Child Health: A fair start in life >> Equity objectives Equity objectives interim equity objectives – or ‘stepping stone’ targets – linked to achievement of the 2030 goals could play a valuable role in guiding policy on child and maternal well-being. national strategies aimed at halving disparities in child survival in five to seven years, for example, would help put the most vulnerable women and children at the centre of policy. The strategies could focus on inequities associated with household wealth, education levels, rural-urban divides and differences between regions or ethnic groups. Translating these interim targets into outcomes would require fundamental changes in how child and maternal health services are financed and delivered, and in policies aimed at lowering background risks. But interim equity objectives could act as a powerful catalyst towards meeting the 2030 commitments. The objectives would also provide a reference point for monitoring and reporting. in effect, they would serve as milestones on the road to 2030. This is a key link in the chain of accountability. objectives become meaningful only when they provide a benchmark, backed by data, against which performance can be measured. Currently, there are large gaps in both coverage and quality of the data available. Civil registration systems cover only a small fraction of global births, and coverage is mostly limited in countries with the highest child and maternal death rates. Coverage of deaths is even sparser.88 Globally, the births of nearly one in four children under age 5 have not been recorded.89 of the 74 countries reviewed by the Commission on information and accountability for Women’s and Children’s health, only two registered more 90 than half of all deaths. in low- and middle-income countries, up to 80 per cent of deaths occur outside of health facilities, and many are not 91 reported accurately. This means that critical information on the deaths of newborns, children and mothers is incomplete. Because of deficits in these areas, data on child and maternal deaths have to be extrapolated and interpolated through modelling. as child and maternal deaths decline and become more statistically rare, the importance of observational data increases – especially for the most marginalized and hard-to-reach populations. High return on health investments The investments needed to end preventable child and maternal deaths offer high returns. The scale of the returns reflects the hidden costs of health risks. Childhood illness not only claims lives and causes suffering, but also undermines the potential of children, their communities and countries. Malnutrition and childhood illness compromise cognitive development and reduce adult productivity. When health systems fail to prevent illness, society pays a price in the form of treatment costs and lost productivity. Conversely, improved maternal and child health and nutritional status can create a positive cycle, enabling children to realize their potential and helping their communities and countries to prosper. What would it cost to effectively end preventable deaths among children and mothers? detailed financial costings developed under the Global investment framework for Women’s and Children’s health provide valuable insights.92 The STaTe of The World’S Children 2016 26