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CHALLENGES TO OVERCOME

Although widespread progress has been made in recent decades, women, children and adolescents still face numerous health challenges, with many factors often affecting each other. Causes of preventable death and ill-health include communicable and non-communicable diseases, mental illness, injuries and violence, malnutrition, complications of pregnancy and childbirth, unwanted pregnancy and lack of access to, or use of, quality health-care services and life-saving commodities.8,9,34 Underlying structural causes include poverty, gender inequality (manifested in discrimination in laws, policies and practice) and marginalization (based on age, ethnicity, race, caste, national origin, immigration status, disability, sexual orientation and other grounds) that are all human rights violations.35,36

Other factors that significantly influence health and well-being include: genetics; families, communities and institutions; underlying unequal gender norms within households; income and education levels; social and political contexts; the workplace; and the environment.34

SPOTLIGHT ON HEALTH CHALLENGES

The data in the following infographics highlight some of the most pressing health challenges faced globally by women, children and adolescents at the time of the Global Strategy launch in September 2015. The challenges have their roots, to a very great extent, in human rights failures. The statistics and sources for the infographics are available at:: www.everywomaneverychild.org.

Women’s health challenges

Despite progress, societies are still failing women, most acutely in poor countries and among the poorest women in all settings. Gender-based discrimination leads to economic, social and health disadvantages for women, affecting their own and their families’ well-being in complex ways throughout the life course and into the next generation. Gender equality is vital to health and to development.

Child health challenges

The high rates of preventable death and poor health and well-being of newborns and children under the age of five are indicators of the uneven coverage of life-saving interventions and, more broadly, of inadequate social and economic development. Poverty, poor nutrition and insufficient access to clean water and sanitation are all harmful factors, as is insufficient access to quality health services such as essential care for newborns. Health promotion, disease prevention services (such as vaccinations) and treatment of common childhood illnesses are essential if children are to thrive as well as survive.

Adolescent health challenges

Globally, millions of adolescents die or become sick from preventable causes. Too few have access to information and counselling and to integrated, youth-friendly services, and especially to sexual and reproductive health services without facing discrimination or other obstacles. In many settings, adolescent girls and boys face numerous policy, social and legal barriers that harm their physical, mental and emotional health and well-being. Among adolescents living with disabilities and/or in crisis situations, the barriers are even greater.

Environmental health challenges

Environmental factors such as clean water and air, adequate sanitation, healthy workplaces and safe houses and roads all contribute to good health. Conversely, contaminated water, polluted air, industrial waste and other environmental hazards are all significant causes of illness, disability, and premature deaths. They contribute to and result from poverty, often across generations.

Humanitarian and fragile settings

The SDGs will not be reached without specific attention to countries with humanitarian and fragile settings that face social, economic and environmental shocks and disasters.37 Risks include conflict and violence, injustice, weak institutions, disruption to health systems and infrastructure, economic instability and exclusion, and inadequate capacity to respond to crises.38 It is crucial and urgent for the international community to better support countries in upholding fundamental human rights across the life course in every setting.

THE HEALTH EQUITY GAP WITHIN AND BETWEEN COUNTRIES

Health outcomes among women, children and adolescents are worse when people are marginalized or excluded from society, affected by discrimination, or live in underserved communities—especially among the poorest and least educated and in the most remote areas.6 In low- and middle-income countries there can be:34

  • Up to three times more pregnancies among teenage girls in rural and indigenous populations than in urban populations
  • Up to an 80 percentage point difference in the proportion of births attended by skilled health personnel between the richest and poorest groups within countries
  • At least a 25 percentage point difference in antenatal care coverage (at least four visits) between the most and least educated and the richest and poorest groups within countries
  • At least an 18 percentage point gap in care-seeking for children with pneumonia symptoms between the poorest and richest groups within countries, with low careseeking rates overall
  • Up to 39 percentage points higher stunting prevalence in children of mothers with no formal education compared with those children whose mothers completed secondary school or higher education

This equity gap is clearly visible when comparing health outcomes for women, children and adolescents within countries (Figure 2) and across regions (Figure 3).

Figure 2:

The in-country equity gap in under-five deaths by economic status and mother’s education*

* Data from national Demographic and Health Surveys in 49 low- and middle-income countries, 2005–2012.
** Education data are not available for 10 countries.39

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“Gender equality and women’s empowerment bring huge economic benefits. Countries with better gender equality have faster-growing, more competitive economies. Gender equality is the right thing to do, but it’s also a smart thing to do.”

MICHELLE BACHELET President of Chile

Figure 3:

Inequitable risks of maternal and child death across regions*

* These data are based on the 2014 United Nations Interagency Estimates and the WHO regional grouping of countries with separate data for North America and Latin America.8,9 Data on individual countries, and by alternative regional groupings, are available in the related references. MM=maternal mortality—lifetime risk (probability that a 15-year-old female will die eventually from a maternal cause assuming that current levels of fertility and mortality, including maternal mortality, do not change in the future, taking into account competing causes of death); U5M=under-five mortality—proxy measure of the risk of a child dying before the age of five (calculated by dividing 1,000 live births by the average under-five mortality rate for each region).8,9

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