Success stories in reproductive, maternal, newborn, child and adolescent health: a regional compendium from WHO South-East Asia Region

The WHO South-East Asia Region has achieved a commendable 71% reduction in under-5 mortality rate (U5MR) and 62% reduction in neonatal mortality rate (NMR) in 2018, from the baseline of 1990.1 The maternal mortality ratio in the Region has also declined by 71% between 1990 and 2017, which was the largest reduction among the WHO regions.2 This achievement allows us to move into the remaining decade of the SDGs phase with five of our Member States having already achieved the targeted U5MR of 25 per 1000 live births, four having achieved the targeted NMR of 12 per 1000 live births, three having achieved the targeted stillbirth rate of 12 per 1000 total births and two countries being on track to achieve the targeted MMR, as of 2019–2020.

However, the progress has been variable among the diff erent countries of the Region, wherein some countries have already achieved selected SDG targets while others need to accelerate mortality reduction to reach the target by the year 2030. In addition to the mortality reduction, countries also need to pay attention to the “Thrive” and “Transform” objectives of the Global Strategy (2016–2030) to support health and development of all women, children and adolescents across the life-course continuum to improve the quality

of their lives and develop an enabling environment towards societal transformation.

This progress in mortality reduction can be related to an increase in the coverage of known life-saving evidence-based interventions. The progress in scaling up coverage of such interventions varies across and within countries owing to wide disparities on account of social and economic factors such as wealth status, gender, education of women and geographical locations within the countries.

Several countries in the Region experience financial, human and other health system constraints for the health programmes for women, children and adolescents, which make it diff icult to achieve high coverage of life-saving, evidence-based interventions. Despite the challenges, it has been observed that Member States in the SEA Region have diverse strengths and capacities and have achieved progress in specific areas of reproductive, maternal, neonatal, child and adolescent health (RMNCAH) programmes by adopting eff ective and innovative approaches and have demonstrated success in specific areas. 

Defining “success” depends on the local context specific to a country. For example, while one country may consider achieving 90% implementation coverage of an RMNCAH intervention as “success”, another country may view even an introduction of the same service in the country’s policy dialogue as a reasonable success.