Regional meeting on Accelerating the Reduction of Maternal, Newborn mortality and Stillbirths: towards achieving the Sustainable Development Goals (SDGs)
10 July 2018, New Delhi, India
Distinguished participants, programme managers, esteemed partners, ladies and gentlemen,
Welcome to New Delhi and to this meeting on accelerating the reduction of maternal and newborn mortality as well as stillbirths across the South-East Asia Region. It comes at a moment of great significance.
As many of you know, India recently surpassed the MDG target of a 75% reduction in maternal mortality, recording a decline of 77% since 1990, as per national estimates. Pregnant women and women giving birth across India have never been safer; high-level commitment to these outcomes has never been stronger.
In reaching and surpassing this target, India joins a number of countries in our Region – including Bhutan, Maldives and Timor-Leste – that have delivered on MDG5, as well as others such as Thailand and Sri Lanka that have made strong relative gains, despite starting from baseline levels that were among the lowest in our Region and across the developing world.
Importantly, India’s achievement – and the Region’s broader success – help fulfill the unfinished MDG agenda and is aligned with our regional Flagship Priority of ending preventable maternal, newborn and child mortality.
Moreover, it provides a cogent reminder of what is needed to achieve the Sustainable Development Goals: First, for each of the Region’s countries to reduce maternal mortality by two-thirds from 2010 baseline levels, thereby helping attain a global ratio of at least as low as 70 per 100 000 live births by 2030; and second, for each country to reduce newborn mortality and stillbirths to at least as low as 12 per 1000 live births in the same period.
Though to their immense credit Maldives, Sri Lanka and Thailand have already achieved rates that are below the global SDG targets for newborn mortality and stillbirths, sustained – and in many cases rapid – progress is needed from all countries to achieve the maternal mortality target. It goes without saying that achieving all three targets Region-wide will be a challenge. But as our world-beating progress during the MDG era demonstrates, when our ambition is fixed and our resolve firm, anything is possible.
From 1990 to 2015, for example, maternal mortality across the Region was reduced from 525 per 100 000 live births to 164 – a decrease of 69% compared to a global decline of 44%. The Region meanwhile slashed newborn mortality by 54% as compared to 47% globally. By 2016 newborn mortality had declined a further three percentage points to 57% on 1990 levels. Our performance has been remarkable. Indeed, it has been lauded the world over.
Maternal and newborn mortality as well as stillbirths nevertheless remain a core concern for WHO South-East Asia, its Member States and partners, and communities burdened by the problem. Though maternal mortality ratios vary widely between and even within countries, an estimated 61 000 women Region-wide die from preventable causes during pregnancy and childbirth each year. Key causes include post-partum hemorrhage, pregnancy-induced hypertension and complications associated with abortion.
At the same time, almost 800 000 newborns don’t make it beyond 28 days of life, primarily as a result of perinatal conditions such as preterm birth complications, neonatal infections including sepsis, and birth asphyxia. A similar number are stillborn, with around 50% of stillbirths a result of related intranatal conditions. Despite accounting for just over a quarter of the world’s population, our Region accounts for around 30% of the global burden of newborn deaths and stillbirths – not massively disproportionate, but disproportionate nevertheless.
As is often the case, the problems of maternal and newborn mortality as well as stillbirths are interlinked and interdependent. They also span the life-course, from before conception to pregnancy and on to delivery and immediate post-partum care.
Though that makes these problems appear uniquely complex, it also means that with the right mix of quality services and high coverage of essential interventions, especially around the time of delivery, there are significant opportunities to save the lives of mothers and their newborns, reduce stillbirths and accelerate towards achieving the Sustainable Development Goal targets. Indeed, this is the triple investment we are gathered to actualize.
Distinguished participants and programme managers, esteemed partners,
Achieving this outcome has been a core concern for many years. As you know, in 2015 I constituted a regional Technical Advisory Group – or TAG – for women’s and children’s health. Since then the TAG has provided Member States, implementing partners and other stakeholders actionable guidance to hasten progress Region-wide.
As many of you will also know, the Regional Summit of the H6 Partners – which includes WHO, UNICEF, UNFPA, UN WOMEN, UNAIDS and the World Bank – has now operationalized its mandate and is providing coordinated support to Member States.
It is inspiring to see members of each of these groups today. Indeed, I look very much forward to your collaboration with programme managers in pursuit of our shared objectives.
To that end, I here want to emphasize the critical importance of fully implementing WHO’s recently released guidelines on Antenatal care and Intra-natal care for a positive pregnancy experience. These guidelines represent the gold standard for policy implementation in their respective areas, and should be adapted to meet country-specific needs.
From providing key guidelines for nutritional interventions to looking at how health systems as a whole can improve the coverage, utilization and quality of antenatal and intrapartum care, there is much to be gleaned, adapted and implemented, especially with regard to better linking antenatal and intrapartum care to enhance the quality and uptake of institutional deliveries.
I urge you to do exactly that, and to use this opportunity to plan interventions that advance the quality and coverage of care for women and newborns across our Region via a continuum of services that can be accessed throughout the life-course. I also urge you to take this opportunity to develop a roadmap to meet the unfinished MDG agenda and go on to achieve the SDGs.
Beyond the human impact your efforts will have, as well as the contribution they will make towards achieving the Sustainable Development Goal targets, they will also help fulfill WHO’s Thirteenth global programme of work – or GPW13 – which was recently adopted by Member States from across the world, including in our Region. Each of GPW13’s strategic priorities – achieving universal health coverage, addressing health emergencies, and promoting healthier populations – will be advanced by accelerating the reduction of maternal and neonatal mortality as well as stillbirths.
With that in mind, I appreciate the integrated approach this meeting has embraced. By engaging those working in health systems and nutrition departments and specific disease programmes like HIV, TB and malaria, as well as through collaboration with the Global Fund, our impact will be significantly increased.
Indeed, our partnerships and ability to work in synergy with one another – including within organizations and across programmes – is one of our greatest strengths, and is crucial to achieving the life-saving outcomes we are striving to attain.
Distinguished participants and programme managers, esteemed partners,
As you are aware, 11 July is World Population Day, with this year’s theme focusing on a principle we all hold dear, and which is fundamental to our work – that family planning is a human right. Importantly, as the evidence demonstrates in great detail, the provision and use of contraception is a powerful primary prevention strategy to reduce maternal and newborn mortality in developing countries, including in our Region.
World Population Day’s emphasis on this principle, message and the data supporting it is particularly timely given that later this month WHO South-East Asia is organizing a high-level regional meeting with parliamentarians to address the policy and programme issues needed to operationalize a key part of our agenda: the Global Strategy for women’s, children’s and adolescents’ health, and with it the Survive, Thrive and Transform objectives.
That meeting will go a long way to helping you gain the high-level support required to finance and implement the policy work you carry out and the ways in which you adapt WHO’s new guidelines on Antenatal care and Intra-natal care for a positive pregnancy experience.
With that in mind, the decisions you make and the degree to which you engage over the coming days has the capacity to save the lives of tens of thousands of women across the Region, and to reduce hundreds of thousands of newborn deaths and stillbirths. That is a great responsibility, but also a great privilege.
I wish you all the best in taking advantage of the opportunity before you and hope you have a comfortable stay in New Delhi.
Thank you very much.