Every day, 14,000 children under the age of 5 die from preventable or treatable causes, resulting in 5.2 million deaths annually.  Close to half of these deaths occur within the first month of life, with almost one million newborns dying on their first day of life.
Complications during pregnancy and childbirth cause the deaths of 300,000 women annually. In the 19 countries where U.S. involvement has been most significant, maternal mortality has declined by 44% in the last 20 years.
These preventable deaths primarily occur in resource-limited settings, where women and children lack access to basic health care services. The most effective interventions often don’t require expensive tools or services and are best provided as a health services package.
Significant progress has been made in improving maternal and child health globally, cutting annual child and maternal deaths by nearly 60%, in part due to increased U.S. leadership and support.
The United States has committed to a bold agenda to save the lives of women and children, as well as to strengthen health systems that enable countries to plan, fund, and manage their own continued progress in maternal and child health (MCH). Continued U.S. support and leadership, with the help of bilateral partnerships and multilateral stakeholders, are necessary to achieve this goal.
Reducing maternal and child death rates is estimated to produce benefits exceeding the costs of investment by 9 to 20 times for low- and lower-middle-income countries.
Follow through on the U.S. commitment to prevent child and maternal deaths with financial and technical assistance: support the MCH account in coordination with other priority global health accounts. Agencies must have support from Congress to ensure continued prioritization, leadership, and effective programming, with a focus on reporting against established metrics of success. As a leading global MCH donor, the U.S.should also encourage more financial and political support from multilateral and bilateral donors, endemic country governments, and the private sector.
Increase support for bilateral and multilateral MCH programs; provide robust funding for other global health and development initiatives that are vital to achieving maternal, newborn, and child health goals. These programs include the U.S. contributions to Gavi, the Vaccine Alliance (Gavi), and efforts to eradicate polio; USAID global health programs, including nutrition, family planning, and water, sanitation, and hygiene (WASH) initiatives; Centers for Disease Control and Prevention (CDC) global health programs; and UN agencies, such as the United Nations Children’s Fund (UNICEF). Congress should also advance policies that expand access to evidence-based interventions for preventing child and maternal deaths, while rejecting any attempts to restrict access to lifesaving services.
Promote the rapid scale-up of proven, quality interventions. Invest in research and development (R&D) of critical tools, such as vaccines and other essential health commodities that will improve global MCH. If coverage of only 11 new interventions is scaled up to meet the need, a projected 6 million maternal and child deaths can be prevented.
Photo Credit: PAI Ghana- August 2016, Sala Lewis
Photo Credit: Annie Spratt
MCH investments have proven to be “best buys” for the United States. Since 1990 support has helped to cut global rates of child and maternal mortality by nearly 60 percent, making it possible to commit to ending preventable child and maternal deaths.
The U.S. invests its resources bilaterally through USAID and multilaterally, through Gavi, the Vaccine Alliance and UNICEF. The United States also contributes key technical leadership and support through other mechanisms, including the World Health Organization (WHO). These collective efforts have saved millions of lives while driving down health costs, reducing newborn deaths, and improving immunization rates.
USAID carries out maternal and child survival programming in 25 priority countries that comprise 70% of the world’s preventable maternal and child deaths. In the past 10 years, USAID has helped save the lives of more than 9.3 million children and 340,000 women. USAID outlines a roadmap for success in its Acting on the Call initiative, which supports the scale-up of high-impact, evidence-based approaches for driving down the leading killers of mothers and children. Its investments help to ensure access to high-quality antenatal, labor, delivery, and postpartum care; provide nutrition for children and for women who are pregnant or recently gave birth; deliver life saving vaccines; save newborns from severe infections; protect young children from the risks of diarrhea, pneumonia, and malaria; and support the healthy timing and spacing of pregnancy through voluntary family planning that protects both women and children.
U.S. commitments to Gavi are also key in driving down vaccine-preventable deaths globally. Two of the leading killers of children are pneumonia and diarrhea, yet both can be averted by highly effective vaccines that prevent pneumococcal infections or severe bouts of rotavirus, which causes deadly diarrhea.
The hard-won gains in maternal and child survival are at great risk as countries around the world face COVID-19. As facilities become overloaded, close or limit services, there are significant risks for the health of women and their children. COVID-19 is disrupting essential care, including facility-based delivery, pre- and post-natal care, and immunization programs. These disruptions stall progress and require intensified efforts to achieve global goals and end preventable child and maternal deaths. Continued U.S. support and leadership, with the help of bilateral partnerships and multilateral stakeholders, can prioritize the lifesaving interventions, effective programming, and evidence-based reporting necessary to continue progress.
Amanda Medlock, World Vision, email@example.com
Jill Carney, Save the Children, firstname.lastname@example.org
 “Levels & Trends in Child Mortality,” UNICEF, WHO, World Bank Group. https://data.unicef.org/resources/levels-and-trends-in-child-mortality/.
HEADER PHOTO CREDIT: UNF- Allison Shelley