS, preventing mother-to-child transmission (PMTCT) of HIV and preventing and treating malaria. We should coordinate efforts on such interventions by, for example, integrating PMTCT into maternal and child health services and ensuring that mothers who bring children for immunization are offered other essential interventions
Ensure environmental sustainability – safe drinking water and sanitation (MDG 7). Dirty water and inadequate sanitation cause diseases such as diarrhea, typhoid, cholera and dysentery, especially among pregnant women, so sustainable access to safe drinking water and adequate sanitation is critical. Community-based health efforts must educate women and children about sanitation and must improve access to safe drinking water.
Develop a global partnership for development (MDG 8). Global partnership and the sufficient and effective provision of aid and financing are essential. In addition, collaboration with pharmaceutical companies and the private sector must continue to provide access to affordable, essential drugs as well as to bring the benefits of new technologies and knowledge to those who need them most.