While substantial progress has been achieved, 803 women still die every day due to child birth. About 99% of the world’s maternal deaths occur in developing regions, with Sub-Saharan Africa alone accounting for two in three (66%) deaths. Most of these deaths are preventable if pregnant women receive the healthcare they need, and when they need it. The lifetime risk of death for women in high income countries, where health services are more accessible, is 1 in 2400; but in low income countries it is 1 in 180 and under conditions of fragility and conflict, it is even higher with 1 in every 54 women dying due to complications related to pregnancy.
Child mortality rates more than halved between 1990 and 2016 – with under-five deaths dropping from 12.7 million per year in 1990 to 5.6 million in 2016. Yet, , 16,000 children under five still die every day. A child’s chance of survival is still vastly different based on where he or she is born: Sub-Saharan Africa has the highest under-five mortality rate in the world with one child in 12 dying before his or her fifth birthday—more than 12 times higher than the one in 147 average in high-income countries.
Globally women are giving birth to fewer children today than three decades ago. However, there are still a handful of countries with persistently high fertility such as Niger (7.2), Mali (6.1) or Afghanistan (4.6). In many other countries with lower fertility, there are variations. For example, in Ethiopia fertility varies within different regions. It ranges from 1.7 in Addis Ababa to 6.4 in Somali, a regional state in Ethiopia. Among countries with persistently high fertility, there is also a high burden of maternal, infant and child mortality.
Adolescent fertility is also high in countries with high fertility. More than a fourth of girls and women in Sub-Saharan African cannot access family planning services, fueling unplanned pregnancies and maternal, infant and child mortality and morbidity. Adolescent girls are more likely to experience complications due to pregnancy such as obstructed labor and eclampsia increasing their risk of death. Children born to adolescents are also more likely to have a low birth weight, ill-health, stunting and other poor nutritional outcomes.
Fertility is also a key driver of population dynamics. Many countries that are experiencing rapid population growth also have young populations. Such countries have the potential of benefiting from demographic dividend when key investments are made in the health and well-being to build their human capital.
Ensuring that every woman and child has access to health care is pivotal for human capital formation, building robust economies, and ending poverty. It is also fundamental to achieving Universal Health Coverage. Improving reproductive, maternal, newborn, child and adolescent health (RMNCAH) supports these outcomes. To propel this agenda and harmonize fragmented RMNCAH approaches, the WBG and partners launched the Global Financing Facility (GFF) in 2015, a multi-stakeholder partnership that supports country-led efforts to improve the health of women, children, and adolescents. Since its inception, US$482 million in funding from the GFF Trust Fund had been linked to US$3.4 billion in funding from the World Bank’s International Development Association (IDA) and International Bank for Reconstruction and Development (IBRD) in support of the health and well-being of women, children and adolescents. In November 2018, world leaders pledged US$1 billion to help the GFF partnership on the pathway toward expanding to a total of 50 countries with the greatest health and nutrition needs.
Another key effort is the Sahel Women’s Empowerment and Demographic Dividend (SWEDD) project. Approved in 2014 and now being scaled up to more countries in the region, SWEDD is improving women’s and girls’ reproductive health, their education and skills, and consequently their competitiveness in the labor market in Burkina Faso, Chad, Cote d’Ivoire, Mauritania, Mali and Niger. Specifically, the effort is generating demand for reproductive, maternal, neonatal, child health and nutrition commodities and services; improving the supply of commodities and qualified personnel; and strengthening advocacy and policy dialogue, as well as capacity for monitoring and policymaking in relation to demographic dividends.
Last Updated: Apr 17, 2019