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'Backsliding' in women's and kids' health care

Health care for women and children suffered major setbacks from multiple crises in recent years, requiring serious investment in public health resources.

Mothers carrying babies wash their hands on arrival at a maternal and child health center in Mogadishu, Somalia
Mothers carrying babies wash their hands on arrival at a maternal and child health center in Mogadishu, Somalia in Sept. 2020, after the health ministry, WHO, UNICEF, GPEI and Gavi, the Vaccine Alliance immunized 400,000 Somali children against measles and polio (AN/Mokhtar Mohamed)

Health care for women and children around the world suffered major setbacks from multiple crises in recent years and will require serious investment in public health to turn things around, a new report found.

Some 10.5 million children lost a parent or caregiver due to COVIV-19 and 25 million children were not vaccinated as they should have been last year to protect against deadly and debilitating diseases, 6 million more than in 2019, according to the "Protect the Promise" report from several United Nations agencies and partner organizations on Tuesday. About 80% of all children among 104 nations and territories lost precious time for learning because of school closures.

Virtually all major indicators of childhood well-being and many key measures of progress used in the U.N.'s 17 Sustainable Development Goals for 2030 showed a "critical regression," the report's authors said, with hunger, partner violence, child marriage, adolescent depression and anxiety all on the rise.

"While challenges persist and progress continues to be too slow to achieve the goals set out for 2030, there are reasons to be optimistic," said Estonia's former president, Kersti Kaljulaid, who is now the U.N. secretary-general's global advocate for the Every Woman Every Child movement to address major health challenges facing women, children and adolescents.

"The backsliding in outcomes shows that commitments, when delivered on, can be effective and life-changing," she said. "Conversely, in a void of will, attention and action, the results are devastating. This report should be seen as an urgent appeal to get on track to meet the ambitious but achievable goals."

The report, released on the last day of the annual World Health Summit in Berlin, was prepared by the World Health Organization, UNICEF, UNFPA, Partnership for Maternal, Newborn & Child Health and Countdown to 2030.

Protecting and promoting the health of women, children and young people, said WHO's Director-General Tedros Adhanom Ghebreyesus, is "essential for supporting and sustaining the global recovery" from the pandemic.

U.N. Secretary General António Guterres said the report shows that "at the core of our unkept promise is the failure to address the gaping inequities at the root of global crises" that particularly impact women, children and adolescents in areas ranging from maternal mortality to education losses to severe malnutrition.

A 17-year gap in life expectancy

The report found wide discrepancies in health based simply on where people were born, how much money their family had, and whether there was peace or war.

“There is a crisis of inequity that is piling on already increasing and compounding threats," said Kaljulaid. "In a world where too many children, adolescents and women are dying, equity, empowerment and access are what needs urgent focus."

The erosion of sexual and reproductive rights in the United States and other countries has left many women without many of the protections they had just a decade ago, said UNFPA's Executive Director Natalia Kanem.

“Access to sexual and reproductive health services, including contraception, is a fundamental right that directly and acutely affects the ability of women and adolescent girls to thrive," she said. "We need to expand these rights and services to the most marginalized, leaving no one behind.”

In poor countries, the report pointed out, children have an average life expectancy at birth of around 63 years, compared to 80 in wealthy nations — and the 17-year gap hasn't changed much over the years.

Africa and South Asia had the most maternal, child and adolescent deaths and stillbirths. In 2020, 5 million children died before the age of five mostly from preventable or treatable causes, and more than 45 million children — almost three-quarters of them in lower- to middle-income nations — suffered life-threatening acute malnutrition.

"Hope for an upswing in political commitment to and accelerated progress for women’s, children’s and adolescents’ health has been further eroded since the COVID-19 pandemic began shaking the world in 2020," the report said. "Today, the 'three C’s' — COVID-19, conflict and climate change — represent distinct yet overlapping challenges to the health and well-being of women, children and adolescents."

But there are solutions, said UNICEF's Executive Director Catherine Russell.

“We are not powerless to change this,” she said. “By investing in resilient, inclusive primary health care systems, jumpstarting routine immunization programs, and strengthening the health workforce, we can make sure that every woman and every child can access the care they need to survive and thrive.”