2 The World Health Report 2005 translate life-saving knowledge into effective action and to invest adequately in public health and a safe environment. This leaves many mothers and children, particularly he poorest among them, excluded from access to the affordable, effective and re- sponsive care to which they are entitled For centuries, care for childbirth and young children was regarded as a domestic affair, the realm of mothers and midwives. In the 20th century, the health of mothers and children was transformed from a purely domestic concern into a public hea priority with corresponding responsibilities for the state. In the opening years of the 21st century, the Millennium Development Goals place it at the core of the struggle against poverty and inequality, as a matter of human rights. This shift in emphasis has far-reaching consequences for the way the world responds to the very uneven progress in different countries THE EARLY YEARS OF MATERNAL AND CHILD HEALTH The creation of public health programmes to improve the health of women and chil dren has its origins in Europe at the end of the nineteenth century. With hindsight, the reasons for this concern look cynical: healthy mothers and children were seen by governments at that time to be a resource for economic and political ambitions. Many of Europe's politicians shared a perception that the ill-health of the nation,s children threatened their cultural and military aspirations (4). This feeling was particularly strong in France and Britain, which had experienced difficulties in recruiting soldiers fit enough for war. Governments saw a possible solution in the pioneering French experiments of the 1890s, such as Leon Dufour's Goutte de lait (drop of milk) clinics and Pierre Budin's Consultations de noumssons(infant welfare clinics)(5). These programmes offered a scientific and convincing way to produce healthy children who would become productive workers and robust soldiers. The programmes also increas- ingly found support in the emerging social reform and charitable movements of the time. As a result, all industrialized countries and their colonies, as well as thailand and many Latin American countries, had instituted at least an embryonic form of maternal and infant health services by the onset of the 20th century(6). The First World War ac- celerated the movement. Josephine Baker, then Chief of the Division of Child Hygiene of New York, summed it up as follows: One of the first matemal and child health clinics, in the late 19th century, was L'OEuvre de la goutte de lait: Dr Variot's consultation at the Belleville Dispensary, Paris2 The World Health Report 2005 translate life-saving knowledge into effective action and to invest adequately in public health and a safe environment. This leaves many mothers and children, particularly the poorest among them, excluded from access to the affordable, effective and re￾sponsive care to which they are entitled. For centuries, care for childbirth and young children was regarded as a domestic affair, the realm of mothers and midwives. In the 20th century, the health of mothers and children was transformed from a purely domestic concern into a public health priority with corresponding responsibilities for the state. In the opening years of the 21st century, the Millennium Development Goals place it at the core of the struggle against poverty and inequality, as a matter of human rights. This shift in emphasis has far-reaching consequences for the way the world responds to the very uneven progress in different countries. THE EARLY YEARS OF MATERNAL AND CHILD HEALTH The creation of public health programmes to improve the health of women and chil￾dren has its origins in Europe at the end of the nineteenth century. With hindsight, the reasons for this concern look cynical: healthy mothers and children were seen by governments at that time to be a resource for economic and political ambitions. Many of Europe’s politicians shared a perception that the ill-health of the nation’s children threatened their cultural and military aspirations (4). This feeling was particularly strong in France and Britain, which had experienced difficulties in recruiting soldiers fit enough for war. Governments saw a possible solution in the pioneering French experiments of the 1890s, such as Léon Dufour’s Goutte de lait (drop of milk) clinics and Pierre Budin’s Consultations de nourrissons (infant welfare clinics) (5). These programmes offered a scientific and convincing way to produce healthy children who would become productive workers and robust soldiers. The programmes also increas￾ingly found support in the emerging social reform and charitable movements of the time. As a result, all industrialized countries and their colonies, as well as Thailand and many Latin American countries, had instituted at least an embryonic form of maternal and infant health services by the onset of the 20th century (6). The First World War ac￾celerated the movement. Josephine Baker, then Chief of the Division of Child Hygiene of New York, summed it up as follows: One of the first maternal and child health clinics, in the late 19th century, was ‘L’Œuvre de la goutte de lait’: Dr Variot’s consultation at the Belleville Dispensary, Paris