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Seventy-six countries are off track to meet ambitious global health targets for maternal and child health, according to an analysis by researchers from the Brookings Institution and the Duke Global Health Institute (DGHI). If those countries were to recover and accelerate their progress according to the targets, the authors note, 11.8 million lives—1.6 million mothers and 10.2 million children—could be saved.

To arrive at these numbers, John McArthur and Krista Rasmussen of the Brookings Institution and Gavin Yamey of DGHI examined trends in child and maternal mortality and extrapolated them forward to 2030.

They examined how their findings stacked up against targets in the third Sustainable Development Goal (SDG), “ensure healthy lives and promote well-being for all at all ages.” Adopted by United Nations member states in 2015, the SDGs established a road map for ending poverty, fostering good health, fighting inequalities and tacking climate change by 2030.

The global health community has made tremendous progress in maternal and child health initiatives in recent years, but vexing challenges persist in many countries. Nigeria, Pakistan and the Democratic Republic of the Congo, the researchers note, will face the steepest uphill battle, together accounting for 5.9 million, or 57 percent, of the lives at stake.

McArthur, Rasmussen and Yamey offer strategies to step up progress on these targets. Most important, they say, is to scale up integrated packages of evidence-based health interventions for reproductive health, maternal and newborn health and child health. Other recommendations include improving the collection and use of evidence to inform health policy and scaling up investments in developing new health technologies, such as low-cost, reusable and easy to use resuscitators to improve newborn survival in low-resource settings. They note that policies outside the health sector, such as those directed at expanding girls’ education, also hold potential to drive progress.

McArthur and Yamey discussed their findings in a “BMJ talk medicine” podcast with Duncan Jarvis at The BMJ, where the analysis was published. Listen: