Having just returned from the International Conference on Population and Development (ICPD), I was reminded of the tremendous progress the world has made in improving access to health care, especially when it comes to reproductive, maternal, and child health.
When the first ICPD conference was held 25 years ago, fertility was especially high in less developed, lower income countries. The total fertility rate for the South Asia, Middle East, and Latin America regions was nearly 4 births per women. In sub-Saharan Africa, it was even higher with over 6 births per woman. Similarly, the burden of maternal mortality in the region was highest at an estimated 920 maternal deaths per 100,000 live births, followed by South Asia with 461 maternal deaths per 100,000 live births.
We have come a long way since then – there has been a 38 percent decline in maternal mortality globally, and under 3 births per woman in most cases.
Addressing the remaining challenges
But significant challenges remain. Today, 800 women still die globally on a daily basis due to pregnancy related complications, and while fertility in most of the world has declined, it remains persistently high in some countries, particularly in Sub-Saharan Africa.
The last decade has also seen an unprecedented population displacement due to conflict and natural disasters uprooting people and reversing gains made in their access to health, including reproductive health. These situations have also contributed to heightened violence against women and girls.
To address these global challenges, the World Bank puts girls and women at the center of its work. We support countries to invest in the human capital of their countries and to make the most of human capital investments, we must empower girls and women, together with boys, men and communities. We must ensure quality sexual and reproductive health services are available according nationally designed minimum service packages. Investing in girls and women supports a virtuous cycle: healthier, better-educated mothers have healthier, better-educated families.
Increasing investments in people
Over the last decade IDA, the World Bank’s fund for the poorest, has provided US$45.7 billion to support human development outcomes in the poorest countries. Earlier this year, through the Human Capital Plan for Africa, we have committed to significantly increase our investments in human capital in the next funding cycle. This includes new World Bank grants and concessional finance for human capital projects in Africa totaling $15 billion by 2023.
Take the Sahel Women’s Empowerment and Demographic Dividend (SWEDD) project which focuses on women’s empowerment, including family planning and reducing gender-based violence through cross-cutting interventions. Through SWEDD investments, 40,000 girls have benefitted from schooling-related interventions like transportation services, accommodation, food, school supplies and cash transfer programs. Keeping girls in school, especially secondary school, helps to reduce the burden of unwanted and early pregnancies, and allows girls the opportunity to develop to their fullest potential. SWEDD investments have also helped to increase the presence of midwives in Mali by 12 percent; and are helping to enhance the quality of training for midwives and OBGYN nurses across the project countries.
The Global Financing Facility
Another major initiative is the Global Financing Facility, a partnership hosted at the World Bank, that works with countries and other partners to improve the health of women, children and adolescents and strengthen primary healthcare and financing systems.
With a strong focus on reproductive and maternal health (along with newborn, child, and adolescent health) in some of the poorest countries in the world, the GFF was launched in 2015 to help governments transform how they invest in the health and nutrition of women, children and adolescents. The GFF supports government-led, multi-stakeholder platforms to develop and implement a national, prioritized health plan (called an investment case), that aims to mobilize sustainable financing for health and nutrition.
Linking moderate amounts of resources to World Bank financing, the GFF supports countries to strengthen their focus on data, quality, equity, results and domestic resources for health. It is linked to the World Bank’s IDA – each dollar of GFF grants catalyzes at least $7 in IDA investments. As of May 2019, the GFF is working in 36 low- and lower-middle-income countries in Africa, Asia and Latin America. Following its successful $1 billion replenishment effort in November 2018—supported by several key donors including Norway, Canada, Japan, the United Kingdom, the Bill and Melinda Gates Foundation and others—the GFF aims to expand its support to 50 countries with the greatest health and nutrition needs by 2023.
Improving women’s, adolescents’ and children’s health and well-being is an important part of creating conditions for lasting development. GFF supports integration of sexual and reproductive health services within nationally designed basic health services packages. We look forward to continuing this work and strengthening our partnerships and forging new ones to achieve this goal.