A call to action to galvanize momentum around maternal, child health in India

August 18, 2014

(Any opinions expressed here are those of the author and not of Thomson Reuters)

The last decade has witnessed one of the most sincere, dedicated and coordinated efforts toward addressing global development and healthcare challenges. National and international policymakers, development partners and researchers have come together to work toward a common vision of a better and healthier world.

In September 2000, building upon a decade of dialogue, world leaders unanimously adopted the United Nations Millennium Declaration. In doing so, they committed to a new global partnership to reduce extreme poverty and laid out a series of time-bound targets with a deadline of 2015 that have come to be known as the Millennium Development Goals (MDGs).

These eight goals formed a blueprint that brought together the world’s countries and leading development institutions and galvanized efforts to meet the needs of the world’s poorest populations.

In the years that followed, the world has witnessed great successes in many areas. Globally, extreme poverty has declined by half from 1990 to 2010, and there is now nearly universal enrolment in primary education.

Thanks to strengthened leadership and commitment, the world is also getting healthier faster than ever before in history. One of the greatest measures of this success is the enormous decline in child mortality worldwide from 12 million in 1990 to 6.6 million in 2011.

Twenty-five years ago, the world had few, if any, good plans for fighting some of the greatest disease threats. Today, more than 10 million people with AIDS are receiving anti-retroviral therapy, which costs 99 percent less than it did just a few years ago. The rate of new HIV infections has fallen by one-third. Deaths from tuberculosis have also fallen by nearly 50 percent. We now have not only the plans but the partnerships and means to win these battles.

In light of these accomplishments, I would like to talk about the significance of today (August 18). We are now 500 days from the target date for the achievement of the Millennium Development Goals. Today, organizations around the world will come together to evaluate the progress made since those targets were set, identify the gaps and set the pace for the next 500 days and beyond.

Taking stock of existing challenges, I believe we must take a renewed look at the issue of maternal and child health. These issues will pose one of the most significant tests in our pursuit of the MDGs.

India has made remarkable progress in health, with close to 60 percent reduction in child mortality (from 3.3 million deaths in 1990 to 1.4 million today), a two-third reduction in maternal mortality and 16.3 percent decrease in new HIV infections per year in comparison with 3.6 percent globally.

Despite significant strides in the past decade in addressing maternal, newborn and child health challenges, India still loses 56,000 mothers each year due to pregnancy-related complications, and 1.4 million children die before the age of five, according to UNICEF Progress Report 2013 and World Bank.

At the current pace of progress, it is very unlikely that India will meet MDG 5 (reduction in maternal mortality goal) but may yet meet MDG4 (reduction in child mortality goal) with an extra push. The assertion and commitment shown by the health minister last month by announcing efforts towards completing this unfinished agenda is worth highlighting.

The good news is that the majority of maternal and child deaths are preventable. Child mortality, for instance, is preventable through simple, early interventions, like drying the baby completely after birth to prevent hypothermia, not applying anything on the umbilical cord, breastfeeding within the first hour of life, breastfeeding exclusively for the first six months, practising what’s known as kangaroo care, being fully immunized, and having access to ORS/Zn to treat diarrhoea. These are really simple methods but make a huge difference.

If we are to accelerate the reduction of maternal and under-five child mortality we are faced with the task of bringing these known solutions rapidly to scale across the country. This requires a combination of relentless focus on the goal; trust-worthy monitoring systems that tell us whether we are making progress fast enough and help identify execution and knowledge gaps; double down on promising channels by which we can reach people with those simple interventions (e.g., social marketing for ORS/Zn); test and scale up promising innovations (e.g., use of ICT to provide timely health messages, train health workers, etc); bring the same urgency and focus to nutrition and sanitation alongside health interventions; and invest in the primary healthcare system and its heroic employees who have the power to make it all come together.

With 500 days to go until the 2015 deadline for achieving the Millennium Development Goals, there is still work to be done. The government and its partners have shown in the recent case of polio elimination that such major accomplishments are entirely feasible with relentless determination. As India takes strides towards the vision set at the outset of the new millennium, it is our duty to renew the focus and commitment to the health of its women and children and it is our privilege to contribute to it.

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