How many lives are at stake? Assessing 2030 world sustainable development goal trajectories for maternal and child health

John W McArthur , Krista Rasmussen , and Gavin Yamey examine how far countries have to go to meet the targets for maternal and child mortality and what needs to be done to help them The launch of the 17 sustainable development goals in 2016 introduced a new era for the global health and development community. The preceding millennium development goals (MDGs) set targets to reduce the mortality rate for children under 5 years by two thirds and the maternal mortality ratio by three quarters between 1990 and 2015, with special focus on the poorest countries. Overall, the world ended up reducing child mortality by an estimated 55% and maternal mortality ratio by 44%, while countries classified as “least developed” by the United Nations experienced a 60% decline in child mortality and 52% decline in maternal mortality.12 At least 10.1 million and as many as 19.4 million additional children’s and mothers’ lives are estimated to have been saved compared with pre-MDG trajectories.3 Many of the biggest improvements occurred in sub-Saharan Africa.3 The new goals, which apply to all countries and run to 2030, include one health goal, SDG 3—to “ensure healthy lives and promote wellbeing for all at all ages”—with 13 associated targets. Target 3.1 calls for the global maternal mortality ratio to be below 70 deaths per 100 000 live births, a 68% reduction in only 15 years. Target 3.2 calls for all countries to lower their child mortality to at most 25 per 1000 live births and their neonatal (age 0-28 days) mortality to at most 12 per 1000 live births. Are countries on course to meet the new targets, and, if not, what do they need to do to accelerate their progress? Recent studies have considered this question with a focus on individual indicators, …

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