MDG4 Progress: Saving Our Little Saviors

A nation’s future is built upon its children. Early childhood development is considered to be the most important phase which determines the overall wellbeing across the individual’s lifespan. Investing in children translates into saving our world from the countless ills that plague society today.

15 years ago, the world made a promise in the form of Millennium Development Goal 4 to reduce the global under-five mortality rate by two-thirds between 1990 and 2015 as our leaders agreed on the eight Millennium Development Goals (MDGs). We have now reached the end of the era of the MDGs, and the world has come together to make a new promise in the form of a new set of goals for the coming 15 years. In that respect, it is important to take a closer look at how well we did in our strive to uphold our promise; and approach the Sustainable Development Goals (SDGs) with a renewed sense of commitment.

We should acknowledge that we have come a long way. According to the 2015 Levels and Trends in Child Mortality report by UNICEF, WHO, World Bank Group and the United Nations, substantial global progress has been made over the years. The number of under-five deaths worldwide has declined from 12.4 million in 1990 to 5.9 million in 2015, leaving us with 19,000 fewer deaths every day. We have also accelerated global progress as a whole. The world’s annual under-five mortality rate reduction has increased from a rate of 1.8% between 1990 and 2000, to 3.9% in 2000-2015. This momentum of recent years was certainly boosted by the Global Strategy for Women’s and Children’s Health launched by the United Nations Secretary- General Ban Ki-moon, and the Every Woman Every Child movement for improving newborn and child survival, including maternal health.

Sub-Saharan Africa, the region with the highest under-five mortality rate in the world has also registered a considerable acceleration with an annual rate of reduction which increased from 1.6% in the 1990s to 4.1% between 2000 and 2015. My own country has contributed its share of achievements for the registered improvement in the region. Among 11 other low income nations, Ethiopia has been able to meet its target of this goal, a success highly attributed to progressive health strategies by the Federal Ministry of Health, stronger partnerships and remarkable outreach work conducted by community health extension workers. Over all, the world has avoided the death of 48 million children under the age of five since 2000- a figure which would not have been possible had the mortality rate at the new millennium remained the same.

A staggering achievement, but not enough! Our progress is shadowed by the realization that despite all the strides, our efforts were still insufficient for us to meet this goal globally. Presently, 16,000 under-five children still die every day. This realization is even more painful with the knowledge that most of these deaths are caused by diseases that are readily preventable or treatable. Our achievements in the MDGs are also varied in-between targets. We now understand that neonatal complications are responsible for the vast majority of under-five deaths; with factors related to the educational attainment of mothers, their level of access to health systems, income, nutrition and the prevalence of HIV. It is particularly worrisome that the 53% global decline we have seen in the under-five mortality rate is far from the two-thirds reduction we need. If current trends are to continue, we would only be able to achieve this goal by 2026! This task is a tremendous unfinished business for the commitment our leaders made in 2012; A Promise Renewed an even more ambitious undertaking with proposed SDG target for child mortality to end preventable deaths of newborns and children under-five, by 2030.

There is a huge fight awaiting us. The SDGs come at a time where emerging global issues that should have been foreseen and prevented well ahead are enormously changing the contexts we work in. The current refugee crisis and the harsh challenges presented by working in conflict settings is a huge wake up call to push for more innovative strategies. We have to explore an integrated approach that complements our success in the different goals and targets. Our movement needs to be people-centered, owned and led by the community. Key actors including powerful players in the private sector have to be equally engaged in the fight.

As a youth advocate, I also want to remind us of the big opportunity we have in our hands. We need to adopt an uncompromising stance for applying the great passion and untapped potential us young people have to offer, in providing more innovative solutions to the multitudes of issues we have yet to confront.

Featured image: Mary Thullah, 20-year old mom comforts her daughter Fatmata Turay after she received vaccinations at the Princess Christian Maternity Hospital on March 10, 2015 in Freetown Sierra Leone. Photo © Dominic Chavez/World Bank

Steering the Post-2015 Agenda in Uganda: Putting Youth Behind the Wheel

Photo c/o CFYDDI
Enoch Magala c/o CFYDDI

The theme of the recent International AIDS Conference held in Melbourne, Australia was “Stepping Up the Pace” – referring to the need to energize and revitalize global efforts to increase investments, collaborative research, and political commitment to bring an end to the epidemic. The conference was packed with researchers, students, non-government organizations, and individuals working to mobilize efforts and build on the current momentum of building the post-2015 agenda.

With so many innovative and engaging advocates in one setting, the conference proved to a motivational event with attendees returning home more empowered in the work they do. AIDS2014 allowed advocates from across the world a chance to meet, share work, and build new relationships for future collaboration. Yet, work to end the AIDS epidemic goes beyond biotechnology and research, recognizing the importance of cross cutting issues like gender-based violence (GBV), sexual and reproductive health (SRH), and youth empowerment.

While these topics are at the top of the international development, many are working to ensure those who have the potential to shape beyond the post-2015 agenda foster them. Inspiring the next generation of advocates is critical to bring an end to all epidemics. One man who doing just that stood out at AIDS2014, sharing his work in Uganda to not only inspire youth, but to build a world where all communities realize their full potential.

“Young people can and must be part of guiding and implementing development solutions.” – Enoch Magala

Photo c/o CFYDDI
Enoch Magala c/o CFYDDI

I first met Magala in the conference’s exhibition hall as he confidently introduced himself to just about every person on the floor. A sexual and reproductive health rights expert with a special interest in advocacy for economic and youth rights, he not only has the passion but the experience to back up his mission. Currently working as the Founder and Program Director for the Centre for Youth Driven Development Initiatives (CFYDDI) in Uganda, Magala has worked with organizations such as Echoes Youth Commission for the World Council of Churches, Restless Development, and the Global Youth Coalition on HIV/AIDS, where he will begin his second term as the National Focal Point leader for Uganda. Recognizing that young people have enormous potential for creativity and innovation, Magala and the CFYDDI are working to involve youth in sustainable development and ensure investment in youth across Africa.

CFYDDI has a clear agenda – to inspire young people to take charge of their own issues, extend information resources and social services, and connect rural communities in Uganda to the outside world. “I want to build a more supportive environment for young people and nurture a new generation of leaders that can drive real change,” Magala stated.

Currently CFYDDI has two main projects centered around disseminating information on topical issues and concerns that affect the young people and communities at large, and equipping young people with necessary education and job skills.

  • Sexual Health and Reproductive Education (SHARE) Project: SHARE works by creating awareness and understanding about sexual and reproduction health, enabling youth to make more informed decisions regarding their bodies. SHARE introduces a sexual education curriculum in upper primary, secondary schools and at the community level that incorporates innovative strategies such as role-playing, debate, creative writing, and personal experiences.
  • Volunteer Doctor and Medical Electives Program: Targeted to certified physicians and volunteers, this program offers an opportunity to work in some of the health centers and hospitals in Uganda’s Wakiso District. Volunteers gain an understanding of infectious diseases and their impact on communities, as well as how to handle common medical practices in a poor resource setting. Qualified doctors gain clinical experience, as well as an opportunity to offer their expertise.

Magala speaks passionately about the mission of CFYDDI and why his current role is creating the change he has been dreaming of.

“I want to help young people make responsible choices about their health and their livelihoods, and give them the skills they need to contribute positively to society.”

Enoch Magala c/o CFYDDI
Enoch Magala c/o CFYDDI

With a country as young as Uganda, youth empowerment is critical to achieve development goals in full. Seventy-eight percent of the country’s population is under the age of 30, making it the second youngest population in the world. “We must provide hands-on and community field experience so that young people begin to feel comfortable as self-starters and innovators,” said Magala.

By investing in youth not only in Uganda but across Africa, Magala believes the impact of young people will stimulate the capacities of all sectors, allowing for both social and economic transformation. It is an attitude upheld by many involved in global development and by all eager to inspire the next generation of leaders, policymakers, and innovators. “We must create the opportunity and platform for the largest, most energetic group people any country can have – youth.”

Learn more about Enoch Magala and how you can get involved with CFYDDI here.


About Enoch Magala: Enoch Magala is the Founder and Program Director of the Centre For Youth Driven Developments Initiatives (CFYDDI). He received the 2011 Giraffe Hero Commendation Award, given to people who stick their neck out for the common good. Magala has participated in the National Youth Consultation on the National Development, he has served as a member of Makerere University Regional Young People’s Advisory group (YAG) in the development and implementation of Young Empowered and Health (Y.E.A.H) campaign partnership and is a Trainer of Trainers in the “Be a Man” campaign.

About CFYDDI: Centre For Youth Driven Development Initiatives arose out of the desire to inspire young people to take charge of their own issues, extend opportunities, information resources, and social services, connecting rural communities to the outside world, and scaling down HIV/AIDS prevalence’s as well as improving the livelihoods amongst the youthful generations in previously under served communities of Uganda. CFYDDI is an independent and equal opportunities CBO dedicated to empowering young people, organizations, institutions and communities at the grass-root level.

Cover photo c/o CFYDDI

The 2014 State of the World’s Midwifery Report: A Summary

Since the establishment of the Millennium Development Goals (MDGs) 14 years ago, global leaders, organizations, and nations have been working to reduce child mortality and to improve maternal health around the world.

Unfortunately, a major barrier in reaching the health-related MDGs is the fact that not everyone has access to quality health care services – whether at a hospital or a clinic. In sub-Saharan Africa, women are 100 times more likely to die as a result of pregnancy or childbirth than a woman in an industrialized country. Around the world, 289,000 women die from childbirth complications annually, nearly 3 million newborns die in the first month of life and 2.6 million newborns are stillbirth each year.

Enter: The midwife.

Midwife: An educated, accountable health professional who possesses the skills and experience to support mothers and babies through the pregnancy, delivery and recovery stages of birth. – UNFPA

Infographic c/o UNFPA
Infographic c/o UNFPA

Educated midwives have the capability to perform nearly 90 percent of the essential care for women and newborns before, during and after delivery. Midwives teach communities (men and boys included) about important family planning techniques and products and thereby help to decrease the risk of unwanted pregnancies. In fact, investing in an educated and well-trained midwifery workforce has the potential to yield a 1,600 percent (16-fold) return on investment due to the economic benefits that arise from improved maternal and newborn health. As a result, investing in an educated midwifery workforce can single-handedly help to improve gender equality, empower women and enhance economic development.

To expand on the importance of midwives, the United Nations Population Fund (UNFPA) recently launched the State of the World’s Midwifery (SOWMy) report.

The 2014 SOWMy aims to do the following:

  • Provide an evidence base on the state of the world’s midwifery to support policy dialogue between governments and their partners;
  • Accelerate progress on the health MDGs;
  • Identify developments in the three years since the SOWMy2011; and
  • Inform negotiations for and preparation of the post-2015 agenda.

Additionally, the report highlights the importance of four key factors – the Availability, Accessibility, Acceptability, and Quality of midwifery care. It argues that countries and health systems must address each aspect of care in order to provide women and newborns with the lifesaving care they need and deserve.


Image c/o UNFPA
Image c/o UNFPA

Shockingly, the 73 countries profiled in the report account for 96 percent of all maternal deaths, 91 percent of all stillbirths and 93 percent of all newborn deaths, yet have only 42 percent of the world’s midwives, nurses and doctors. Even worse, no one country had a sufficient number of educated midwives and health workers to support the health of mothers and infants. The SOWMy stresses that, in order to attract others to a career in midwifery, midwives must be properly compensated for their lifesaving work.


Image c/o UNFPA
Image c/o UNFPA

Aligning with the United Nations Declaration of Human Rights’ assertion that “everyone has the right to life, liberty, and the security of person,” the SOWMy states that all mothers should have access to trained midwives, regardless of their ability to pay. The report urges countries to adopt a “minimum services benefits package” that guarantees a baseline of care for reproductive, maternal and newborn health.


Although maternal and newborn health centered policies accelerate progress, sustainable change comes from the bottom-up – from behavior change and societal acceptance. We must work together to dispel the myths and common preconceptions about midwives that inhibit women and girls from seeking their care.


Perhaps most importantly, the quality of midwife care and training must be addressed in order to most effectively decrease maternal mortality rates. Countries must recognize midwifery as a regulated profession in order to eliminate educational and infrastructural gaps – gaps that currently serve as huge barriers to the supply of skilled midwives.

Progress and Next Steps

Thanks to the first SOWMy report in 2011, the world has finally realized the incredible importance of skilled midwives. In the past three years alone, serious improvements have been documented among profiled countries:

  • 45 percent reported taking action to improve midwife retention in rural areas;
  • 71 percent reported improvement in data collection and accountability;
  • 28 percent have increased recruitment and deployment of midwives;
  • 18 percent have prepared plans to establish regulatory bodies or associations; and
  • 20 percent have a new code of practice and/or regulatory framework.

To ensure the availability, accessibility, acceptability and quality of maternal and newborn health care, policymakers, organizations and communities must champion all aspects of midwifery in the post-2015 agenda and let it be known that not only do midwives matter, but midwives save lives.

Learn more:

Cover image c/o UNFPA

United Nations High Level Luncheon on MDG Progress

CEOs, dignitaries, political figures, and organization representatives attended a high level panel luncheon today at the United Nations. The topics of discussion centered on the progress made thus far in the 2015 MDG agenda. In a comfortable round table format, notable speakers discussed the challenges as well as the way forward in the count down to 2015.

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Kathy Calvin, CEO of UN Foundation opens the United Nations high level luncheon on MDG Progress.

No one can do everything but everyone can do something. – UN Deputy Secretary General, Jan Eliasson

Water is life and sanitation is dignity. – Former President of Ghana, John Agekum Kufor

Barbara Lee

We must educate the public and have programs and policies to achieve goals. -Congresswoman Barbara Lee

We are seeing progress in just a short time. The goal is for 120 million new women to have access to family planning. – Melinda Gates

MDG Progress

MDG Progress 2015