Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival

Abstract

Conceived in 2003 and born in 2005 with the launch of its first report and country profiles, the Countdown to 2015 for Maternal, Newborn, and Child Survival has reached its originally proposed lifespan. Major reductions in the deaths of mothers and children have occurred since Countdown's inception, even though most of the 75 priority countries failed to achieve Millennium Development Goals 4 and 5. The coverage of life-saving interventions tracked in Countdown increased steadily over time, but wide inequalities persist between and within countries. Key drivers of coverage such as financing, human resources, commodities, and conducive health policies also showed important, yet insufficient increases. As a multistakeholder initiative of more than 40 academic, international, bilateral, and civil society institutions, Countdown was successful in monitoring progress and raising the visibility of the health of mothers, newborns, and children. Lessons learned from this initiative have direct bearing on monitoring progress during the Sustainable Development Goals era.

Figure 1. Coverage of interventions varies across the continuum of care

IPTp=intermittent preventive treatment of malaria during pregnancy. DTP3=three doses of combined diphtheria/tetanus/pertussis vaccine immunisation coverage. Hib3=three doses of Haemophilus influenzae type B immunisation coverage. ITNs=insecticide-treated net use. *Countries where at least 75% of the population is at risk of malaria and where a substantial proportion (50% or more) of malaria cases is due to Plasmodium falciparum (n=44) or where 50–74% of the population is at risk of malaria and where a substantial proportion (50% or more) of malaria cases is due to P falciparum (n=8). Source: Immunisation rates, WHO and UNICEF; postnatal visit for mothers and postnatal visit for babies, Saving Newborn Lives analysis of Demographic and Health Surveys; improved water and sanitation, WHO and UNICEF Joint Monitoring Programme for Water Supply and Sanitation; all other indicators, UNICEF global database, July 2015, based on Demographic and Health Surveys, Multiple Indicator Cluster Surveys and other national surveys; does not include 2014–15 Rwanda data.

Figure 2

Global trends in the composite coverage index at national level and for the poorest and richest 20% of the national samples in 47 countries and (A) global trends in absolute (slope index of inequality) and relative (concentration index) inequalities in the composite coverage index (B) CCI=composite coverage index.

Figure 3. Trends in the adoption of selected tracer policies at macropolicy and micropolicy level, 2008–14 (68 Countdown countries, %)

ORS=oral rehydration salts.