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Holding the World Bank Accountable for Reproductive Health Commitments

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White Ribbon Alliance Champion Princess Sarah Zeid of Jordan spoke at The World Bank Spring meetings in Washington D.C. this week, holding the World Bank to account on commitments to reproductive health.

As an advocate for maternal and newborn health, a women who nearly died during childbirth, and a mother of a son and two daughters, I am committed to this issue because I have seen the power of investing in reproductive health, which is not just good politics and sound economics, it is also the right thing to do.

As we move towards the end of the MDGs and the close of an era that has seen unprecedented cooperation and progress in women and children's health, we are also now clearly seeing where and whom we have failed. We know so much more today than we did in 1990 about the joy and pain, participation and exclusion, life and death of our girls, women, babies and children. The evidence shows us that to maintain the progress made, it is essential that we continue what we have begun, whilst expanding our investments if we are to spread our impact.

To ensure that development is truly sustainable and to avoid far worse -- to prevent a backward slide -- we must do more for more. And we must do better. In two areas, at least, this urgent need for critical action and more proportionate investment stand out and these are newborn survival and health, and adolescents.

New data has exposed the horror of newborn mortality around the world. In 2012, nearly 2.6 million babies were stillborn while another 3 million babies died before they were 28-days-old. In other words, over 5 million babies were alive until -- but died during -- labor, delivery or in their earliest neonatal period.

Not only are these deaths a tragic and irredeemable loss of human potential on a massive scale, they bring with them untold human suffering for their mothers, their fathers and their families. We should not have to look to the fact that women who lose a baby under such circumstances are more likely to become pregnant again very quickly, and more likely to have larger numbers of children, to motivate investments in policies and programs that can reverse this suffering.

Access to family planning -- to choices about contraception -- improves both maternal and newborn survival by lengthening inter-pregnancy intervals. Spacing the birth of children by three years will decrease under-5 deaths by 25 percent.

Allowing men and women to prevent unwanted pregnancy would not only stop 300 million unintended pregnancies, including 21 million unplanned births, it would mean 26 million fewer abortions (of which 16 million are likely to be unsafe), 7 million fewer miscarriages, 79,000 fewer maternal deaths, and 1.1 million fewer infant deaths.

Pregnancy and childbirth is the leading cause of death for girls aged 15-19 in the world. Each year 16 million girls give birth and 1 million die or suffer serious injury. Their babies are at greater risk too as newborn deaths and stillbirths are 50 percent higher among these girls. I would like to join Michael Gerson in his statement that for many, many girls and women in the world, contraception is a "pro-life" strategy.

The work ahead of us is enormous, but so too are the rewards. The MDGs pulled us together globally so that through shared focus we could positively impact the daily lives of those who need us most. But, the evidence is in and the reality is that the "easier to reach" have been reached.

From now on, if there is to be continued progress, things are going to get really complicated! We have to rebalance efforts so as to tackle inequity in access to services and to better and more fairly meet the sexual and reproductive health needs of groups whose circumstances -- and our failings -- means they suffer more, such as unmarried young women, poor women and rural women.

We must also more urgently and more effectively tackle the plight of women, girls and newborns in emergency settings, whether they be "man-made" or the work of "mother-nature." In any disaster or crisis or conflict setting, it is women, girls and their babies who are made the most vulnerable -- including though gender-based violence and because of the breakdown of healthcare systems, the shortage of qualified health personnel, and the disruption of reproductive and other health supplies.

As the conflict in Syria enters its fourth year, for instance, urgent support is needed to protect the lives of Syria's estimated 200,000 pregnant women, including 1,480 women who give birth in dire conditions every day. More than 2.5 million people, mostly women and children, have been registered as refugees in neighbouring countries. Family planning and access to essential information and services are their fundamental human rights.

In post conflict settings and beyond, these same rights -- when upheld -- unlock unprecedented rewards for sustainable development. Family planning saves lives, it empowers women and girls to make choices, to seek and stay in education, to participate fully in society and contribute to the economy.

When women and their children live healthier, longer lives their families, their communities and ultimately their nations are made stronger, safer and more prosperous.

Family planning is a key to unlocking the promise of this extraordinary human potential. A comprehensive approach to reproductive, maternal, newborn and child health is proven in its success, urgent for further inclusive development and essential if we are to uphold the dignity of those who uphold us. In a world were resources are stretched, massive youth bubbles are rising to the surface, conflicts are destabilizing not just countries but entire regions and environmental instability is threatening to undermine progress, we have to act decisively, courageously and with vision to preserve and advance prosperity on a global level, for each and everyone of us. We must act now. We must do more. We must do better.


White Ribbon Alliance and IPPF launched the IPPF Scorecard Revisited at the World Bank Spring Meetings giving an in-depth analysis of investment and the Bank's priorities; compelling examples of how investment in reproductive health changes lives in communities; and a robust representation of the World Bank's current activities and future plans in this area. If you are interested in working to hold the World Bank to account on its commitments to reproductive health, please get in touch with Katy Woods