Women's and children's health pays the price of inequalities

A new UN report* shows that the health of women and children has suffered around the world, as the impact of conflict, the COVID-19 pandemic and climate change converge with devastating effects on the prospects of children, young people and women. 

The data presented in the report, entitled 'Protecting the Promise', show clear and critical regression on virtually every major measure of child well-being, and on many key indicators of the Sustainable Development Goals. 

Since the last 'Every Woman Every Child' report, published in 2020, food insecurity, hunger, child marriage, risks of domestic violence, depression and adolescent anxiety have all increased. 

An estimated 25 million children were under-vaccinated or not vaccinated at all in 2021, which is six million more than in 2019, increasing their risk of contracting deadly and debilitating diseases. 

Millions of children were out of school during the pandemic, many for more than a year, while approximately 80% of children in 104 countries and territories experienced learning losses due to school closures. 

Since the start of the global pandemic, 10.5 million children have lost a parent or caregiver to COVID-19. 

The report provides extensive evidence showing that children's and adolescents' chances of leading healthy lives vary considerably for reasons as simple as where they are born, their exposure to conflict and their families' economic circumstances. For example: 

• A child born in a low-income country has an average life expectancy of about 63 years, compared to 80 in a high-income country. This devastating 17-year gap in survival has changed little in recent years. In 2020, five million children died before their fifth birthday, most from preventable or treatable causes. In addition, the majority of maternal, child and adolescent deaths and stillbirths are concentrated in just two regions: sub-Saharan Africa and South Asia. 
• More than 45 million infants were acutely malnourished in 2020, a life-threatening condition that increases the risk of death, stunting and disease. Nearly three quarters of these children live in lower-middle-income countries. In 2020, 149 million children were stunted, an alarming figure. Africa is the only region where the number of children affected by stunting has increased over the past 20 years, from 54.4 million in 2000 to 61.4 million in 2020. 
• The six countries with the highest number of internally displaced people - Afghanistan, Ethiopia, the Syrian Arab Republic, the Democratic Republic of the Congo, Sudan and Yemen - are also among the top 10 most food insecure countries. 
• A woman in sub-Saharan Africa has a 130 times greater risk of dying from causes related to pregnancy or childbirth than a woman in Europe or North America. Coverage of antenatal care, skilled birth attendance and postnatal care is far from universal for women in low- and middle-income countries, putting them at high risk of death and disability. 
• Millions of children and their families suffer poor physical and mental health due to recent humanitarian disasters in Afghanistan, Ethiopia, Pakistan, Somalia, Ukraine and Yemen. In 2021, an unprecedented 89.3 million people worldwide were driven from their homes due to war, violence, persecution and human rights abuses. 

For all these reasons, the report calls on the international community to address this damaging trajectory and protect the promises made to women, children and adolescents in the Sustainable Development Goals of the 2030 Agenda. 

In particular, it advocates for countries to continue to invest in health services, to address all crises and food insecurity, and to empower women and young people around the world. 

Following the release of the report, the UN Secretary-General said that "at the heart of our unfulfilled promise is the failure to address the massive inequalities that underlie the global crises, from the COVID-19 pandemic to conflict and the climate emergency. 

For António Guterres, the report describes the impact of these crises on women, children and adolescents, from maternal mortality to losses in education and increases in severe malnutrition. 

For his part, the head of the World Health Organization said, "The long-term impact of the COVID pandemic on the health and well-being of women, children and adolescents is becoming clear: their chances of leading healthy and productive lives have been significantly diminished." 

"As the world emerges from the pandemic, protecting and promoting the health of women, children and young people is essential to support and sustain global recovery," added Dr. Tedros Adhanom Ghebreyesus. 

The UNICEF chief noted that the pandemic has increased risks for all vulnerable communities and reversed hard-won gains for women, children and adolescents. 

"But we are not powerless to change this... By investing in resilient and inclusive primary health care systems, putting routine immunisation programmes in place and strengthening the health workforce, we can ensure that every woman and child can access the care they need to survive and thrive," said Catherine Russell. 

Her colleague, the Executive Director of the United Nations Population Fund, Dr. Natalia Kanem, commented that "in the face of a growing political backlash against sexual and reproductive health and rights in many countries, women, children and adolescents today are missing many of the protections they had just a decade ago, and many others have yet to see the progress they need". 

*The report, entitled "Protecting the Promise," is published by a number of global partners, including WHO, UNICEF, UNFPA, the Partnership for Maternal, Newborn & Child Health (MNCH) and Countdown to 2030, and is a biennial summary of progress made in response to the UN Secretary-General's "Every Woman, Every Child Global Strategy" for women's, children's and adolescents' health. It is the most comprehensive synthesis of evidence on the current state of maternal, newborn, child and adolescent health, and updates the last 'Every Woman, Every Child Global Strategy Progress Report', published in 2020.