WHO Library Cataloguing-in-Publication Data The World health report: 2005: make every mother and child count. 1 Word health trends 2 Maternal welfare 3. child welfare mal health services-organization and administration. 5.child health services-organization and administration 6. World Health Organization L Title Il. Title: Make every mother and child ISBN 92 4 1562900(NLM Classification: WA 540.1) SSN1020-3311 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857, e-mail: bookorders @who. int). Requests for permission to reproduce or translate WHO publications- whether for sale or for noncommercial distribution-should be addressed to WHo Press, at the above address ( fax +41 22 791 4806; e-mail: permissions @who. int) nations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the of proprietary products are distinguished by initial capital letters. ng distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of th lies with the reader. In no event shall the worid Health Organization be liable for damages arising from its use. can be obtained from 1211 Geneva 27. Switzerland E-mail: whr@who int opies of this publication can be ordered from: bookorders @who int This report was produced under the overall direction of Joy Phumaphi (Assistant Director-General, Family and child Health), Tim Evans(Assistant Director-General erghe(Editor-in-Chief). The principal authors were Wim Van Lerberghe, Annick Manuel, Zoe Matthews and Cathy kground papers, analytical work, reviewing suggestions and criticism) were received from Elisabeth Aahman, Carla Abou-Zahr, erta Bacci, Rajiv Bahl, Rebecca Bailey, Robert Beaglehole engo Bilous, Ties Boerma, Jo Borghi, Paul Bossyns, Assia Brandrup-Lukanov, Eric Buch, Flavia Bustreo, Meena Cabral de Mello, Virginia Camacho, Guy Carrin, Andrew ryn Church, Alessandro Colombo, Jane Cottingham, Bernadette Daelmans, Mario Dal Poz, Catherine d'Arcangues, Hugh Darrah, Luc de Bemis, isabelle Carmen car lles Dussault, Steve Ebener, Dominique Egger, Gerry Ejkema ue, David Evans, Vincent Fauveau, Paulo Ferrinho, Helga Fogstad, Marta Gacic Dobo, Ulf Gerdham, Adrienne Germa izabeth Goodburn. veloshne icht, Sarah Hall nce haller Julia ussein, Guy Hutton, Mie Inoue, Monir islam, Christopher James, Craig Janes, Ben Johns, Rita Kabra, wood. Lia Lawn, Je Mason, Matthews Mathai, Dileep I I Mayers, Juliet McEachren, Abt al. Mario Merialdi. Tom Susan Murray, Adepeju Olukoya, Guillermo Paraje, Justin Parkhurst, Amit Patel, Vikram Patel, Steve Pearson, Gretel Pelto, Jean Perrot, Annie Portela, Dheepa Rajan, K.V. Ramani, Esther Ratsma, Linda Richter, David Sanders, Parvathy Sankar, Robert Scherpbier, Peelam Sekhri, Gita Sen, Iqbal Shah, Della Sherratt, Kenji shibuya, Kristjana tir, Angelica Sousa, Niko Speybroeck, Karin Stenberg, will Stones, Tessa Tan- Torres Edejer, Petra Ten Hoope-Bender, Ann Tinker, Wim Van Damme Van Look, Marcel Vekemans, Cesar Victora, Eugenio Villar Montesinos, Yasmin Von Schimding, Eva Wallstam, Steve Wiersma, Karl Wilhelmsen, Lara Wolfson, Juliana Yartey an tables were: Elisabeth Aahman, Dorjsuren Bayarsaikhan, Ana Betran, Zulfiqar Bhutta, Maureen Birmingham, Robert Black, Ties Boerma Boschi-Pinto, Jennifer Bryce, Agnes Couffinhal, Simon Cousens, Trevor Croft, David D Vans, Charu C Garg, Kim Gustavsen, Nasim Haque, Patricia Hernando dikadahena, Mie Inoue, Gareth Jones, Betty Kirkwood, Joseph Kutzin, Joy Lawn, Eduardo Levcovitz, Edilberto Loaiza, Doris Ma Fat, Jose Marti aux, Alex Rowe, Hossein Salehi, lan Scott, U Than Sein, Kenji shibuya, Rick Steketee, Ruben Suarez, Tessa Tan-Torres Edejer, Nathalie van de Maele, Tessa Wardlaw eff Walker, Hongyi Xu, Jelka Zupan, nts and guidance were prowided by Denis Aitken and Michel Jancloes. Additional help and advice were kindly provided by Regional Directors and torial, administrative and production support was prowided by Shelagh Probst and Gary hs. The web site version and other electronic media were provided by gael Kernen. Proofreading was by Marie Fitzsimmons ft): L. Gubb/WHO; F H0; gero/wHO/PAHO; Lit Pierre virot/ wHo. Back (left to right): Pierre Virot/WHO: J. Gorstein/WHO; G Diez/WHO; Pierre Virot/wHO. This report contains several photographs m"River of Life 2004-a WHO photo competition on the theme of sexual and reproductive health sign: Reda Sadki Layout: Steve Ewart and Reda Sadki to retouching: Reda Sadki and Denis Meissner inting coordination Keith Wynn Printed in franceii Design: Reda Sadki Layout: Steve Ewart and Reda Sadki Figures: Christophe Grangier Photo retouching: Reda Sadki and Denis Meissner Printing coordination: Keith Wynn Printed in France This report was produced under the overall direction of Joy Phumaphi (Assistant Director-General, Family and Child Health), Tim Evans (Assistant Director-General, Evidence and Information for Policy) and Wim Van Lerberghe (Editor-in-Chief). The principal authors were Wim Van Lerberghe, Annick Manuel, Zoë Matthews and Cathy Wolfheim. Thomson Prentice was the Managing Editor. Valuable inputs (contributions, background papers, analytical work, reviewing, suggestions and criticism) were received from Elisabeth Aahman, Carla Abou-Zahr, Fiifi Amoako Johnson, Fred Arnold, Alberta Bacci, Rajiv Bahl, Rebecca Bailey, Robert Beaglehole, Rafael Bengoa, Janie Benson, Yves Bergevin, Stan Bernstein, Julian Bilous, Ties Boerma, Jo Borghi, Paul Bossyns, Assia Brandrup-Lukanov, Eric Buch, Flavia Bustreo, Meena Cabral de Mello, Virginia Camacho, Guy Carrin, Andrew Cassels, Kathryn Church, Alessandro Colombo, Jane Cottingham, Bernadette Daelmans, Mario Dal Poz, Catherine d’Arcangues, Hugh Darrah, Luc de Bernis, Isabelle de Zoysa, Maria Del Carmen, Carmen Dolea, Gilles Dussault, Steve Ebener, Dominique Egger, Gerry Eijkemans, Bjorn Ekman, Zine Elmorjani, Tim Ensor, Marthe Sylvie Essengue, David Evans, Vincent Fauveau, Paulo Ferrinho, Helga Fogstad, Marta Gacic Dobo, Ulf Gerdham, Adrienne Germain, Peter Ghys, Elizabeth Goodburn, Veloshnee Govender, Metin Gulmezoglu, Jean-Pierre Habicht, Sarah Hall, Laurence Haller, Steve Harvey, Peggy Henderson, Patricia Hernández, Peter Hill, Dale Huntington, Julia Hussein, Guy Hutton, Mie Inoue, Monir Islam, Christopher James, Craig Janes, Ben Johns, Rita Kabra, Betty Kirkwood, Lianne Kuppens, Joy Lawn, Jerker Liljestrand, Ornella Lincetto, Craig Lissner, Alessandro Loretti, Jane Lucas, Doris Ma Fat, Carolyn Maclennan, Ramez Mahaini, Sudhansh Malhostra, Adriane Martin Hilber, José Martines, Elizabeth Mason, Matthews Mathai, Dileep Mavalankar, Gillian Mayers, Juliet McEachren, Abdelhai Mechbal, Mario Merialdi, Tom Merrick, Thierry Mertens, Susan Murray, Adepeju Olukoya, Guillermo Paraje, Justin Parkhurst, Amit Patel, Vikram Patel, Steve Pearson, Gretel Pelto, Jean Perrot, Annie Portela, Dheepa Rajan, K.V. Ramani, Esther Ratsma, Linda Richter, David Sanders, Parvathy Sankar, Robert Scherpbier, Peelam Sekhri, Gita Sen, Iqbal Shah, Della Sherratt, Kenji Shibuya, Kristjana Sigurbjornsdottir, Angelica Sousa, Niko Speybroeck, Karin Stenberg, Will Stones, Tessa Tan-Torres Edejer, Petra Ten Hoope-Bender, Ann Tinker, Wim Van Damme, Jos Vandelaer, Paul Van Look, Marcel Vekemans, Cesar Victora, Eugenio Villar Montesinos, Yasmin Von Schirnding, Eva Wallstam, Steve Wiersma, Karl Wilhelmson, Lara Wolfson, Juliana Yartey and Jelka Zupan Contributers to statistical tables were: Elisabeth Aahman, Dorjsuren Bayarsaikhan, Ana Betran, Zulfiqar Bhutta, Maureen Birmingham, Robert Black, Ties Boerma, Cynthia Boschi-Pinto, Jennifer Bryce, Agnes Couffinhal, Simon Cousens, Trevor Croft, David D. Vans, Charu C. Garg, Kim Gustavsen, Nasim Haque, Patricia Hernández, Ken Hill, Chandika Indikadahena, Mie Inoue, Gareth Jones, Betty Kirkwood, Joseph Kutzin, Joy Lawn, Eduardo Levcovitz, Edilberto Loaiza, Doris Ma Fat, José Martines, Elizabeth Mason, Colin Mathers, Saul Morris, Kim Mulholland, Takondwa Mwase, Bernard Nahlen, Pamela Nakamba-Kabaso, Agnès Prudhomme, Rachel Racelis, Olivier Ronveaux, Alex Rowe, Hossein Salehi, Ian Scott, U Than Sein, Kenji Shibuya, Rick Steketee, Rubén Suarez, Tessa Tan-Torres Edejer, Nathalie van de Maele, Tessa Wardlaw, Neff Walker, Hongyi Xu, Jelka Zupan, and many staff in WHO country offices, governmental departments and agencies, and international institutions. Valuable comments and guidance were provided by Denis Aitken and Michel Jancloes. Additional help and advice were kindly provided by Regional Directors and members of their staff. The report was edited by Leo Vita-Finzi, assisted by Barbara Campanini. Editorial, administrative and production support was provided by Shelagh Probst and Gary Walker, who also coordinated the photographs. The web site version and other electronic media were provided by Gael Kernen. Proofreading was by Marie Fitzsimmons. The index was prepared by Kathleen Lyle. Front cover photographs (clockwise from top left): L. Gubb/WHO; Pepito Frias/WHO; Armando Waak/WHO/PAHO; Carlos Gaggero/WHO/PAHO; Liba Taylor/WHO; Pierre Virot/WHO. Back cover photographs (left to right): Pierre Virot/WHO; J. Gorstein/WHO; G. Diez/WHO; Pierre Virot/WHO. This report contains several photographs from “River of Life 2004” – a WHO photo competition on the theme of sexual and reproductive health. WHO Library Cataloguing-in-Publication Data World Health Organization. The World health report : 2005 : make every mother and child count. 1.World health - trends 2.Maternal welfare 3.Child welfare. 4.Maternal health services - organization and administration. 5.Child health services - organization and administration 6.World Health Organization I.Title II.Title: Make every mother and child count. ISBN 92 4 156290 0 (NLM Classification: WA 540.1) ISSN 1020-3311 © World Health Organization 2005 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published mate￾rial is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Information concerning this publication can be obtained from: World Health Report World Health Organization 1211 Geneva 27, Switzerland E-mail: whr@who.int Copies of this publication can be ordered from: bookorders@who.int The World Health Report 2005