2016: OLD CHALLENGES, NEW HOPES

Is the global community keeping its promise to give every woman, every adolescent, and every child the opportunity to survive, thrive and transform?
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

A WORLD OF INEQUALITIES

Inequality within and between countries is at the root of women’s, children’s and adolescents’ health.

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.

IN HUMANITARIAN SETTINGS, WOMEN, CHILDREN AND ADOLESCENTS SUFFER MOST

IN HUMANITARIAN SETTINGS, WOMEN, CHILDREN AND ADOLESCENTS SUFFER MOST

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.

ADOLESCENTS: THE FUTURE BEGINS NOW

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 CAN DRIVE ECONOMIC GROWTH

THE HEALTH SECTOR CAN DRIVE
ECONOMIC GROWTH

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.

WE NEED A HEIGHTENED SENSE OF URGENCY

The previous Global Strategy helped to reduce maternal mortality from 385 deaths per 100,000 live births in 1990 to 216 in 2015. But to reach the global goal of no more than 70 deaths per 100,000 live births, the rate of progress will need to be three times faster.
In order to reach the Sustainable Development Goals’ target of 25 or fewer under-five deaths per 1,000 live births, 47 countries need to accelerate their reduction in under-five mortality.
The 2025 target also requires the current trend in overweight children to be reversed to a zero increase.
Policies are needed to support the poor – such as conditional cash transfers, breastfeeding support, taxing unhealthy processed food and sugary drinks, and promoting physical activity.
We must scale up efforts to prevent violence and provide services for women experiencing it.
The Global Strategy has included a stillbirth reduction target of 12 or fewer per 1,000 total births. To reach this, stillbirths must be recognized as a fundamental marker of inequity, counted and reported.

A CLEARLY DEFINED ROADMAP IS CRUCIAL – MORE MUST BE DONE, AND QUICKLY

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:

0,
commitments,

from governments, donors, civil society and the private sector

US$
0 billion

in financial
commitments

It is crucial for governments to have sufficient fiscal space to pursue the goals of the Global Strategy.

FURTHER ACTION IS REQUIRED
ON THREE FRONTS

Leadership

1. Leadership

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.

Resources

2. RESOURCES

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.

Institutions

3. Institutions

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.

OUR ACCOUNTABILITY FRAMEWORK

In its inaugural report, the Independent Accountability Panel presents its conceptual framework, inspired by human rights principles. Its approach is reinforced by a circular process – at the global and national level.

Monitor

Use data to ensure that legal and policy structures support reproductive, maternal, newborn, child and adolescent health.

Review

Analyze financial audits, assessments of human rights and gender compliance, parliamentary inquiries, citizens’ hearings and a variety of other sources.

act and remedy

Clarify responsibilities between national and international institutions and oversight bodies, promote their findings and ensure that they answer women, adolescents and children everywhere.

Review Remedies and Action Accountability
Remedies and Action Remedies and Action
Review Remedies and Action Accountability