Conflict, climate instability, and COVID-19 are affecting the health of women and children

Fragile gains made to advance women and children's health are threatened by conflict, the climate crisis and COVID-19, according to a new report from Every Woman Every Child.

Protect the Progress: Rise, Refocus, Recover, 2020 highlights that since the Every Woman Every Child movement was launched 10 years ago, spearheaded by the United Nations Secretary-General, there has been remarkable progress in improving the health of the world's women, children and adolescents.

For example, under-five deaths reached an all-time recorded low in 2019, and more than 1 billion children were vaccinated over the past decade. Coverage of immunization, skilled birth attendant and access to safe drinking water reached over 80 per cent.

Maternal deaths declined by 35 per cent since 2000, with the most significant declines occurring from 2010. An estimated 25 million child marriages were also prevented over the past decade.

However, conflict, climate instability and the COVID-19 pandemic are putting the health and well-being of all children and adolescents at risk.

The COVID-19 crisis, in particular, is exacerbating existing inequities, with reported disruptions in essential health interventions disproportionately impacting the most vulnerable women and children.

At the height of pandemic lockdowns, schools were closed in 192 countries, affecting 1.6 billion students. Domestic violence and abuse of girls and women increased. Poverty and hunger are also on the rise.

Even before the COVID-19 pandemic, a child under the age of five died every six seconds somewhere around the world. Millions of children living in conflict zones and fragile settings face even greater hardship with the onset of the pandemic. We need to work collectively to meet immediate needs caused by the pandemic while also strengthening health systems. Only then can we protect and save lives."

Henrietta Fore, Executive Director, UNICEF

In 2019, 5.2 million children under the age of 5 and 1 million adolescents died of preventable causes. Every 13 seconds a newborn baby died. Every hour 33 women did not survive childbirth; and 33,000 girls a day were forced into marriages, usually to much older men.

The report examines the deep-rooted inequities which continue to deprive women, children and adolescents of their rights – noting birthplace as a significant determinant of survival. In 2019, 82 percent of under-5 deaths and 86 percent of maternal deaths were concentrated in sub-Saharan Africa and South Asia.

Nine in 10 paediatric HIV infections occurred in sub-Saharan Africa. Maternal, newborn, child and adolescent mortality rates were substantially higher in countries chronically affected by conflict.

"For too long, the health and rights of women, children, and adolescents have received insufficient attention and services have been inadequately resourced," said former Prime Minister of New Zealand and Board Chair of the Partnership for Maternal, Newborn and Child Health, Helen Clark. "We call on all partners to work together to support governments to strengthen health systems and tackle the inequities that constrain progress."

The report calls upon the global community to fight COVID-19 while honoring and respecting commitments that can improve the lives of women and children, and not widen the gap between promise and reality. "The COVID-19 pandemic threatens to turn back the clock on years of progress in reproductive, maternal, child and adolescent health.

This is unacceptable," said Muhammad Ali Pate, Global Director for Health, Nutrition and Population at the World Bank Group and Director, Global Financing Facility. "The GFF partnership will double down on its efforts to engage with partners and countries and honor the global commitment to ensure that all women, adolescents and children can access the quality, affordable health care they need to survive and thrive."

The past decade of progress to advance the health of women, children and adolescents must be protected from the impact of the pandemic and the responses to it, the report says. "Rapid reversal of hard-fought progress in women's, children's and adolescents' health is a real threat," said Ties Boerma, Director of the Countdown to 2030 for Reproductive, Maternal, Newborn, Child and Adolescent Health.

"As the intensive tracking of the COVID-19 pandemic tells us, timely local data are necessary to be able to target actions and prevent rising inequalities. Global and country investments in local health information systems are much needed to guide the response and protect progress."

Without intensified efforts to combat preventable child deaths, 48 million children under age 5 could die between 2020 and 2030. Almost half of these deaths will be newborns. The report advocates for countries to continue investing in the health of all women, children and adolescents, in all crises.

"As we respond to COVID-19 and reimagine a better future, with sustained peace, including at home, we must repeat unequivocally that the rights of women and girls are not negotiable. Even in times of crisis – especially in times of crisis – their sexual and reproductive health and rights must be safeguarded at all costs," said Natalia Kanem, UNFPA Executive Director.

The report argues that the Every Woman Every Child movement is more critical than ever as we step into the SDG Decade of Action in the midst of the worst global health crisis of a generation.

The momentum of the movement must continue to champion multilaterialism, to mobilize action across all sectors to safeguard the tremendous investments and gains realized by commitments since its launch 10 years ago, and to protect the health and well-being of every woman, child and adolescent, everywhere.

"There is no doubt that the pandemic has set back global efforts to improve the health and well-being of women and children, but that should only serve to strengthen our resolve," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "Our joint action under the Every Woman Every Child movement is more important than ever. We now must renew our commitment to a healthier, safer, fairer and more sustainable world for women, children and future generations."