Dr Saia Ma’uPiukala, WHO regional director for the Western Pacific. Supplied
One Saturday night in 2021, I received an urgent call from a hospital doctor in Vava’u, Tonga. A pregnant mother who had undergone two previous caesarean sections was in labour and needed an emergency procedure to prevent uterine rupture. Her last procedure had been just a year ago and she weighed 180 kilogrammes, making the procedure highly risky.
Given the difficulty of arranging a medical evacuation for her to Tongatapu − the main island with comprehensive emergency obstetric services − I immediately cancelled my plans so I could rush to the hospital to support the medical team.
Upon arriving, I said a quick prayer for guidance, administered the spinal anaesthesia and proceeded with the caesarean section − my first operation at this hospital in 18 years.
Despite the risks and challenges, the medical team successfully saved both mother and child. This stressful experience underscores the value of efforts to provide healthy beginnings for mothers and their newborns, even in the most challenging situations.
This is why the 2025 World Health Day theme − “Healthy Beginnings, Hopeful Futures” − resonates deeply with me as someone who has witnessed firsthand the critical importance of providing the right care for mothers and their babies.
Progress and persistent challenges
The Western Pacific region has made significant strides in improving maternal health. The maternal mortality ratio has dramatically decreased from 49 deaths per 100,000 live births in 2010 to 35 in 2023. This is a result of dedicated health-care workers, use of evidence-based policies and collaborative efforts between governments and organisations.
WHO’s Action Plan for Healthy Newborn Infants in the Western Pacific Region (2014–2020) introduced Early Essential Newborn Care (EENC) − a cost-effective solution that prevents avoidable deaths. This approach strengthens health systems and encourages essential practices at every birth.
With support from WHO, more than 42,000 health-care providers in the Western Pacific region have received coaching in EENC, which has been implemented in 6500 facilities across nine priority countries where 95% of regional newborn deaths occur. The results have been remarkable. Now, 93% of full-term babies in these countries experience the life-saving “first embrace” − immediate skin-to-skin contact with their parents, which helps to regulate babies’ body temperature, strengthen their immune system and bolster the bond between parents and child. In the decade since the implementation of EENC, the number of neonatal deaths has halved in the region.
Yet, challenges remain. Prematurity, birth complications and infections still claim too many lives. While 98% of regional births are attended by skilled professionals, there is still significant room for improvement in the quality of essential care for women and their babies.
Another pressing issue is the resurgence of vaccine-preventable diseases, particularly measles, with cases more than doubling compared to last year. Strengthening immunisation programmes alongside maternal care is critical to safeguarding the health of infants and children.
Investment for our futures
Investing in maternal and newborn health is both morally imperative and economically sound. In low- and middle-income countries, every $1 invested in maternal and newborn health can yield a return of up to $20, contributing to economic growth through healthier populations.
WHO remains committed to enhancing access to quality-assured services across the pregnancy−childbirth−postnatal care continuum. To do so, we work closely with national counterparts, health authorities and health-care providers.
Health authorities can accelerate progress through three key actions: First, by sustaining investments in quality-assured, safe and accessible maternal and newborn care. Second, by creating enabling environments for health workers to provide safe and good-quality care, such as ensuring reliable water and sanitation. Last but not least, by ensuring facilities are well-stocked with essential medicines and supplies.
The Western Pacific is at a critical juncture. While much progress has been made, there is still more work to be done. WHO stands ready to support Member States in improving maternal and newborn care, building resilient health facilities and strengthening trust in health-care systems.
By working together, we can achieve a future where every newborn has a healthy beginning and a hopeful future.
Dr Saia Ma’uPiukala is WHO regional director for the Western Pacific. The views and opinions expressed are his own.
