2016: OLD CHALLENGES, NEW HOPES
Accountability for the Global Strategy for Women’s, Children’s and Adolescents’ Health
NOW IS THE TIME TO PUT WOMEN, CHILDREN AND ADOLESCENTS AT THE HEART OF THE WAY WE ADDRESS PUBLIC HEALTH
A WATERSHED YEAR
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).
A WORLD OF INEQUALITIES
Inequality within and between countries is at the root of women’s, children’s and adolescents’ health challenges.
- Gaps are increasing in 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 meeting the demand for family planning
- Childbirth remains a leading cause of death among girls aged 15–19 globally
- 159 million children suffer from stunted growth due to malnutrition worldwide, with widening inequality trends
- Children in rural areas are nearly twice as likely to be out of primary school compared to urban children
- More than half (59%) of infants under 12 months have their births registered globally, but only 33% in South Asia and sub-Saharan Africa
- Nearly one in five adolescent girls in low- and middle-income countries becomes pregnant before age 18
- 120 million girls under age 20 (about 1 in 10) have experienced forced sexual acts
- Poorer girls are significantly more likely to become mothers than wealthier peers
- Young people are almost three times more likely than adults to be unemployed
- Gender inequalities in youth employment remain significant despite global improvements
- Unsafe sex rose from the 13th ranked risk factor in 1990 to the second in 2013 among adolescents
- The likelihood of adolescent pregnancy remains largely unchanged over decades
IN HUMANITARIAN SETTINGS, WOMEN, CHILDREN AND ADOLESCENTS SUFFER MOST
The world is experiencing the greatest level of humanitarian need since the Second World War.
- Forced displacement has exceeded 60 million people for the first time
- 125 million people require life-saving assistance
- Women, children, adolescents and the elderly are less able to flee, access resources, and are more vulnerable to violence and risk
ADOLESCENTS: THE FUTURE BEGINS NOW
Today’s generation of adolescents is the largest in history, with 1.2 billion people aged 10–19 worldwide.
Their unprecedented numbers, particularly in low-resource settings, mean they are not only beneficiaries of development but also key drivers of progress.
- Investment in education, health and livelihoods is essential
- Adolescents require integrated support including life skills, education and employment opportunities
- Young people have the right to comprehensive and non-discriminatory sexual and reproductive health education
- As of 2015, 89 countries had policies allowing adolescents access to sexual and reproductive health services
THE HEALTH SECTOR CAN DRIVE ECONOMIC GROWTH
The health sector is a major driver of employment and economic development.
- The global economy is expected to create approximately 40 million new health sector jobs by 2030
- Women make up a large proportion of the health workforce (nurses, midwives, community health workers)
- Strengthening the health workforce—especially for maternal, newborn, child and adolescent health—is critical for equitable progress
WE NEED A HEIGHTENED SENSE OF URGENCY
- Maternal mortality declined from 385 deaths per 100,000 live births in 1990 to 216 in 2015
- Progress must accelerate threefold to reach global targets
- To achieve fewer than 25 under-five deaths per 1,000 live births, 47 countries must accelerate progress
- Overweight trends in children must be reversed to zero increase
- Policies must support vulnerable populations, including social protection, breastfeeding, and healthier food environments
- Efforts to prevent violence against women must be scaled up
- Stillbirth reduction targets (12 per 1,000 births) must be prioritized
- Stillbirths must be recognized as a key indicator of inequality
A CLEARLY DEFINED ROADMAP IS CRUCIAL — MORE MUST BE DONE, AND QUICKLY
To ensure women, children and adolescents survive and thrive:
- Increased investment and financing frameworks are required
- Governments and international actors must mobilize additional resources
- As of June 2016:
- 177 commitments from governments, donors, civil society and private sector
- US$ 25.5 billion in financial commitments
It is crucial for governments to have sufficient fiscal space to achieve the goals of the Global Strategy.
FURTHER ACTION IS REQUIRED ON THREE FRONTS
1. Leadership
Global and national leadership must prioritize women’s, children’s and adolescents’ health within the 2030 Agenda. Strong coordination across sectors and institutions is essential.
2. Resources
Better estimates of costs and benefits are needed, alongside stronger financial commitments. Governments must improve tax systems and reduce evasion. Donor criteria must be reassessed to better reflect global needs.
3. Institutions
National statistical systems, independent oversight bodies, and civil society engagement must be strengthened. The private sector and professional organizations must also play an active role.
OUR ACCOUNTABILITY FRAMEWORK
The IAP introduces a human rights-based accountability framework built on a continuous cycle:
Monitor
Use data to ensure laws, policies and systems support health outcomes.
Review
Conduct audits, assessments, parliamentary reviews and citizen engagement.
Act and Remedy
Clarify responsibilities, take corrective action and ensure accountability at all levels.
This operates across both:
- Country accountability
- Regional and global accountability
FINAL MESSAGE
The IAP welcomes feedback and inputs for future reports.
We are all accountable to the women, children and adolescents of this world.