The World Health Organization’s 77th World Health Assembly passed a resolution on Wednesday calling on countries to bolster maternal and child health by expanding universal healthcare and strengthening primary healthcare, as progress in reducing maternal and child deaths has stagnated globally.

The resolution, led by Somalia, commits countries to tackle the leading causes of maternal and child deaths, particularly in the hardest-hit nations. They agreed to improve access to maternal, sexual, reproductive and comprehensive child health services through stronger primary healthcare and expand access to emergency services, including urgent obstetric care and units for small and sick newborns.

“The political will has been expressed, now the focus must be on implementation by countries and the technical support WHO provides in the context of universal health coverage,” said Dr. Flavia Bustreo, Governance and Ethical Committee Chair at PMNCH, a global alliance for women’s, children’s and adolescents’ rights. “We cannot accept preventable and treatable causes claiming women’s lives.”

Maternal mortality rates stagnated in 131 countries and increased in 17 between 2016 and 2020, putting over 80% of nations on track to miss the Sustainable Development Goals’ target of reducing maternal deaths to under 70 per 100,000 live births by 2030. Gains in newborn and child survival have also slowed.

To meet the Sustainable Development Goals, the world must accelerate progress on reducing maternal mortality by a staggering nine times and slash newborn and under-five mortality by a factor of four, according to the WHO.  

“Prioritizing women’s and children’s health is crucial. This requires increased leadership, commitment and investment in all levels of maternal, neonatal, child and adolescent health. To accelerate progress future strategies to address inequality ensuring no one is left behind,” said a representative for Saima Wazed, WHO Regional Director for South-East Asia, during the discussions.

What the countries have agreed to do

The WHA resolution marks the WHO’s first significant action on maternal mortality in nearly a decade, following the adoption of the Global Strategy for Women’s, Children’s and Adolescents’ Health in 2015. The resolution emphasizes the need for well-stocked facilities, trained health workers, safe water and sanitation, and comprehensive sexual and reproductive healthcare services.

Discussions before the vote focused on improving care quality, leveraging technology and strengthening primary healthcare. The UK highlighted the need to address adolescent pregnancies, unsafe abortions and the growing impact of climate change.

“Political leadership is critical to accelerate progress on maternal, newborn and child health,” said Margot Nauleau, Health and Nutrition Senior Advocacy Advisor from Save the Children. “Now we need to see this resolution translated into action at national and local levels with increased investments and effective interventions to improve health outcomes for women and children,” she added.

China makes progress, quality of care a concern for India

The global effort to reduce maternal mortality is marked by wide disparities, with some countries making significant progress while others struggle to keep pace. China, recently surpassed by India as the world’s most populous nation, has already met the 2030 Sustainable Development Goals (SDG) targets for maternal mortality.

“Since 2009, China has been providing systematic care to all pregnant women and newborns. In 2023, China’s maternal mortality decreased to 15.1 per 100,000,” a Chinese representative said.

India, despite reducing its maternal mortality ratio (MMR) from 130 in 2015-16 to 97 per 100,000 live births, remains far from the SDG targets. Given India’s population size, its progress significantly impacts global figures. The country maintained at the WHA that it is on track, but the quality of care remains poor, particularly for women from rural, impoverished, and marginalized communities.

African countries, which bear a disproportionate burden of maternal deaths, highlighted the challenges of improving care amidst humanitarian crises.

“Maternal mortality is especially high in fragile, conflict-affected, and vulnerable settings,” said the Ethiopian representative whose country co-sponsored the resolution. She noted that Africa’s maternal mortality ratio remains the highest worldwide, accounting for roughly 66% of maternal deaths in 2020.

Humanitarian crises and increasingly frequent extreme weather events tied to climate change are pushing fragile health systems to the brink, and taking a heavy toll on maternal and child health globally as a result, according to the WHO. Despite the challenges, African nations reaffirmed their commitment to improving maternal health.

“This is an absolute priority for our government. Senegal is committed to addressing more causes of neonatal, child, and maternal mortality,” the country’s representative said. “We’ve strengthened our health system to deal with this issue, and we need accountability to achieve these goals.”

Additional inputs from Elaine Ruth Fletcher

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