Apr 14, 2018 Volume 391 Number 10129 p1455-1548
A call to action: improving women’s, children’s, and adolescents’ health in the Muslim world
Amina J Mohammed
We have witnessed considerable progress in reducing maternal and child mortality in recent decades, but fragility and inequity continue to leave our most vulnerable communities behind. The study presented by Nadia Askeer and colleagues1 in The Lancet sheds welcome light on why, despite improvements, progress in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) has been generally slower in some Muslim majority countries (MMCs). This study has a special meaning to me, not only as Deputy Secretary-General of the United Nations; but as a Muslim woman, a mother, and a grandmother.
In its universality, the 2030 Agenda for Sustainable Development urges us to go the last mile to deliver a sustainable, prosperous, and inclusive future for all—leaving no one behind. Building on the traditional development paradigm, the Sustainable Development Goals (SDGs) promise a world in which people not only survive but thrive.
The health and wellbeing of women and children are key. At a historic 1·2 billion,2 today’s adolescents also demand our focus so we can unlock a demographic dividend that can yield benefits for generations to come. With the proportionally youngest population of all major religious groups,3 this holds particular relevance for MMCs.
As Akseer and colleagues note, greater investment in national public health systems in MMCs is needed to reduce out-of-pocket health-care spending and improve RMNCAH outcomes, particularly for reproductive and maternal health and childhood vaccination. As we work to achieve universal health coverage, this investment must be central to our efforts to strengthen entire health systems so that we can ensure access to quality, affordable, and respectful services for all. Increased efforts at the community level will also be important, including through the strengthening of local institutions, skilled, gender-responsive community health workers, the engagement of men and boys, and the buy-in of religious communities. We must also strengthen our communications and advocacy efforts to improve practices and promote healthy behaviours such as birth spacing, exclusive breastfeeding, and care for lactating mothers, particularly in Islamic countries. Coupled with greater intergenerational engagement, we can create the environment needed to improve health outcomes for years to come.
In an evolving and complex development landscape, we must move beyond the traditional silos that have hampered our efforts to address the contextual barriers that keep so many back, particularly women and girls. Simply put, we cannot achieve the RMNCAH targets of SDG 3—globally or within the Islamic context—without also investing in social sectors. These investments must work to improve the overall status of women, which continues to halt progress globally against RMNCAH targets and the SDGs.
The current study articulates this well, with better RMNCAH outcomes observed in countries such as Bangladesh and Egypt, where targeted investments beyond the health sector have been made to improve girls’ access to education and women’s empowerment. Health does not exist in a vacuum. Success will require bold partnerships, building linkages and leveraging unique functions within and across sectors to deliver on an integrated agenda. Strengthened engagement of women in decision-making processes, particularly at the local level, will be paramount to help ensure approaches that prioritise both the health and wellbeing of our women and girls.
Greater investments in RMNCAH are also some of our greatest tools in the face of rising levels of conflict and humanitarian crisis, which disproportionately affect MMCs. We must prioritise the potential of women and adolescents as agents of peace through greater investments across health, education, and economic sectors.
The Every Woman Every Child (EWEC) Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030)4 provides a roadmap for country-specific implementation of the SDGs, accounting for the very barriers raised in the current study. I was pleased to play a part in the development and launching of this robust strategy during the SDG Summit in 2015. The Organisation of Islamic Cooperation (OIC) previously committed to implementing the first EWEC global strategy (2010–15), and since its launch in 2015, nearly 20 OIC member states have committed to implement the updated EWEC global strategy. I encourage OIC leaders and member states to recommit to implementing the EWEC global strategy as a key driver of the 2025 Programme of Action,5 the United Nations Commission on Population and Development, and the broader SDGs.
With just 12 years to deliver on the promises enshrined within the 2030 agenda, the time for action is now. I call on my fellow leaders, including those in predominantly Muslim countries, to consider the findings of this study and work together—with ambitious resolve, across borders and sectors—to fully implement the 2030 agenda. Investing in women’s, children’s, and adolescents’ health is a smart place to start.