The post-2015 agenda: staying the course in maternal and child survival

In this article, we draw on available evidence from Countdown to 2015 and other sources to make the case for keeping women and children at the heart of the next development agenda that will replace the Millennium Development Goal (MDG) framework after 2015. We provide a status update on global progress in achieving MDGs 4 and 5, reduce child mortality and improve maternal health, respectively – showing that although considerable mortality reductions have been achieved, many more women's and children's lives can be saved every day through available, cost effective interventions. We describe key underlying determinants of poor maternal and child health outcomes and the need for well-coordinated, comprehensive approaches for addressing them such as introducing a combination of nutrition specific and sensitive interventions to reduce pervasive malnutrition, targeting interventions to the underserved to reduce inequities in access to care, and increasing women’s social status through improved access to education and income-earning opportunities. In the wake of population momentum and emergencies such as the recent ebola outbreak and other humanitarian crises, health systems must be strengthened to be able to respond to these pressures. In conclusion, we underscore that the unfinished business of women's and children's health must be prioritized in the days ahead, and that ending preventable maternal and child deaths is not only a moral obligation but is achievable and essential to sustainable development moving forward.

[1]  Brooke Aksnes,et al.  Global Nutrition Report , 2015 .

[2]  Jamie Perin,et al.  Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis , 2015, The Lancet.

[3]  Joy Lawn,et al.  Countdown to 2015 and beyond: fulfilling the health agenda for women and children , 2015, The Lancet.

[4]  E. Emanuel,et al.  Ethical considerations of experimental interventions in the Ebola outbreak , 2014, The Lancet.

[5]  Alan D. Lopez,et al.  Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2014, The Lancet.

[6]  A. Starrs Survival convergence: bringing maternal and newborn health together for 2015 and beyond , 2014, The Lancet.

[7]  Özge Tunçalp,et al.  Global causes of maternal death: a WHO systematic analysis. , 2014, The Lancet. Global health.

[8]  Jai K Das,et al.  Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? , 2014, The Lancet.

[9]  R. Black,et al.  Global maternal, newborn, and child health--so near and yet so far. , 2013, The New England journal of medicine.

[10]  J. Bryce,et al.  The unfinished agenda in child survival , 2013, The Lancet.

[11]  F. Branca,et al.  The World Health Organization's global target for reducing childhood stunting by 2025: rationale and proposed actions. , 2013, Maternal & child nutrition.

[12]  L. Magee,et al.  Measuring maternal health: focus on maternal morbidity. , 2013, Bulletin of the World Health Organization.

[13]  Jai K. Das,et al.  Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? , 2013, The Lancet.

[14]  R. Martorell,et al.  Maternal and child undernutrition and overweight in low-income and middle-income countries , 2013, The Lancet.

[15]  M. Ezzati,et al.  Inequalities in non-communicable diseases and effective responses , 2013, The Lancet.

[16]  Qingfeng Li,et al.  Maternal deaths averted by contraceptive use: an analysis of 172 countries , 2012, The Lancet.

[17]  S. Cousens,et al.  Stillbirths: Where? When? Why? How to make the data count? , 2011, The Lancet.

[18]  Sir Michael Marmot Closing the health gap in a generation: the work of the Commission on Social Determinants of Health and its recommendations , 2009, Global Health Promotion.

[19]  Linda Richter,et al.  Maternal and child undernutrition: consequences for adult health and human capital , 2008, The Lancet.

[20]  Z. Bhutta Beyond Bellagio: addressing the challenge of sustainable child health in developing countries , 2004, Archives of Disease in Childhood.

[21]  Countdown to,et al.  Fulfilling the Health Agenda for Women and Children: The 2014 Report , 2014 .

[22]  D. You,et al.  Levels and trends in child mortality : report 2013 , 2013 .

[23]  L. Fagerlund The United Nations , 1993 .