Countries are making progress toward the Sustainable Development Goals (SDG) related to health, but the pace falls short of what would be needed to achieve the global targets on time, concludes a Countdown to 2030 report published by The Lancet. The report will be presented to policymakers and other key stakeholders during an event taking place in Senegal on 14 April; the event will also be livestreamed.
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“This report presents a comprehensive analysis of progress in reproductive, maternal, newborn, child and adolescent health and nutrition,” said Ties Boerma of the University of Manitoba, one of the report’s lead authors. “Even though there’s been progress, there are some major slowdowns which means that many countries will not be able to reach the Sustainable Development Goal targets, especially in sub-Saharan Africa.”
In addition, Boerma noted, “It also shows that there are worrisome headwinds, such as economic stagnation, armed conflict, and also recent declines in international assistance.”
The report presents data around three areas – (1) contextual factors; (2) mortality, causes of death and nutritional status; and (3) coverage, equity and service quality – then concludes with discussion on priority areas for action. These priorities include focusing on sub-Saharan Africa, strengthening health systems, protecting progress against crises, improving data, and revitalizing the global movement.
“The report explains the drivers or the reasons behind the slowing down of progress for women’s and children’s health,” said Professor Agbessi Amouzou of the Johns Hopkins Bloomberg School of Public Health, one of the report’s lead authors. “Health care must be accessible, equitable, of high quality. Everyone deserves the best care at every stage of life.”
The main report was finished before the USAID fundings cuts in early 2025, but some authors have published a commentary discussing the impact that these cuts will have on reproductive, maternal, newborn, child and adolescent health (RMNCAH).
“The positive effects of development assistance for health on maternal and child survival are well documented,” the authors wrote. “Major increases in external funding for RMCNAH have driven substantial declines in child and maternal mortality since 2000. Country in-depth studies have shown the strong association between increased external funding, better intervention coverage, reduced inequalities, and increased maternal and child survival.”
Report sections:
Section 1 discusses contextual factors that have limited global progress. These include population dynamics, economic threats, gender gaps including education, armed conflict, food insecurity as well as unhealthy food environments, and climate change.
Section 2 presents data on mortality, cause of death and nutritional status.
Key points:
- Since 2015, stillbirth, child and adolescent mortality rates continued to decline, but in low- and middle-income countries the rate of decline was slower than it was in 2000-2015.
- Lack of quality data limits maternal mortality trend analysis but suggest that progress has slowed.
- Improvements in stunting prevalence among children under five were measured during this period, but the prevalence of wasting has shown little change. Overall obesity rates increase and underweight decreased among older children, adolescents, and women.
Section 3 tracks 20 indicators related to healthcare during pre-pregnancy, pregnancy, infancy, childhood, and adolescence. These include: coverage along the continuum of care, the composition coverage index, and the slope index of inequality (SII).
Key points:
- As with mortality, coverage increased during 2016-2023 relative to 2000-2015 but was inadequate for achieving global goals.
- Skilled birth attendance reached the highest coverage, with 95.6% as the median for 113 low- and middle-income countries.
- Data limitations make it challenging to measure quality of care.
Learn more about Countdown’s measurement of equity and effective coverage.
Conclusions – The report concludes by calling for more focused effort on sub-Saharan Africa, better strategies for improving health systems, safeguarding against crises, improved monitoring and accountability, and revitalized global coordination.
Countdown has an extensive history of tracking progress toward global goals, first during the Millenium Development Goal era (2000-2015) and now during the Sustainable Development Goal era.
Access previous global monitoring reports.
Access country profiles for RMNCAH, equity and early childhood development.