Parliamentary Leadership for Women’s, Children’s and Adolescents’ Health

Statement by PMNCH on the Occasion of the 152nd Inter-Parliamentary Union Assembly, Türkiye

• Rajat Khosla, Executive Director, PMNCH

• Dr Flavia Bustreo, Co-Chair, PMNCH Working Group on WCAH in Crisis and Climate Contexts 

• Dr Zulfi Bhutta, Co-Chair, PMNCH Working Group on WCAH in Crisis and Climate Contexts [TBC]

Across the world, overlapping crises—escalating conflicts in multiple regions and attacks on international humanitarian law are placing unprecedented strain on the global systems built to safeguard peace and human dignity. Today, more than 122 million people are forcibly displaced globally, underscoring the scale of instability and shared responsibility for action.¹

At the same time, economic pressures, rising costs of living and climate-related shocks are deepening food insecurity, while cuts to foreign aid are undermining access to life-saving services—particularly in the Global South. 

Furthermore, policy regressions including attacks on science and the rollback of sexual and reproductive health and rights are putting lives and futures at risk.

In the midst of these compounding challenges, women, children and adolescents are the worst affected, and without urgent action to uphold the rule of law, humanitarian principles and solidarity they will bear the greatest cost.

 For example, in 2023, they accounted for 70% of civilian deaths, with women making up 40% and children 30%.² 

• In 2023, almost two thirds (64%) of maternal deaths occurred in conflict and fragile settings, despite these countries accounting for only around one in ten of global live births.³

• As violence has intensified in the Middle East, more than 2,200 children have been killed or injured—deepening a crisis that is pushing already vulnerable communities at heightened risk with essential services stretched to collapse.⁴

• In Gaza, over 55,000 pregnant women require urgent maternal healthcare, with many forced to give birth in unsafe conditions;⁵

These are not isolated crises. They signal a systemic breakdown and with each new shock, systems are pushed closer to collapse. This is not inevitable—it is the result of policy and financing choices. 

Increasing funding volatility is severely constraining countries’ ability to finance health systems and sustain access to essential health services. Rising debt burdens estimated at nearly 70% of GDP across Africa—combined with escalating debt servicing costs, which have already surpassed health expenditure in 40% of African countries, are limiting governments’ fiscal space to allocate domestic resources to health.^6,7 At the same time, a sharp reduction in Official Development Assistance (ODA)—with development assistance for health declining by approximately 20% between 2023 and 2025—is further compounding these pressures.⁸ This dual squeeze is particularly acute in fragile and humanitarian settings, where reliance on external funding is highest and where over 14% of global ODA is directed.⁹ As a result, countries are increasingly unable to absorb financial shocks, leading to service disruptions, reduced access to essential WCAH services, and a growing shift toward out-of-pocket expenditures for households.

Political and ideological pressures have reshaped the operating environment in ways that are compounding these financing shocks. For example, the expanded application of the Global Gag Rule –  a major escalation of regressive policies impose donor-imposed restrictions on diversity, equity and inclusion, and broader rollbacks on sexual and reproductive health and rights (SRHR) are translating directly into service disruptions, reduced access to contraception and safe abortion, and weakened civil society engagement.¹⁰ These trends, including the attacks on women’s and girls’ social rights, are not inevitable—they are the result of policy and financing choices backed by concerted effort by key stakeholders to advance morality based legislative solutions to health and other human rights issues. 

At this critical moment, the 152nd IPU Assembly offers a vital platform for parliamentary leadership to take a bold stance to protect those most affected, and to restore hope, justice and security for future generations.  

If we are to nurture hope and secure peace for future generations, we must confront a stark truth that there can be no peace, justice, or sustainable future while the health and rights of women, children and adolescents are under threat across conflict and fragile settings.

In these challenging times the decisions parliaments make today will determine the future generations inherit—whether we allow hard-won progress to slip away, or hold the line and chart a more just, peaceful and prosperous future for all—girls and boys, women and men, in every country. 

From crises response to system correction

Crisis response asks parliaments to appropriate emergency funds and pass temporary measures; system correction asks them to examine why the system failed and legislate so it cannot fail the same way again. This requires treating women’s, children’s and adolescents’ health not as a humanitarian afterthought or a sectoral priority, but as a standing pillar of national security and governance — and a foundation for peace, justice and sustainable development based on the principles of  human security and common security.

Parliaments are uniquely positioned to make this shift — through their core functions of law-making, budgeting, oversight and representation. They also play a critical role in rebuilding trust, strengthening multilateral cooperation, and advancing peace through parliamentary diplomacy.

In practice, this means:

• Ensuring that health systems can deliver essential services even during conflict and displacement – including SRHR services and extend access to displaced populations since investing in these services is linked to societal impact including poverty reduction¹¹

• Addressing structural drivers of vulnerability — conflict, poverty, inequality and climate change

• Embedding intergenerational accountability into law, so that today’s policy choices are measured against their impact on future generations

• Fostering solidarity across countries as the impacts of climate disasters and conflicts are far-reaching and extend well beyond national borders.

PMNCH call to action: Parliamentary leadership for WCAH and future generations

We call on all parliamentarians to exercise decisive, forward-looking leadership—anchored in the responsibility to protect human dignity today while safeguarding the rights of future generations, and leadership and embed WCAH at the center of peace, security and future-oriented governance mechanisms .

1. Advance rights based legislation for women’s children’s and adolescents’ health: Ensure that the health services that WCA require are guaranteed as enforceable rights through legislation which is aligned with international humanitarian and human rights law and international frameworks;

• Enshrine universal access to essential health services including SRHR with inclusive coverage for  displaced population groups while safeguarding continuity of WCAH services in fragile and crisis settings through explicit measures for emergency preparedness, service delivery continuity, and protection of frontline health workers. Address attacks on human rights including strengthening enforcement against gender-based violence as a core security and justice issue by making clear referral pathways between health, legal, and social protection systems.

• Ensure national legislation is aligned with international humanitarian and human rights law and international frameworks including those in the UN Pact for the Future by establishing or strengthening parliamentary committees or caucuses on WCAH to lead alignment efforts and monitor compliance with international obligations, while integrating WCAH into peace, security and climate agendas. In parallel, strengthen parliamentary diplomacy across borders on these issues by engaging in inter-parliamentary platforms to harmonize legal frameworks and share best practices on WCAH as well as promote regional agreements, joint resolutions and dialogue addressing cross-border issues.

There can be no sustainable peace without providing justice to and protecting the health, rights and dignity of women, children and adolescents.

2. Reprioritize and protect sustainable financing for WCAH as a peace and stability investment

Recognize WCAH not as a cost—but as a strategic investment in peace, resilience and human security – resulting in fewer maternal deaths, more girls in school, and overall, more resilient communities. Every 1 USD invested in health systems strengthening, and RMNCH services is estimated to yield USD 9-20 for economies and societies:¹²

• Protect funding in national budgets for WCAH services by ensuring dedicated funding is maintained, at a minimum, for essential health services and commodities for WCAH issues, including SRHR in national budgets, even in times of fiscal pressure and especially in fragile and humanitarian contexts.

Financing WCAH means financing stability, social cohesion, and long-term peace.

3. Strengthen inclusive accountability for results and future impact

Shift from commitments to measurable accountability that invites the perspectives and expertise of diverse constituencies.

• Establish or strengthen dedicated parliamentary accountability mechanisms (committees, scorecards, hearings) for regular reporting on WCAH outcomes including in fragile and crises settings in national dialogues

• Ensure meaningful engagement with civil society, youth groups and other constituencies that bear the brunt of these crises to ensure that their lived experience influences national policy processes and outcomes¹³

Accountability must be systemized to extend beyond electoral cycles so that it can ensure the well-being of future generations.

4. Elevate women’s and youth leadership in decision-making 

Advance inclusive governance as a foundation of peace, legitimacy and effective policy making. 

• Accelerate progress toward gender parity in parliaments and leadership positions (women hold only approximately 27% of parliamentary seats globally) by eliminating structural barriers for women to enter politics, including through the legislation of gender quotas and enforcement mechanisms, ensuring parliamentary procedures are family friendly as well as establishing independent reporting and protection mechanisms within parliaments addressing violence against women, ¹⁴ 

• Address the current underrepresentation of youth in parliaments by institutionalizing their participation in legislative and oversight processes (only 2.8% under 30, while more than half of the global population is less than 30) through quotas, tracking and publishing age disaggregated data, annual reporting and sharing best practices in regional/global inter-parliamentary fora.^15,16 

Decisions about future generations cannot be made without those who represent them and primarily care for them.

A moment for political courage and action

Nurturing hope is a political responsibility and not just an aspiration. It is realized through collective action anchored in inclusive dialogue, and guided by a commitment to dignity and the future. Nowhere are these decisions more consequential than in the lives of women, children and adolescents. 

If we fail them, we fail our shared future. But if we act boldly and collectively together we can still secure a  just, peaceful and resilient world. 

PMNCH stands ready to support you as the world’s largest alliance for women’s, children’s and adolescent’s health we bring together governments, parliamentarians, civil society, youth and partners to drive this agenda forward.

Through the Global Leaders Network, chaired by H.E. President Ramaphosa, Heads of State are elevating WCAH issues at the highest political level across national, regional, and global platforms. The Network aims to accelerate progress in 10 key target countries against key mortality indicators: maternal mortality (SDG 3.1), neonatal mortality (SDG 3.2.2), and adolescent mortality in Sub-Saharan Africa. 

Through the Collaborative Advocacy Action Plan Initiative, we are bringing CSO and other partners, especially those that are underrepresented in national policy processes, together in 10 prioritized countries to accelerate implementation of commitments towards WCAH made towards national, global and regional pledging platforms and frameworks. By linking to institutional mechanisms  and processes such as parliamentary processes, it aims to advance collective and constructive accountability for WCAH commitments.

Through the Parliamentary Network of Champions, launched at the last IPU Assembly and convened by Honourable Thokozile Didiza, Speaker of National Assembly of South Africa, parliamentary leaders are stepping forward to champion the health and rights of women, children and adolescents—advancing dialogue, peer exchange and accountability for results.

Together, let us be the generation that holds the line and shapes a future where justice, dignity, health and opportunity are guaranteed for every woman, child and adolescent—everywhere for generations to come.

References

1. Global Trends report 2024 | UNHCR
2. United Nations Secretary-General. (2024). Protection of civilians in armed conflict (Report of the Secretary-General, S/2024/385). United Nations
3. Trends in maternal mortality estimates 2000 to 2023: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization; 2025
4. UNICEF, Middle East Crisis: The Humanitarian Impact on Children – Update No. 1, 26 March 2026
5. Struck down by malnutrition, pregnant Gazan woman can only pray for a healthy baby | Reuters
6. Afreximbank. (2024). State of Play of Debt Burden in Africa 2024: Debt Dynamics and Mounting Vulnerability. Cairo: African Export-Import Ban
7. United Nations General Assembly. 2024: External debt sustainability and development
8. Health financing.IHME.
9. International aid falls in 2024 for first time in six years, says OECD
10. US Government Expands Global Gag Rule in a Major Escalation of Regressive Foreign Policy | IPPF
11.  Greene, M. E., & Merrick, T. (2005). Poverty reduction: Does reproductive health matter? Health, Nutrition and Population (HNP) Discussion Paper No. 33399. Washington, DC: World Bank
12. Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwah, A et al. (2013). Global health 2035: a world converging within a generation. Lancet, Vol 382, pp. 1898-1955
13. The Practical Guidance Resource is a helpful tool which is provides guidance on how to practically implement the Global Consensus Statement on Meaningful Adolescent and Youth Engagement which policy makers and other stakeholders who wish to work with young people in an inclusive and equitable way can leverage
14. Women in Parliaments Around the World – The International Parliament Journal (IPJ)
15. IPU finds that lawmakers are getting younger but not everywhere – BGIPU
16. Are We Prepared to Serve the Youngest Half of the Global Population?