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Protect the progress

At the start of 2020, more children lived to see their first birthday than at any other time in history.

Child mortality had fallen by 50% since 2000. Maternal mortality and child marriages were on the decline and more girls were going to school and staying in school than ever before.

But the progress has not reach everyone. The gains have proven fragile and the future is now uncertain. The realization of human rights, particularly sexual and reproductive health and rights, remains seriously uneven in many countries, risking the reversal of hard-won advances in preventable maternal and child mortality and undermining the health of adolescents in particular.

Discrimination, abuse and violence against women, children and adolescents – among the most widespread of human rights violations – continue to erode physical and mental health. Meanwhile, conflicts, migration, climate instability and ecological degradation are introducing new dangers and intensifying known impediments to the health of women, children and adolescents.

We must rise in this Decade of Action to refocus our efforts towards ensuring the overall and lasting health and well-being of women, children and adolescents so that we can recover stronger and achieve the 2030 Sustainable Development Goals.

As the world addresses the COVID-19 pandemic, we must safeguard decades of progress on maternal and child health and well-being.

Mr. António Guterres

United Nations Secretary-General and Senior Co-Chair of Every Woman Every Child High-Level Steering Group

Section 1
Progress and develop Created with Sketch.

Since the launch of Every Woman Every Child in 2010, the world has achieved significant gains in maternal, newborn and child health and well-being.

More children

have lived to see their first birthday than ever before.

Since 2000,

child mortality has decreased by 50% and under-5 deaths have reached at an all-time recorded low.

More than 1 billion

children have been vaccinated over the past decade.

More than 80%

coverage of immunization, skilled birth attendants and access to safe drinking water has been reached.

There has been a 35% decline

in the global number of maternal deaths.

85% of pregnant women

living with HIV have received effective antiretrovirals for the prevention of mother-to-child transmission of the virus, up from 45% in 2010.

25 million

child marriages have been prevented since 2010.

122 countries

had already achieved the Sustainable Development Goal for under-5 mortality.

These important advances would not have been as successful – or perhaps not attained at all – in the absence of dedicated, focused work through the Every Woman Every Child partnership, including its landmark Global Strategy for Women’s, Children’s and Adolescents’ Health.

The progress before COVID-19: Accelerated, stagnated or reversed?

15 out of the 17 interventions showed either positive change or stayed roughly the same

  • Demand for family planning satisfied with modern methods

  • Antenatal care (4+)

  • Treatment of pregnant women living with HIV

  • Neonatal tetanus protection

  • Skilled attendant at delivery

  • Postnatal visit for mothers

  • Postnantal visit for babies

  • Early initiation of breastfeeding

  • Exclusive breastfeeding (<6 months)

  • Continued breastfeeding (year 1)

  • DTP3 immunization

  • MCV1 immunization

  • Rotavirus immunization

  • Vitamin A supplementation (two doses)

  • Pneumonia: Careseeking for symptoms of pneumonia

  • Diarrhoea: ORS treatment

  • Population using at least basic drinking-water services

  • Population using at least basic sanitation services

  • 0%
  • 25%
  • 50%
  • 75%
  • 100%

Median national coverage of select interventions along the continuum of care, for two time periods, 2010–2014 and 2015–2019, among low- and middle-income countries that have data for both periods

However, these improvements are still not evenly distributed across the world, and the great progress did not reach every woman, nor every child. In 2019:

Every 13 seconds

a newborn baby died.

Every hour 33

women did not survive childbirth.

7.4 million

children and young people aged under 25 years died of preventable causes.

An estimated 14 million

infants were not reached by vaccination services.

75% of children

aged 2 to 4 years were regularly subjected to violent forms of discipline.

33,000 girls

a day were forced into marriages, usually to much older men.

132 million

girls were out of school.

43% of schools

around the world lacked access to basic handwashing with soap and water.

Where a baby is born is a significant determinant in whether the child survives and thrives or suffers hardship.

  • 82%

    of under-5 deaths were concentrated in sub-Saharan Africa and South Asia.

  • 86%

    of all maternal deaths occurred in sub-Saharan Africa and South Asia.

  • 4 500

    adolescent girls and young women aged 15–24 years became infected with HIV every week in sub-Saharan Africa.

Millions of internally displaced women and children, refugees and migrants are facing an acute state of vulnerability.

  • Maternal and child

    mortality rates are substantially higher in countries chronically affected by conflict.

  • Nearly 40%

    of the global under-5 deaths occurred in fragile contexts.

  • The under-5 mortality

    rate is 3 times higher in the 36 countries classified as ‘fragile’ than in ‘non-fragile’ countries.

We are not safe
unless everyone is safe.

H.E. Kersti Kaljulaid

President of the Republic of Estonia and Co-Chair of the High-level Steering Group for Every Woman Every Child

Low- and middle-income countries were far from achieving universal coverage for many interventions.

  • Pre-pregnancy

  • Pregnancy

  • Birth

  • Postnatal

  • Infancy

  • Childhood

  • Environment

  • Pre-pregnancy
  • Pregnancy
  • Birth
  • Postnatal
  • Infancy
  • Childhood
  • Environment
  • Demand for family planning satisfied with modern methods

  • Antenatal care (4+)

  • Treatment of pregnant women living with HIV

  • Neonatal tetanus protection

  • Skilled attendant at delivery

  • Postnatal visit for mothers

  • Postnantal visit for babies

  • Early initiation of breastfeeding

  • Exclusive breastfeeding (<6 months)

  • Continued breastfeeding (year 1)

  • DTP3 immunization

  • MCV1 immunization

  • Rotavirus immunization

  • Vitamin A supplementation (two doses)

  • Pneumonia: Careseeking for symptoms of pneumonia

  • Diarrhoea: ORS treatment

  • Population using at least basic drinking-water services

  • Population using at least basic sanitation services

  • 0%
  • 25%
  • 50%
  • 75%
  • 100%

There are solutions for advancing maternal, newborn and child survival, and they must be adapted to widely divergent realities in countries.

We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths be lost.

Ms. Henrietta F. Fore

Executive Director, UNICEF

Spotlight

Immunization coverage

Some achievements include:

  • 1 billion+ children vaccinated over the past decade
  • most children today receive life-saving vaccines
  • uptake of new and underused vaccines is increasing
  • 2–3 million deaths prevented every year through immunization
  • 8.8+ billion US$ raised at the Global Vaccine Summit to immunize 300 million children and support the global fight against COVID-19
LEARN MORE

Despite the success, hard-fought gains in immunization coverage are at risk without basic health services for all children. We can do more.

There are alarming slowdowns and reversals in coverage of child health interventions, exacerbated by COVID-19. Unless addressed, these will put the world at jeopardy of not reaching the Sustainable Development Goals (SDGs) and EWEC Global Strategy targets for child survival.

Countries must act now to protect immunization services to further minimize disease outbreaks and loss of life by:

  • Facilitating urgent catch-up programmes in places where services have been disrupted.
  • Ensuring strong supply chains, disease surveillance and trained health workers.
  • Making sure that caregivers continue to vaccinate their children in line with national policies.
LEARN MORE

The return on investment in global health is tremendous, and the biggest bang for the buck comes from vaccines. Vaccines are among the most successful and cost-effective health investments in history.

Dr Seth Berkley

CEO Gavi, the Vaccine Alliance

Spotlight

EARLY CHILDHOOD DEVELOPMENT

Building a baby’s brain

More than 80%

of a baby’s brain is formed by the age of 3

Up to 75%

of each meal goes to build a baby’s brain

15 minutes

of play can spark thousands of brain connections in a baby’s brain

Faster than we ever thought: the first years of a child’s life set the stage for all future growth

In the earliest years of life, especially from pregnancy to age 3, babies need nutrition, protection and stimulation for healthy brain development. Recent advances in neuroscience provide new evidence about a baby’s brain development during this time. As a result, we know that in their earliest years, babies’ brains form new connections at an astounding rate – according to Harvard University’s Center on the Developing Child, more than 1 million every single second – a pace never repeated again.

Fast-growing brains need family-friendly policies and environments to keep them going.

Good news: the right interventions at the right time can bolster development, break intergenerational cycles of inequity and provide a fair start in life for every child

LEARN MORE

It’s about time: supporting parents to bring up happy and healthy children

During the first 1000 days, parents have a once-in-a-lifetime opportunity to build a baby’s brain and shape a child’s ability to learn and grow.

To help parents get the time and support they need to bring up happy and healthy children, UNICEF works with governments and businesses around the world to invest in family-friendly policies.

LEARN MORE

13 KEY FACTS

How young children are faring today

Section 2

Every Woman Every Child: а decade of investment and action

Achievements in EWEC’s first decade include:

776

commitments mobilized from governments and other partners

Almost US $186 billion

in financial commitments mobilized to improve the health and well-being of women, children and adolescents globally

The achievements of the EWEC movement in the past 10 years have been outstanding in terms of mobilizing action to generate greater investment in and to deliver services for the health and rights of more and more women, children and adolescents. Through active promotion of the EWEC framework – survive, thrive and transform – EWEC plays a central role in maintaining momentum towards the achievement of the SDGs, and ultimately towards securing gender equality and human rights. As the world faces multiple crises that threaten this important progress, now more than ever, partners need to recommit to the EWEC agenda and prioritize attention to ensuring the health, lives and rights of all women, children and adolescents.

Michelle Bachelet

United Nations High Commissioner for Human Rights, OHCHR

The number of people reached with service-delivery activity

Numbers indicate gaps in resource allocation, with more investments needed for services in humanitarian and fragile settings.

  • Quality, equity and dignity in services, 24% (146 MI)
  • Empowerment of women, girls and communities, 0.2% (1 MI)
  • Humanitarian and fragile settings, 6% (34 MI)
  • Early childhood development, 34% (204 MI)
  • Adolescent and young adult health and well-being, 8% (50 MI)
  • Sexual and reproductive health and rights, 28% (64 MI)

Due to the COVID-19 pandemic, almost half of the nongovernmental commitment makers anticipate a decrease in their financial commitments in the coming years or a degree of uncertainty on their ability to deliver on pledges to contribute to the EWEC Global Strategy.

This underscores the urgent need to safeguard the gains made throughout the past 10 years in women’s, children’s and adolescents’ health while also exploring ways to sustain progress.

The continuity of essential services and funding for reproductive, maternal, newborn, child and adolescent health must not only be protected from cuts or reallocation as part of national COVID-19 response and recovery efforts, but also, prioritized and increased to respond to the immediate and long-term repercussions of the pandemic.

At Merck for Mothers, we are optimistic about the future of private sector engagement and the powerful positive impact we can have on the lived experiences of women and girls, when we work together across sectors. Private sector collaborators are catalysing new innovations to leapfrog progress; they are applying their expertise in scaling sustainable solutions, and they are augmenting the provision of critical health-care services – all capabilities and resources that will be needed to achieve the Sustainable Development Goals by 2030.

Dr. Mary-Ann Etiebet

Lead and Executive Director, Merck for Mothers

The pace of increases in commitments to women, children and adolescent health varies by sector and needs to pick up speed to ensure that women, children and adolescents are not left behind as the pandemic continues.

Dive into financial commitments

86%

of the cumulative financial commitments were generated by low- and lower-middle-income countries (an increase over the past year).

14%

of the cumulative financial commitments from high-income and upper-middle-income countries remained at the same level (estimated US$ 17.8 billion).

Driving accountability for meaningful adolescent and youth engagement

To help deliver on the EWEC Global Strategy’s “transform” priority area, the Global Consensus Statement on Meaningful Adolescent and Youth Engagement (MAYE) was developed as a joint effort spearheaded by the Partnership for Maternal, Newborn & Child Health (PMNCH), Family Planning 2020 (FP2020) and the International Youth Alliance for Family Planning.

You can pledge to advance MAYE by endorsing the Global Consensus Statement.

SUBMIT

Section 3
COVID-19 Threat to progress Created with Sketch.

The COVID-19 pandemic represents an unprecedented threat to the core focus of the Every Woman Every Child movement: the health and well-being of women, children and adolescents worldwide. Hard-earned progress in improving their ability to thrive and survive and in creating new opportunities for the world’s most vulnerable people is endangered on nearly all fronts.

The COVID-19 pandemic is exposing vulnerabilities and failures in health, social, political and economic systems that ought to safeguard women, children and adolescents. School closures impacting 1.6 billion children, the growing burden on local health systems for the delivery of primary care, heightened risk of gender-based violence and sexual exploitation amid intensifying containment measures and rising economic pressures are all threatening livelihoods and exacerbating gender inequality.

The overall message is dire. In times of crisis, the well-being and rights of women, children and adolescents are rarely prioritized. The COVID-19 pandemic is no different, as women, children and adolescents are bearing a disproportionate brunt of the economic and social consequences of shutting down societies. Their lives and prospects are more precarious as a result and could remain at this level of insecurity after the pandemic ends.

The COVID-19 crisis, awful as it is, is a once-in-a-lifetime opportunity for a reset to tackle the structural inequalities that make our societies and economies so vulnerable. The actions that G20 leaders take this year will determine the world’s recovery from the COVID-19 crisis: the futures of billions of people are being written now; so, too, are leaders’ legacies.

Ms. Winnie Byanyima

Executive Director, UNAIDS

The impact of COVID-19 on the health and well-being of women, children and adolescents

50%

of the countries report partial or severe disruptions in routine immunization services, malaria prevention campaigns, family planning and antenatal care services

13 million

additional child marriages taking place by 2030 that otherwise would not have occurred.

1 157 000

additional child deaths and 56700 additional maternal deaths, due to а 45% reduction in the coverage of key high-impact maternal and child health interventions over 6 months in 118 low- and middle-income countries

At least 40 million

children worldwide have missed out on early childhood education as COVID-19 shuttered childcare and early education facilities

7 million

unintended pregnancies in the coming months, due to ongoing lockdowns and major disruptions to health services

150 million

additional children plunged into poverty due to COVID-19

Percentage of countries that report any disruption in reproductive, maternal, newborn, child health and nutrition services due to COVID-19

  • WHO essential services (n=105)
  • UNICEF situation tracking (n=85)
  • WHO/UNICEF immunization (n=129)
  • Family planning services

  • Antenatal care

  • Health facility deliveries or obstetric care

  • Essential newborn care

  • Postnatal visits

  • Routine immunization

  • Sick child visits

  • Malnutrition OR SAM services

  • 0%
  • 25%
  • 50%
  • 75%
  • 100%

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.

Dr. Natalia Kanem

Executive Director of UNFPA and Host of the EWEC Secretariat

COVID-19 threatens the goals of survive, thrive and transform.

Direct response to COVID-19:
lockdown, limitation of movement, school closure

Direct impact to COVID-19 health access/demand:
fear of infection, lack of transport, closure of health facilities

Direct impact to COVID-19 health systems:
overwhelmed systems, redeployment of staff, lack of supplies, revision of standard practices of care to prevent transmission

Secondary environmental:
reduction in emissions, and pollutants

Secondary psychosocial:
increase in isolation, lack of daily activities, lack of peer support

Secondary economic:
loss of income, limitations to WASH, food insecurity and supply disruptions, loss of education

Decreased utilization of essential health servicess

Decreased provision of health services and reduction in quality of care, separation of mother and child, no birth companion, increase used of breast substitutes

Cleaner air, positive environmental impacts

Depression, anxiety, domestic abuse, undernutrition, overnutrition, lack of responsive caregiving and stimulation, child maltreatment, cyber bullying, increased alcohol and substance, increased child marriage, and female genital mutilation

Reduced coverage of essential health services

Survive, Thrive, Transform, Leave no one behind

None of us are prepared to stand by and see this pandemic erode the significant progress that has been made on the health and rights of women and children and adolescents.

Rt. Hon. Helen Clark

Former Prime Minister of New Zealand and Board Chair of the Partnership for Maternal, Newborn and Child Health

How can we get back on track and create a more equal world?

Data, action and advocacy can advance the goals of EWEC Global Strategy, specifically for ending all preventable deaths among women, children and adolescents by 2030.

During the COVID-19 pandemic, Together For Girls (TfG) collected never-before-seen information about violence against children and youth. The data are used to build strategies for violence prevention and response. Using the data as guidelines, TfG works with national governments and civil society to prevent and respond to violence. These efforts include strengthening capacity in-country and providing strategic guidance, training, technical assistance, and funding when possible. These actions, along with appropriate budget and accountability measures, will lead to better prevention, improved health outcomes, and a sustainable protection system for all girls and boys.

Read more

Past experience with other outbreaks and disasters provide hope that it is possible to get back on track, and even reduce inequities. Community health workers can play a critical role in mitigating disruptions to health services.

Guinea, Liberia and Sierra Leone had severe Ebola epidemics in 2014–2015 that negatively impacted their health and other services. There is evidence from these countries that community health workers (CHWs) can help mitigate disruptions to health services, build resilience, strengthen health systems, and provide emergency response capacity. While data show that CHWs’ service utilization dropped during the epidemics, communities reported seeking care more from CHWs after Ebola than from health facilities.

In 2020, in the last remaining Ebola hotspot in the Democratic Republic of the Congo (DRC), a CHW is welcomed as a friend, who comes to monitor the close contacts of an Ebola patient, to make sure they are in good health. While trained medical staff are crucial in responding to an epidemic, one of the biggest lessons from this outbreak has been the importance of community participation. As the last patient leaves the Ebola treatment centre in DRC, and the last contacts are monitored, trained local community workers will play an important part in the transition period after the epidemic ends, and potentially far beyond.

Read more

Adequate hygiene and sanitation act as bulwarks against endemics and pandemics.

The absence of water, sanitation and hygiene (WASH) facilities is a bigger problem for women, children and adolescents in terms of security, dignity and health, generally, and more so during a pandemic. As the lockdown in India eased, Banka BioLoo of India restarted the installation of toilets, so that all people, especially women, children and adolescents could have access to WASH. Toilets and associated handwashing stations prevent, to a large extent, morbidity and mortality.

Read more

There is a real opportunity for government authorities and international partners to work in solidarity and in a coordinated manner with humanitarian actors on the ground to help the most vulnerable and hardest-to-reach people in this pandemic.

The devastating explosion in Beirut in August 2020 that affected more than 300 000 people is a reminder that disasters can happen at a moment’s notice and further hinder COVID-19 response efforts.

The International Federation of Red Cross and Red Crescent Societies coordinated an emergency appeal for 1.9 billion Swiss francs, which allowed layered funding specifically for COVID-19 prevention measures to continue, on top of other humanitarian needs.

Read more

Manufacturers support the advancement of local production and supply of quality assured medicines to improve access to medicine in Africa.

The COVID-19 pandemic has caused disruptions to global supply chains. In Africa, between 70% and 90% of pharmaceuticals are imported, and African countries have faced constraints such as lengthy lead times for the supply of essential medicines. In 2020, Medicines For Malaria Venture has entered into an agreement with three African manufacturers to produce a key preventive antimalarial for pregnant women and infants so as to increase the number of manufacturers and minimize interruptions in the supply chain.

Read more

Ending child marriage and female genital mutilation worldwide is possible within 10 years.

Keeping girls in school and engaging boys in social change are two ways to end FGM and child marriage. Estimated investments by the global community are totalling US$ 3.4 billion a year through 2030.

Read more

Effective communication is key to address COVID-19’s potential to threaten the years of progress towards gender-based violence, adolescent pregnancy and school dropouts.

Girls Not Brides: The Global Partnership to End Child Marriage is working with governments, providing updates on the situation in remote areas, carrying out budget and policy advocacy, and promoting new and progressive ways to reach those most in need. Many have sought to raise awareness of child protection through diverse media, including print and radio, and direct community outreach.

Read more

Section 4
Share your voice Created with Sketch.

Add your voice to the movement

You are invited to join world leaders in their commitment to protect and prioritize the health of women, children and adolescents around the world and in your community. Together we are rising to the challenge of the Decade of Action ahead. Join us.

OPEN LETTER

Signatories


H.E. Kersti Kaljulaid
President
Estonia

H.E. Tarja Halonen
Former President
Finland

H.E. Jakaya Kikwete
Former President
Tanzania

H.E. Epsy Campbell Barr
Vice President
Costa Rica

Rt. Hon. Helen Clark
Board Chair
PMNCH

H.E. Awa Marie Coll-Seck
Minister of State to the President
Senegal

H.E. Jagan Chapagain
Secretary-General
International Federation of Red Cross and Red Crescent Societies (IFRC)

H.E. Gabriela Cuevas Barron
President
Inter-Parliamentary Union (IPU)

Inger Ashing
CEO
Save the Children International

Anne-Birgitte Albrectsen
CEO
Plan International

Natasha Salifyanji Kaoma
Founder and CEO
Copper Rose Zambia

Tedros Adhanom Ghebreyesus
Director-General
WHO

Natalia Kanem
Executive Director
UNFPA

Henrietta H. Fore
Executive Director
UNICEF

Winnie Byanyima
Executive Director
UNAIDS

Phumzile Mlambo-Ngcuka
Executive Director
UN Women

Michelle Bachelet
United Nations High Commissioner for Human Rights
UN OHCHR

Jayathma Wickramanayake
UN Secretary-General's Envoy on Youth
United Nations

Mark Lowcock
UN Under-Secretary-General for Humanitarian Affairs
OCHA

Gerda Verburg
UN Under-Secretary-General and Coordinator
Scaling Up Nutrition Movement

Philippe Duneton
Acting Executive Director
Unitaid

Sign the letter here:

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Resources

The World Health Organization Data Portal for the Every Woman Every Child Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030)

The Indicator and Monitoring Framework for the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030) lists 60 indicators, of which 16 are key, to help countries and their partners promote accountability in ending preventable deaths (“Survive”), ensuring health and well-being (“Thrive”), and expanding enabling environments, so that all women, children and adolescents can reach their potential (“Transform”) and no women or child or adolescent is left behind. The most recently available data for these indicators have been compiled into one space: https://www.who.int/data/maternal-newborn-child-adolescent-ageing/global-strategy-data, bringing together data from various sources and also highlighting gaps in data availability.

Learn more

Countdown to 2030 national country profiles and interactive dashboard

Countdown to 2030 has prepared new country profiles for all low- and middle-income countries. The Countdown profiles present in one place the latest evidence to assess country progress in improving women’s, children’s and adolescents’ health. The profiles, including an interactive version of them and all associated data, showcase a range of data from demographics, mortality, nutritional status, coverage of evidence-based interventions, socioeconomic equity in coverage, and supportive policies, health systems measures and financing. They are produced by UNICEF in consultation with Countdown to 2030 partners. The country profiles and dashboards are available at: https://www.countdown2030.org/country-profiles

Learn more

Equity Countdown to 2030 country profiles

Countdown to 2030 has prepared updated equity profiles that show the magnitude and trends in health disparities in all low and middle income countries with a recent DHS or MICS survey. The profiles include four pages and equip country decision makers with a tool to help them monitor progress and for programming and planning purposes. The equity country profiles are prepared by the Equity Technical Working Group of Countdown and the team at the International Center for Equity in Health, Federal University of Pelotas, Brazil. The equity profiles are available at: https://www.countdown2030.org/equity-profiles

Learn more

Every Woman Every Child Latin America and the Caribbean (EWEC LAC)

This document describes the purpose of the EWEC LAC and its organizational composition. It provides an analysis of key indicators related to progress in women’s, children’s and adolescents’ health with an equity focus.

Learn more

The UNICEF Data website

The website is the global go-to for internationally comparable data on children. It aims to provide governments, UN agencies, NGOs, academics, media and individuals with the necessary insight to prompt action to protect the rights and improve the lives of every child.

Learn more

Commitments to the EWEC Global Strategy

Since 2010, EWEC partners have mobilized 186 billion US dollars 776 commitments in support of women, children and adolescents. Please see this presentation for more details on commitments to the Every Woman Every Child movement.

Learn more

Critical Review of DVTs for WCAH

UNICEF, WHO, PMNCH, and Development Gateways are jointly collaborating on a review of data visualization tools for women, children and adolescent health with the aim of understanding the breath and utility of existing tools and best practices for developing them for different target audiences. This powerpoint provides an overview of the aims and objectives of the study, preliminary findings, and next steps.

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