Countdown to 2015: New Report Documents Progress Towards MDG4 & 5 in 75 Countries

Guest post contributed by our colleagues at the Countdown to 2015 initiative

Since 1990, annual maternal deaths have declined by almost one half and the deaths of young children have declined from 12 million to 7.6 million in 2010.

Some of the world’s poorest countries have achieved spectacular progress in reducing child deaths. Rates of child mortality in many African countries have been dropping twice as fast in recent years as during the 1990s. In Botswana, Egypt, Liberia, Madagascar, Malawi, Rwanda and the United Republic of Tanzania, the rate of decline was on average 5 percent or more a year between 2000 and 2010.

Similar progress has been seen in reducing maternal deaths, although in fewer developing countries: Equatorial Guinea, Nepal, and Vietnam have each cut maternal deaths by 75 percent.

But all the news is not good. Every two minutes, somewhere in the world, a woman dies from complications of pregnancy and her newborn baby’s chances of survival are very poor. For every woman who dies, an additional 20-30 suffer significant and sometimes lifelong problems, as a result of their pregnancy.

In these same two minutes nearly 30 young children die of disease and illness that could have been prevented or effectively treated.

Many countries, especially in Africa and South Asia, are not making progress. Of the 75 countries with the highest burden of maternal and child mortality, 25 have made insufficient or no progress in reducing maternal deaths and 13 show no progress in reducing the number of young children who die.

Progress on maternal, newborn and child health, in the 75 highest-burden countries, most in Sub-Saharan Africa and South Asia, where more than 95 percent of all maternal and child deaths occur, has been laid out in a new 220-page report, Building a Future for Women and Children, which is published by the Countdown to 2015 initiative.

The report is authored by a global collaboration of academics and professionals from Johns Hopkins University, the Aga Khan University, the University of Pelotas in Brazil, Harvard University, London School of Hygiene and Tropical Medicine, UNICEF, the World Health Organization, UNFPA, Family Care International, and Save the Children. The secretariat of the Countdown to 2015 initiative is based at The Partnership for Maternal, Newborn & Child Health.

“The Countdown report shows the who, what, where — and most importantly the why — of maternal, newborn, and child survival,” says Zulfiqar Bhutta, M.D., PhD, of Aga Khan University, Pakistan, who is the co-chair of Countdown and an author of the report. “It offers a clear, consistent report card that countries, advocates, and donors can use to hold each other — and themselves — accountable for real, measurable progress.”

The report assesses the progress that the 75 highest-burden countries are making towards achieving UN Millennium Development Goals 4 & 5 (MDGs). These MDGs call for reducing maternal deaths by three-quarters and the deaths of children under 5 by two-thirds, both by 2015 compared to 1990 levels.

Countdown to 2015 reports were first published in 2005 to track the progress in the highest-burden countries, to identify knowledge gaps, and to promote accountability at global and national levels for improving maternal and child survival.

Since then, massive global attention and resources have been focused on Millennium Development Goals 4 and 5.

In 2010, UN Secretary General Ban Ki-moon launched a Global Strategy for Women’s and Children’s Health, an effort that has generated $40 billion in commitments to meet key goals supporting women’s and children’s health. These goals include more trained midwives, greater access to contraceptives and skilled delivery care, better nutrition, prevention of infectious diseases and stronger community education.

Notably, 44 of the world’s poorest countries — among them Bangladesh, Ethiopia, Nigeria, Burundi, and Nepal — have now joined the Every Woman, Every Child effort, which takes forward the Global Strategy for Women’s and Children’s Health. This brings the total number of partners in this joint effort to 220, with low-income countries committing nearly $11 billion of their own limited resources.

The Countdown reports help to hold governments and donors accountable for fulfilling their commitments to the Global Strategy, and it will be a key input to the first report to the Secretary General in September 2012 from the independent Expert Review Group, set up following the launch of the report of the Commission on Information and Accountability for Women’s and Children’s Health, ‘Keeping Promises, Measuring Results’.

The release of the Countdown 2012 Report coincides with a two-day forum to chart a course toward the end of preventable child deaths, taking place June 14-15 in Washington, DC. The governments of the United States, India, and Ethiopia, in collaboration with UNICEF, will convene this Child Survival Call to Action. US Secretary of State Hillary Clinton will attend.

Following in July, the UK government and the Bill & Melinda Gates Foundation will hold a summit to emphasize the need for greater attention to family planning.

In September, the United Nations Secretary-General, Ban Ki-moon, will issue an update on the impact of his Every Woman Every Child effort.

Key findings of the new report

On reducing maternal deaths: Annual maternal deaths are down by 47 percent over the past two decades. Nine Countdown countries are on track to meet their 2015 MDG 5 goal by reducing the maternal mortality rate by 75 percent. But more than a third of the 75 Countdown countries have made little, if any progress.
On reducing deaths of children under age 5: Twenty-three Countdown countries are expected to achieve MDG 4. But 13 countries have made no progress in reducing child deaths.
Forty percent of child deaths occur during the first month of life and most of these deaths are preventable through better nutrition and access to health services before, during and immediately after childbirth.
Complications due to preterm birth are the leading cause of newborn deaths and the second leading cause of death in children under 5.
More than 10 percent of all babies are born too soon. Preterm births are rising, instead of declining.
Inadequate nutrition is a crisis in most Countdown countries, contributing to more than one-third of child deaths under 5 and one-fifth of maternal deaths.
In most of these countries, more than one-third of the children are stunted, a condition especially common among the poorest populations where children are small because of a lack of good nutrition.
Short maternal stature, often a result of stunting in childhood, and micronutrient deficiencies place pregnant women at greater risk for complications and low birth weight babies.
Forty Countdown countries allocate less than 10 percent of total government spending to health.
Fifty-three of the 75 Countdown countries face a severe shortage of health workers. Countries including Ghana, Malawi, the Lao People’s Democratic Republic and Tanzania have implemented innovative policies to hire, retain and motivate skilled health workers.

Learn more about the new report here.