Quality, equity, and dignity for women and babies
This Lancet Series on maternal health comes just 1 year after countries committed to the Sustainable Development Goals (SDGs) The SDGs call on all stakeholders to leave no one behind in addressing the unfi nished agenda for maternal and child health. The Global Strategy for Women's, Children's and Adolescents' Health (Global Strategy) calls for integrated solutions to prevent maternal, newborn, and child deaths and stillbirths and to realise a world where women and children thrive and transform their communities and nations. To achieve this, we must address social determinants of maternal and newborn health, and improve access to respectful, high quality, integrated care. As representatives of civil society organisations working with women and children, we are deeply concerned about the divergence in the burden of poor maternal health "refl ecting inequities in wealth, rights, and access to care" and the concomitant eff ect on newborn and child health, and survival and adverse birth outcomes. The health and survival of women and their babies are inextricably linked; a coordinated, integrated "continuum of care" approach that optimises the health of the mother baby dyad is required to fully maximise the potential benefi ts. Linking health care for a mother and her baby promotes greater effi ciency, lower costs, reduces duplication of resources, and maximises the eff ect on their health and survival in the same way investments in family planning and reproductive health improve health and wellbeing of women and their children. The investment case is strong, since the return on investment includes not only averted deaths (maternal, newborn, and stillbirth) but also improved child neurodevelopmental outcomes and reduced maternal morbidities. There have long been calls to integrate maternal and newborn baby health priorities. A comment by Ann Starrs in The Lancet Every Newborn Series challenged the maternal and newborn health communities "to pledge to each other that any policy, programme, or initiative focusing on either maternal or newborn health will incorporate the other as well" 2 years later, the global health community seems to have heeded that call. The 2015 Global Maternal Newborn Health Conference gave voice to a shared vision of maternal and newborn health. Two strategies developed in the lead up to the SDGs the Every Newborn Action Plan and Strategies toward Ending Preventable Maternal Mortality converged with common objectives, and were incorporated into the Global Strategy. The Global Financing Facility supports countries in identifying national priorities across the spectrum of reproductive, maternal, newborn, child and adolescent health (RMNCAH) and was built upon a full potential investment case. The Lancet has also published multiple Series relating to maternal newborn health in the past 2 years: Midwifery (2014) Every Newborn (2014) Ending preventable stillbirth (2016) and Maternal health (2016) Even though these Series' titles appear siloed in approach, each Series calls for integration. Evidence also indicates that women are more satisfi ed with a more integrated approach. With the many global strategies in place and multiple Lancet Series published, one wonders whether countries are eff ectively supported to act upon these priorities as well as respond to what women want and deserve, in terms of quality, accessible, aff ordable, respectful maternal and newborn health care. How can governments, UN agencies, donors, private sector organisations, civil society, and other stakeholders work with women, communities, and countries to end preventable deaths in the face of the great divergence described in this Series? One promising development is WHO's Quality of Care Framework for Maternal and Newborn Health with accompanying technical standards and guidelines for
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