Tremendous achievements have been made in decreasing the number of deaths of children under the age of five. However, the rate of these improvements varies greatly from region to region. In sub-Saharan Africa, for example, 1 in 9 children dies before the fifth birthday—more than 15 times the average for developed regions. For Southern Asia, about 1 in 16 children dies before age five. The good news is that the primary killers of children—pneumonia, diarrhea and malaria—are preventable and treatable.

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Gender inequality inhibits women and girls from effectively understanding, accessing and utilizing reproductive, maternal, neonatal, child and adolescent health (RMNCAH) services. This includes the use of family planning methods to control if, when and how often to become pregnant; the ability to deliver safely in a facility or with a skilled birth attendant; and access to the respectful care needed to ensure women and their children are healthy.

USAID invests in health systems strengthening (HSS) to promote country ownership and sustainability, scale-up solutions, and promote greater efficiencies in investments. Sustained improvements to reproductive, maternal, newborn and child health (RMNCH) cannot be achieved through a stand-alone program or individual interventions.

Globally, immunization prevents 2-3 million deaths each year. The World Health Organization estimates that the remaining under-5 deaths — approximately 1.5 million deaths annually — could be prevented with existing vaccines. Success in reducing vaccine-preventable mortality has been dramatic, but it cannot be taken for granted.

Closing gaps in coverage, quality and equity of health services requires that proven, high-impact interventions be implemented at scale. It also necessitates conceptualizing, developing and taking to scale novel processes and products to end preventable child and maternal deaths. Innovation not only helps developing nations catch up, but enables them to "leapfrog" over constraints to improve reproductive, maternal, newborn, child and adolescent health.

An estimated 85% of all deaths from malaria occur in children under five. In malaria-endemic areas, 50 million women will become pregnant each year. These women are highly susceptible to the consequences of malaria, which lead to increased maternal death and severe maternal anemia, low birth weight, and infant death.

Over the last two decades, the global community has witnessed remarkable reductions in the number of maternal deaths worldwide. Yet, too many women — nearly 800 women per day — still die in pregnancy and childbirth from treatable complications.

MCSP’s wide programmatic scope and integrated approach present unprecedented opportunities to scale up proven interventions and test innovative approaches to achieve improved outcomes at scale.

Despite global efforts to develop and promote high-impact interventions for newborn health, nearly three million infants die each year within the first month of life, with more than three-quarters of these deaths occuring in sub-Saharan Africa and South Asia. Improvements in the prevention of newborn death have lagged behind those for maternal and child health.

Maternal anemia, even moderate cases, increases the risk of dying during childbirth. Iron deficiency also contributes to poor birth outcomes and can reduce iron stores at birth, jeopardizing cognitive development and increasing the risk of child mortality. Moreover, stunting compromises adult height attainment, ability to learn, grade completion in school, productivity, and income.

Worldwide, 225 million women currently wish to delay or prevent pregnancy, yet do not use contraceptives. The reasons for non-use are complex, involving social, cultural and economic barriers, fears about side effects, and lack of access to a trusted provider. Greater access to family planning will be vital to achieving global goals in maternal health and child survival.

As USAID’s flagship global program in maternal, newborn and child health, MCSP has the opportunity to reach women and their families throughout Asia and Africa with contextualized Social and Behavioral Change Communication approaches at both facility and community levels.

Handwashing is the single most cost-effective intervention to prevent pneumonia and diarrhea in children, and reduces infections in mothers and children during pregnancy and childbirth. Both A Promise Renewed and the Integrated Global Action Plan for the Prevention and Control for Pneumonia and Diarrhoea (GAPPD) list handwashing and other hygiene behaviors as core interventions for protecting children from these leading causes of death.