1. Callister, Lynn Clark PhD, RN, FAAN

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As we look at the health and well-being of women and children globally over the past 15 years of millennium, we could ask: Where have we been and where are we going? The new Sustainable Development Goals (SDGs), also known as the Global Goals were adopted by 139 countries at the United Nations in September 2015 with a global emphasis on attaining healthy life for all at all ages. The Global Goals are guiding strategies for development worldwide through the year 2030. They build on the eight Millennium Development Goals (MDGs), which provided direction for global initiatives in policy and funding from 2000 to 2015.


Significant progress has been made over the past 15 years in important areas such as access to improved water sources, child mortality, income poverty, and primary school enrollment (United Nations [UN], 2015). Impressive strides have been made in child health globally, particularly in the under-5 year mortality rate, which has declined more than 50% between 1990 and 2015 (UN). But still every day across the world, 16,000 children under 5 years of age die, the majority from preventable causes such as birth complications and treatable infections. "Mother's education remains the most powerful determinant of inequality in survival" (p. 34) meaning there is much to be done in educating and empowering women throughout the world (UN). Child survival must remain the focus of the post-2015 development agenda if we intend to improve the health and well-being of the next generations of children across the world (UN).


According to the 2015 MDGs report (UN, 2015), the maternal mortality ratio has been reduced by 45% since 1990, with most of the decline occurring since 2000. Over 71% of births are attended by skilled birth attendants compared to 59% in 1990. But this means that over 25% of women are not attended by professionals while giving birth. Voices of women beyond statistical data document the pathos of maternal mortality. Maria Elena, a woman who gave birth in the remote highlands of Guatemala died within 4 hours of giving birth from severe postpartum hemorrhage. The village woman who told me this sad story said simply, "Many women die." (Callister, 2005, p. 186). Such tragic disparities still exist, particularly in sub-Saharan Africa and Southern Asia, where rates of maternal/newborn mortality remain high. It is well established that critical healthcare interventions across the childbearing year include prenatal care, intrapartum care, and support following giving birth. According to the MDG 2015 Report (UN, p. 37), "Maternal, newborn, and child survival must remain at the heart of the post 2015 global development agenda." The SDGs include (1) no poverty, (2) zero hunger, (3) good health and well-being, (4) quality education, (5) gender equality, (6) clean water and sanitation, (7) affordable and clean energy, (8) decent work and economic growth, as well as (9) industry, innovation, and infrastructure (UN). Additional goals include (10) reduced inequalities, (11) sustainable cities and communities, (12) responsible consumption and production, (13) climate action, (14) life below water, (15) life on land, and (16) peace, justice, and strong institutions, and partnerships for the goals.


The development agenda outlined in the new Global Goals is applicable to all countries, rather than focusing on low resource countries (UN, 2015). It seeks to address causes of environmental, social, and economic challenges around the world. Although great progress has been made since the beginning of this millennium, it is critical that the health of women and children "must remain the focus of the post-2015 development agenda" (UN, p. 37). Improvements that have been made in maternal/child health over the past 15 years, and the new Global Goals provide clear and bold direction for the next 15 years. More work is needed to support the best health of women and children around the world.




Callister L. C. (2005). Global maternal mortality: Contributing factors and strategies for change. MCN. The American Journal of Maternal Child Nursing, 30(3), 184-192. [Context Link]


United Nations. (2015). The Millennium Development Goals 2015 Report. New York: Author. [Context Link]