In 2020, the COVID-19 pandemic stuck, driving PMNCH partners to regroup and adopt measures to prevent the pandemic from becoming a lasting crisis for women, children and adolescents. The PMNCH Annual Report presents highlights of the work done in 2020 to ensure that underserved and vulnerable groups received greater investments, effective policies, and improved services.

The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

Having a child remains one of the biggest health risks for women worldwide. Fifteen hundred women die every day while giving birth. That's a half a million mothers every year. UNICEF's flagship publication, The State of the World's Children 2009, addresses maternal mortality, one of the most intractable problems for development work.The difference in pregnancy risk between women in developing countries and their peers in the industrialised world is often termed the greatest health divide in the world. A woman in Niger has a one in seven chance of dying during the course of her lifetime from complications during pregnancy or delivery. That's in stark contrast to the risk for mothers in America, where it's one in 4,800 or in Ireland, where it's just one in 48,000. Addressing that gap is a multidisciplinary challenge, requiring an emphasis on education, human resources, community involvement and social equality. At a minimum, women must be guaranteed antenatal care, skilled birth attendants and emergency obstetrics, and postpartum care. These essential interventions will only be guaranteed within the context of improved education and the abolition of discrimination.