The UN Sustainable Development Goals set a target of ensuring universal access to reproductive health care services by 2030, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes. Providing family planning services is one of the most cost-effective public health interventions, contributing to significant reductions in maternal mortality and morbidity (UNFPA, 2018).

Preterm birth (i.e. birth before 37 completed weeks of gestation) is the leading cause of neonatal death during the first four weeks of life (days 0-28), and the second leading cause of death in children under 5 (see indicator “Under age 5 mortality” in ). Many survivors of preterm births also face a lifetime of disability, including learning disabilities and visual and hearing problems as well as long-term development. But preterm birth can be largely prevented. Three-quarters of deaths associated with preterm birth can be saved even without intensive care facilities. Current cost-effective interventions include kangaroo mother care (continuous skin to skin contact initiated within the first minute of birth), early initiation and exclusive breastfeeding (initiated within the first hour of birth) and basic care for infections and breathing difficulties (WHO, 2013; see indicator “Infant mortality” in ). Preterm birth rates can be also reduced if women, particularly adolescents, have better access to family planning and increased empowerment, as well as improved care and nutrition during pregnancies (see indicator “Family planning” in ).

Optimal feeding practices of infants and young children can increase their chances of survival. They play an important role for healthy growth and development, decrease rates of stunting and obesity and stimulate intellectual development (Victora et al., 2016).

National development is largely dependent on healthy and well-nourished people, but many children are not able at all times to access sufficient, safe, nutritious food and a balanced diet that meets their needs for optimal growth and development, an active and healthy life (UNICEF, 2013). Maternal and child malnutrition in low and middle income countries encompasses both under nutrition and a growing problem with overweight and obesity. Many countries are facing a double burden of malnutrition – characterized by the coexistence of undernutrition along with overweight, obesity or diet-related NDC – which poses a real and growing health challenge. The identification, promotion and implementation of actions that simultaneously and synergistically address undernutrition as well as overweight, obesity and diet-related NCDs are important opportunities and immediate priorities to foster the United Nations Decade of Action on Nutrition: food systems for healthy, sustainable diets; aligned health systems providing universal coverage of essential nutrition actions; safe and supportive environments for nutrition at all ages; social protection and nutrition-related education; trade and investment for improved nutrition; and strengthen and promote nutrition governance and accountability (WHO, 2017c).

Adolescence is a vulnerable phase in human development as it represents a transition from childhood to physical, psychological and social maturity. During this period, adolescents learn and develop knowledge and skills to deal with critical aspects of their health and development while their bodies mature. Adolescent girls, especially younger girls, are particularly vulnerable because they face the risks of premature pregnancy and childbirth (UNICEF, http://data.unicef.org/topic/maternal-health/adolescent-health/). The Global Strategy for Women’s, Children’s and Adolescent’s Health 2016-2030 fosters a world in which “every woman, child and adolescent in every setting realises their rights to physical and mental health and well-being, has social and economic opportunities, and is able to participate fully in shaping prosperous and sustainable societies”.

Globally, overweight and obesity is a major public health concern, and there are more overweight or obese than underweight adults. In 2016, 39% men and 39% of women aged 18+ were overweight and 11% of men and 15% of women were obese. Thus, nearly 2 billion adults worldwide were overweight and, of these, more than half a billion were obese. Both overweight and obesity have shown a marked increase over the past four decades (WHO, 2018a). Obesity is a known risk factor for numerous health problems, including hypertension, high cholesterol, diabetes, cardiovascular diseases, respiratory problems (asthma), musculoskeletal diseases (arthritis) and some forms of cancer, and mortality also increases progressively once the overweight threshold is crossed (Sassi, 2010). Social determinants of health such as poverty, inadequate water and sanitation, and inequitable access to education and health services underlie malnutrition. A key driver of the increasing obesity epidemic is a changing food environment, in which nutrient poor and energy dense processed foods are aggressively marketed, readily available and often cheaper than healthier alternatives. The economic priorities and policies that promote consumption-based growth, and the regulatory policies that promote market and trade liberalisation are increasingly regarded as contributing to the global rise of obesity too (Swinburn et al., 2011).

Safe water and adequate sanitation are vital to individual health, livelihood and well-being. Exposure to diarrhoea-causing agents is frequently related to the use of contaminated water and to unhygienic practices in food preparation and disposal of excreta. Globally, diarrhoeal diseases are responsible for the deaths of 525 000 children under age 5 every year (WHO, www.who.int/en/news-room/fact-sheets/detail/diarrhoeal-disease). It was estimated that 88% of that burden is attributable to unsafe water supply, sanitation and hygiene and is mostly concentrated on children in developing countries (UNICEF and WHO, 2017b). Better access to water and sanitation contributes to better health but also leads to great social and economic benefits, whether through higher educational participation, improved living standards, lower health care costs or a more productive labour force. The United Nations set a target of achieving universal and equitable access to safe and affordable drinking water for all, as well as achieving access to adequate and equitable sanitation and hygiene for all and end open defecation by 2030. Furthermore, UNICEF’s strategy for WASH (UNICEF, 2017) seeks to ensure that every child lives in a clean and safe environment, gains access to basic sanitation and safe drinking water in early childhood development centres, school, health centres and in humanitarian situations.

Tobacco use is the leading global cause of preventable deaths and kills more than 7 million people each year, of whom more than 6 million are from direct tobacco use and around 900 000 are non-smokers exposed to second-hand smoke (WHO, 2018a). It is estimated that there were 1 1 million current smokers in 2015, 84% of which were males (WHO, 2018c). The UN SDGs call for strengthening the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.

The health burden related to harmful alcohol consumption, both in terms of morbidity and mortality, is considerable in most parts of the world (Rehm et al., 2009; WHO, 2018d). Alcohol use is associated with numerous harmful health and social consequences, including an increased risk of a range of cancers, stroke, and liver cirrhosis, among others. Foetal exposure to alcohol increases the risk of birth defects and intellectual impairment. Alcohol misuse is also associated with a range of mental health problems, including depressive and anxiety disorders, obesity and unintentional injury (Currie et al., 2012). In 2016, the harmful use of alcohol resulted in some 3 million deaths (5.3% of all deaths) worldwide and 132.6 million DALY – 5.1% of all DALY in that year (WHO, 2018d). While many countries set age limits for purchasing or drinking alcohol, lack of enforcement and no age limits in some countries allow young people to access alcohol easily, increasing their consumption and risk of harmful consequences.

There were 1.25 million road traffic deaths globally in 2013. While the global rate for road traffic deaths is 17.4 per 100 000, there is great disparity by income, with rates more than twice as high in low- and middle-income countries than in the world’s high income countries (WHO, 2015a). The burden of road traffic injuries falls disproportionately on vulnerable road users – pedestrians, cyclists and motorcyclists. Two thirds and half of those who die in road traffic crashes in WPRO and SEARO respectively are pedestrians, cyclists, or users of motorized two-wheelers, and this proportion is higher in emerging economies where urbanisation and motorisation accompany rapid economic growth. In many of these countries, necessary infrastructural developments, policy changes and levels of enforcement have not kept pace with vehicle use (WHO, 2015a).