In 2015 the United Nations adopted the Sustainable Development Goals – almost all of which relate to health in some capacity. As part of this effort, this inaugural report of the Independent Accountability Panel (IAP) tracks accountability for the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016–2030.
Gaps are increasing in the adolescent birth rates between rich and poor countries.
The lifetime risk of dying from pregnancy and childbirth-related complications is 80 times higher in low-income countries than in high-income countries.
Within countries, progress is slow in addressing stunted growth for the poorest children and satisfying the demand for family planning.
Childbirth remains a leading cause of death among girls aged 15–19 globally.
159 million children have stunted growth due to malnutrition worldwide. Trends in reducing stunting shows increasing inequity between countries.
Children in rural areas are nearly twice as likely to be out of primary school as their urban counterparts.
In 2016, little more than half (59%) of infants younger than 12 months had their births registered, with only 33% registered in South Asia and sub-Saharan Africa.
Nearly one in five adolescent girls in low- and middle-income countries become pregnant before they reach 18.
120 million girls under the age of 20 (about 1 in 10) have been subjected to forced sexual intercourse or other sexual acts at some point of their lives. Incidents of violence are particularly high among young women aged 15–19 (29.4%).
Poorer girls are more likely to become mothers than the better-off (136 births per thousand women in 2013 for the poorest adolescents, versus 47 for the richest).
Young people are almost three times more likely than adults to be unemployed.
Gender differentials in youth unemployment rates are decreasing at a global level and in most regions, but remain significant.
Unsafe sex rose from the 13th ranked risk factor among 15–19 year-olds in 1990 to the second in 2013.
The likelihood of an adolescent girl becoming a mother is about the same as in previous decades.
The world is experiencing its greatest period of human need since the Second World War, with forced displacement exceeding 60 million for the first time, and 125 million people requiring life-saving assistance.
Women, children, adolescents and the elderly are less able to flee, less able to access resources and most susceptible to violence and risk.
Today’s generation of adolescents is the largest in history, with 1.2 billion people aged 10 to 19 years worldwide. Their unprecedented numbers, particularly in less developed countries, means this generation will not only be among the primary beneficiaries of the new international development agenda, but also a key force driving it.
It is imperative to urgently invest in the education, health, livelihoods and participation of adolescents.
Adolescent health requires special efforts that are integrated with life skills, education and employment opportunities, in addition to the new skills of the health workforce.
Young people need and have a right to comprehensive and non-discriminatory sexuality education to make informed decisions before they become sexually active. As of 2015, 89 countries had laws and policies in place to allow adolescents to access sexual and reproductive health services.
The health sector is a phenomenal source of employment. The global economy is expected to create about 40 million new health sector jobs by 2030, mostly in middle- and high-income countries.
Increasingly, women make up the health workforce as nurses, midwives, doctors, community health workers and allied health professionals.
Strengthening the health workforce for reproductive, maternal, newborn, child and adolescent health, if done in a gender equitable way, is a critical pathway to progress.
To ensure that women, children and adolescents survive and thrive will require more resources and an investment framework, with more precise estimates of the costs and potential benefits of various investments. World leaders and UN agencies must establish a plan to tap additional resources, both domestically and internationally.
The Global Strategy has already galvanized enthusiasm worldwide to achieve better health outcomes for all. As of June 2016, there are:
from governments, donors, civil society and the private sector
The IAP urges the UN Security Council and General Assembly to choose as the next Secretary-General a candidate who has a clear commitment to the Global Strategy. The health of women, children and adolescents must remain central to the 2030 agenda and all sectors and UN agencies must work collaboratively. We advocate similar leadership at the WHO’s World Health Assembly.
More precise estimates of the costs and potential benefits of various investments are needed, along with a clear plan from world leaders and UN agencies to tap additional resources. Governments must set new expectations for tax collection and more effectively combat tax evasion. Donors countries, meanwhile, must reassess their aid eligibility criteria, which excludes two thirds of the world’s poor who live in middle-income countries.
National statistical offices, administrative data collection entities, independent judiciaries, human rights bodies, and civil society activities, such as citizen hearings, must be strengthened; while the private sector, professional associations and accreditation boards must be engaged.
Use data to ensure that legal and policy structures support reproductive, maternal, newborn, child and adolescent health.
Analyze financial audits, assessments of human rights and gender compliance, parliamentary inquiries, citizens’ hearings and a variety of other sources.
Clarify responsibilities between national and international institutions and oversight bodies, promote their findings and ensure that they answer women, adolescents and children everywhere.