After successfully eradicating polio, the South-East Asia region must strive to reduce maternal and new-born deaths by getting its priorities right

Seven years ago this year, the South-East Asia region recorded its last case of wild poliovirus. In 2014, three years later, the region was declared polio-free. Not a single case of wild poliovirus has been recorded region-wide since then, sparing millions of children the risk of contracting the paralysing and life-threatening disease.  The region's achievement and its contribution to global polio eradication is one of the world's greatest public health success stories. Our progress continues. last year, three million more children in the region survived the first five years of life than in 1990 — the most dramatic reduction anywhere in the world.

Meanwhile, the region's contribution to global under-five mortality dropped to 25 per cent, down from 37 per cent at the start of the same period. The region has now achieved the Millennium Development Goal target for under-five mortality, while a few of its member countries have already surpassed the child health-related Sustainable Development Goals (SDG). In short, across the South-East Asia region, more children than ever are not only surviving, but are also growing into strong, healthy and productive adults. To maintain this trajectory and to ensure all countries achieve SDG targets, accelerated progress is nevertheless needed. By 2030, all countries should have reduced under-five mortality to at least as low as 25 per 1,000 live births, while neonatal mortality should be at least as low as 12 per 1,000 live births. Maternal mortality, a related concern, should meanwhile be reduced to less than 70 per 1,000 live births. To achieve these targets, concerted action is needed.

First, member countries should expand access to good quality health services, especially for women, children and adolescents, with universal health coverage (UHC) remaining a top priority. Through targeted investments, countries can reduce each of the leading causes of maternal, new-born and under-five deaths (a regional flagship priority), including complications associated with prematurity, pneumonia, birth asphyxia, diarrhea, sepsis and birth defects.  Notably, better services will have the added benefit, often couraging institutional deliveries. As per the decade of action on human resources for health, a good way to achieve these outcomes is by recruiting more health workers, advancing skills of health workers at all levels of care, and finding innovative ways to retain health workers in rural and hard-to-reach areas.

Second, and complementary to the UHC, member countries must focus on mitigating cause and context-specific mortality. Even where national averages are good, for example, children belonging to poor or marginalised groups can suffer mortality rates well above the national level, often due to easily preventable diseases, such as pneumonia or diarrhea. By pursuing equitable access to safe water and sanitation, and reducing indoor air pollution, member countries can forge progress that not only reduces mortality from these diseases, but also  crucially helps ensure that no child is left behind. This is especially so when combined with the promotion of health-positive habits, such as handwashing and toilet usage generally, and exclusive breastfeeding for the first six months of a child's life specifically.

And third, we must not be complacent. Member countries should continue to strengthen routine immunisation programmes, including surveillance. In recent years, enhanced routine immunisation has been responsible for some of the region's greatest achievements in new-born child and maternal health, including the elimination of maternal and neonatal tetanus.  As the region strives to eliminate measles — a major childhood killer by 2020 — member countries must ensure that each and every child receives two doses of the combined measles and rubella vaccine. To their immense credit, Bhutan and Maldives have already eliminated the disease, demonstrating that the 2020 target is readily achievable.  Member countries must go beyond the ‘survival agenda' and aim to ensure that every child in the region can live, grow and thrive in an era of unrivaled opportunity. It means ensuring every child lives in an environment where health hazards are mitigated or removed, and where early childhood development is invested in and nurtured, especially during the first three years of life. And it means ensuring that as every child grows into adolescence, they can access the health services needed to navigate a phase of life that has its own special needs.

Each one of these outcomes and more can be achieved. As the region's victory over polio attests, a whole generation's health and well-being can be dramatically enhanced when the right priorities are set and society-wide commitment is secured. As countries across the region strive to reduce new-born, child and maternal mortality to levels at or below the SDG threshold, this opportunity must be fully grasped. Our children are our future. A healthier tomorrow must begin today.

(The writer is Regional Director, WHO South East Asia)