Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries

Abstract

Introduction: Improving reproductive, maternal, newborn, and child health (RMNCH) care services is imperative for reducing maternal and child mortality. Many low- and middle-income countries (LMICs) are striving to achieve RMNCH-related Sustainable Development

Goals (SDGs). We monitored progress, made projections, and calcu- lated the average annual rate of change needed to achieve universal

(100%) access of RMNCH service indicators by 2030. Methods: We extracted Demographic and Health Survey (DHS) data of 75 LMICs to estimate the coverage of RMNCH indicators and composite coverage index (CCI) to measure health system strengths. Bayesian linear regression models were fitted to predict the coverage of indicators and the probability of achieving targets.

Results: The projection analysis included 64 countries with avail- able information for at least 2 DHS rounds. No countries are pro- jected to reach universal CCI by 2030; only Brazil, Cambodia,

Colombia, Honduras, Morocco, and Sierra Leone will have more than 90% CCI. None of the LMICs will achieve universal coverage of all RMNCH indicators by 2030, although some may achieve universal coverage for specific services. To meet targets for universal service access by 2030, most LMICs must attain a 2-fold increase in the coverage of indicators from 2019 to 2030. Coverage of

RMNCH indicators, the probability of target attainments, and the re- quired rate of increase vary significantly across the spectrum of

sociodemographic disadvantages. Most countries with poor histori- cal and current trends for RMNCH coverage are likely to experience

a similar scenario in 2030. Countries with lower coverage had

higher disparities across the subgroups of wealth, place of resi- dence, and women’s/mother’s education and age; these disparities

are projected to persist in 2030. Conclusion: None of the LMICs will meet the SDG RMNCH 2030

targets without scaling up essential RMNCH interventions, reduc- ing gaps in coverage, and reaching marginalized and disadvan- taged populations.