H4+: Speech @theLancet #endstillbirths series launch (#H4plus)

Rama Lakshminarayanan of the World Bank Group speaking on behalf of H4+ at the Lancet Series on Stillbirths Launch in NYC

(c) UNICEF/UNI148621/Ose

I am delighted to be here to represent the H4+ at the release of the Lancet series on Stillbirths.  This is both a moment of great excitement when stillbirths are receiving the attention that they deserve, but it is also a sobering moment since the task ahead is not easy and will require each one of us to put our utmost in our individual agency capacity, but even more importantly, as a collaborative that brings together the comparative advantages of our institution to eliminate preventable stillbirths.

We heard about the size of the problem—2.6 million stillbirths a year, and the fact that 98% of these stillbirths take place in developing countries—one that highlights the importance of addressing equity and quality of care within the continuum of care.  We have also heard a lot today on the issues around stillbirths—the stigma that is attached, the psycho social and economic costs that go beyond the stillbirth itself, and the large research and measurement needs that still remain to be addressed.

Tackling the scourge of stillbirths is essential for us to bring about the “grand convergence”—a promise that lies at the heart of both the Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health.  This series maps out the five priority areas that we, as an international public health community need to focus our efforts on, namely, 1. Intentional leadership; 2. Increased voice, especially of women, 3. Implementation of integrated interventions with commensurate investment, 4. Indicators to measure impact and track progress, and 5.  Investigation of crucial knowledge gaps.

The UN agencies of the H4+ Partnership—UNAIDS, UNFPA, UNICEF, UN Women, WHO and the World Bank Group—strongly support the findings and is committed to the five priority actions to change the trend for stillbirths.  As you all know, under the EWEC umbrella, the governance architecture has evolved to concentrate our combined efforts to meet the the technical, advocacy and financing needs necessary to realize the survive, thrive and transform goals of the GS 2.0.  The H4+ and PMNCH are repositioning themselves to meet the ambitious agenda that has been set for all of us, and a key financing platform, the GFF, has also been launched to mobilize domestic and international resources to meet the SDG targets for women’s, children’s and adolescents’ health.  The quadruple return on investment that we get by investing in high quality antenatal and intrapartum care is exactly the type of investment that is smart, should be brought to scale and needs to be made sustainable.

As Winston Churchill said “It is not enough that we do our best; sometimes we must do what is required.”


Rama Lakshminarayanan is a Senior Public Health Specialist and the Team Leader of the Quality Enhancement Group of the Health, Nutrition and Population Department of the World Bank. She is responsible for undertaking quality enhancement reviews of health sector operations within the Bank, monitoring the health, nutrition and population portfolio and writing the Sector Strategy Implementation Update for the Health Sector. She has extensive operational experience of health sector projects in South East and South Asia regions of the Bank. Her specializations are reproductive and child health. She is a medical doctor as well as holds an MBA degree from Tulane University.