A strong focus on reproductive, maternal, child and newborn health (RMCNH) is integral to improving global health. RMNCH is linked to all 8 Millennium Development Goals (MDGs). MDGs 4 (Reduce Child Mortality), 5 (Improve Maternal Health) and 6 (combat HIV/AIDS, malaria and other diseases) each have specific targets and indicators related to RMNCH.
Photo courtesy of UNF via Megan FingletonThe RMNCH "Continuum of Care" includes integrated service delivery for mothers and children from pre-pregnancy to delivery, the immediate postnatal period, and childhood. Such care is provided by families and communities, through outpatient services, clinics and other health facilities. The Continuum of Care recognizes that safe childbirth is critical to the health of both the woman and the newborn child—and that a healthy start in life is an essential step towards a sound childhood and a productive life.
Across this continuum of care, essential interventions and the commodities required to provide these have been identified, most recently in the publication “The Essential Interventions, Commodities and Guidelines for Reproductive, Maternal, Newborn and Child Health - A global review of the key interventions related to reproductive, maternal, newborn and child Health”. The WHO publication, “Priority medicines for mothers’ and children’s health, 2011” also identifies medicines that are in need of enhanced attention and utilization in order to avoid preventable deaths of women and children.
Informed by this work, an initial list of essential but underutilised life-saving commodities were identified for consideration by the Commission based on three criteria:
1. High-impact, effective commodities. In general, high-impact commodities are those commodities that effectively address avoidable causes of premature death and disease among children under five years old and women during pregnancy and childbirth.  Please see images 1 and 2 below.
2. Inadequate funding. Selected commodities are not funded by existing mechanisms such as The Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Alliance for Vaccines and Immunisation (GAVI), Scaling-up Nutrition (SUN) and UNITAID.
3. Untapped potential. Innovation and rapid scale up in product development and market shaping (including potential for price reduction and improved stability of supply) arising from the work of a UN Commission could rapidly improve access to the selected commodities.
Within reproductive health, family planning plays a critical role in averting maternal and newborn deaths. Among the full range of contraceptive methods needed to meet women’s and couples need for short-term, long-term and permanent methods of contraception and for prevention of STIs, including HIV, the Reproductive Health Supplies Coalition identified three particularly overlooked contraceptive methods: contraceptive implants, emergency contraception, and the female condom. According to the Coalition’s Caucus on New and Underutilized Methods , these products are “not routinely available in the public, private, or social marketing sectors, ... [nor] routinely procured by the major procurers”, such that they are particularly underutilized, face unmet demand, and show promise for public health benefits (including beyond pregnancy prevention) including meeting Millennium Development Goal 5b—universal access to reproductive health.
Based on these criteria, an initial list of 13 affordable, effective, but underutilized life-saving commodities were identified for consideration by the Commission. Please click on the names of the commodities in the chart below to view a product profile for each.
This initial list of commodities is not comprehensive, but is rather a cross-section of vital products, representing access issues that are common to many commodities.
Lessons learned from analysis of this initial group of products will be applicable to other essential commodities in future.
Image 1: Global causes of under-5 deaths in 2008 (Source: Lancet, Black R et al., Lancet 2010)
Note: Under-nutrition is an important underlying cause of under-5 deaths
Image 2: Global causes of maternal deaths in 1997 - 2007 (Source: WHO, Systematic Review of Causes of Maternal Death, 2010)
 The main causes of newborn and maternal mortality and the effectiveness of specific interventions and commodities to substantially reduce these has been well documented, including in the Lancet series on child survival (2003), newborn survival (2005), maternal survival (2006) and on reproductive health (2006), and publications by the Child Health Epidemiology Reference Group (CHERG). http://www.thelancet.com/collections/series ; http://cherg.org/publications.html