Each year, hundreds of thousands of women die from complications related to pregnancy and childbirth that are well understood and largely preventable. 

Most of these deaths occur in low and middle-income countries, with sub-Saharan Africa carrying the greatest burden. At the same time, millions of families continue to face financial barriers to essential health services, with out-of-pocket costs still accounting for a significant share of health spending.

These outcomes are not inevitable. They reflect choices about how health systems are prioritised, financed, and delivered.

As governments gather this week for the 59th Session of the Commission on Population and Development, there is an opportunity to refocus attention on what will determine progress in the years ahead. 

This year’s emphasis on technology is both timely and necessary, but it must be anchored in a broader commitment to equity, financing, and access to quality care, particularly for women, children, and adolescents.

Digital tools to enable informed decisions

Sexual and reproductive health and rights are central to this agenda. Yet access to these services remains uneven, and in many contexts increasingly contested. Today, more than 200 million women globally still lack access to modern contraception. 

Ensuring that women and adolescents can make informed decisions about their health is not only a matter of rights. It is fundamental to public health and long-term development outcomes.

 Technology and scientific research offer practical pathways to address some of these gaps. Across the Global Leaders Network for Women’s, Children’s and Adolescents’ Health countries, digital tools are already improving access to information, strengthening referral systems, and supporting frontline health workers. 

In Kenya, a toll-free digital hotline provides around-the-clock guidance on contraception, sexual violence, and mental health to young women in marginalised communities, reaching tens of thousands of callers annually who would otherwise have had nowhere to turn.

In Tanzania, a mobile application co-designed with community health workers and beneficiaries is improving continuity of care for maternal, child, and adolescent health by connecting facilities, community workers, and local drug dispensing outlets through a shared digital referral system. 

In South Africa, the MomConnect platform has helped register pregnant women attending antenatal clinics in the public health system, delivering targeted health information throughout pregnancy and early infancy directly to women’s mobile phones, including in rural communities where in-person support is harder to access consistently. 

Across Ethiopia and Malawi, governments are investing in integrated health information systems that give decision-makers a clearer picture of where services are reaching people and where they are not. 

And in Liberia, a WhatsApp-based mobile referral system, MORES, linking rural health facilities to district hospitals has shown to improve the transfer of obstetric emergencies and cut the time to emergency caesarean section significantly.

Barriers to digital health 

But the promise of digital innovation will only be realised if we address the scale of the barriers that remain. 

As of 2024, internet penetration in Africa reached 40%, yet more than 900 million people on the continent remain offline, and in rural areas, the internet penetration stands at just 28%. 

The average cost of 1GB of data on the continent consumes nearly 6% of monthly income, more than three times the level the United Nations considers affordable. 

Women, older adults, and people in conflict-affected settings face the steepest exclusion, and research consistently shows that digital health innovations tend to reach more affluent, urban populations first, deepening the very inequalities they are designed to address.

Demographic change makes this work more urgent, not less. Across much of Africa, Asia, and the Global South, populations are young and growing. This can be a source of economic dynamism and social innovation, but only if the right investments are made. 

A young population without access to quality education, health services, and economic opportunity is not a dividend. It is a pressure point. 

The question before us is not whether population growth presents challenges. It is whether we will make the investments that convert demographic potential into genuine human progress.

Domestic investment in health 

The path forward requires prioritisation of domestic investment in health, including reproductive, maternal, newborn, child, and adolescent health. Financing decisions must be aligned with population needs and supported by stronger coordination across sectors, including health, finance, and planning. 

At the same time, international partners have a role to play in supporting country-led strategies and ensuring that resources are predictable and aligned.

Technology and research should support these efforts, not operate in isolation from them. Expanding access to digital infrastructure, reducing the cost of connectivity, and investing in local research capacity will be essential to ensure that innovation contributes to equitable outcomes.

 The cost of inaction is not borne by those who choose it. It is borne by the woman who cannot reach a health facility in time, by the adolescent girl who has no one to turn to, by the newborn who does not survive the first day of life. For their sake, and for the kind of world we want to build, we cannot afford to step back from this agenda.

Dr Louise Kpoto is the Minister of Health of Liberia

Rajat Khosla is executive director of the Partnership for Maternal, Newborn & Child Health (PMNCH).

Image Credits: Unicef.