Jackson Debra
Takeda Chair in Global Child Health, MARCH Centre, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
School of Public Health, University of the Western Cape, Cape Town, South Africa.
Matern Child Health J. 2025 Jun 27. doi: 10.1007/s10995-025-04121-7.
This review paper aims to review Global MCH initiatives and note trends across the last five decades (1974-2023).
As an organizing framework, MCH initiatives and programs have been classified into five categories: Global Health Conferences, Declarations or Strategies; Global Health Surveys; Global MCH Programs; Global MCH related Data Initiatives or Working/Advisory Groups; and Global MCH Partnerships or Networks.
Over 50 Global MCH initiatives and programs have been implemented during this period. The first International Conference on Primary Health Care and the Alma Ata Declaration in 1978 initiated a new era of global public health. International conferences building on Alma Ata with a focus on population health and MCH, along with global surveys to measure the health status of populations across countries and global working groups to analyze these data, emerged over the next decades. Global MCH partnerships also emerged for advocacy and coordination of an increasing number of efforts to improve maternal, newborn, child and adolescent health and well-being-towards achieving the Millennium (2000-2015) and Sustainable (2016-2030) Development Goals.
Four trends were noted across these five decades: (1) MCH Mortality decreased but unacceptable inequities persist with COVID-19, ongoing conflicts and climate change threatening these gains. (2) Implementation of primary health care (PHC) as envisioned by Alma Ata in 1974 continues to see a debate about selective versus comprehensive programs. (3) As mortality declined (Survive), the field expanded focus to child well-being (Thrive) and across preconception through adolescents (Transform). (4) Global MCH issues are relevant across high-income (HIC) and low-middle income (LMIC) settings to achieve health and well-being of all women and children everywhere.
本综述旨在回顾全球妇幼保健倡议，并指出过去五十年（1974 - 2023年）的发展趋势。
作为一个组织框架，妇幼保健倡议和项目被分为五类：全球卫生会议、宣言或战略；全球卫生调查；全球妇幼保健项目；全球妇幼保健相关数据倡议或工作/咨询小组；以及全球妇幼保健伙伴关系或网络。
在此期间实施了50多项全球妇幼保健倡议和项目。1978年的第一届国际初级卫生保健会议和《阿拉木图宣言》开启了全球公共卫生的新时代。在接下来的几十年里，以阿拉木图会议为基础、关注人群健康和妇幼保健的国际会议，以及用于衡量各国人口健康状况的全球调查和分析这些数据的全球工作组纷纷出现。全球妇幼保健伙伴关系也应运而生，以倡导和协调越来越多的努力，来改善孕产妇、新生儿、儿童和青少年的健康与福祉，以实现千年发展目标（2000 - 2015年）和可持续发展目标（2016 - 2030年）。
在这五十年中呈现出四个趋势：（1）妇幼保健死亡率有所下降，但仍存在不可接受的不平等现象，新冠疫情、持续冲突和气候变化威胁着这些成果。（2）1974年阿拉木图所设想的初级卫生保健的实施，在选择性项目与综合性项目方面仍存在争议。（3）随着死亡率下降（生存），该领域的重点扩展到儿童福祉（茁壮成长），并涵盖从孕前到青少年阶段（转变）。（4）全球妇幼保健问题在高收入国家（HIC）和低中收入国家（LMIC）都具有相关性，以实现世界各地所有妇女和儿童的健康与福祉。
