Ewha Womans UniversityInstitute for Development and Human Security

Among the United Nations' Millennium Development Goals (MDGs), the fourth goal, "Reduce child mortality," aimed to decrease the under-five mortality rate by two-thirds between 1990 and 2015. However, most regions, excluding Oceania, achieved only a 50% reduction, falling short of the target. The fifth goal, "Improve maternal health," sought to reduce maternal mortality by three-quarters by 2015. By 2013, there was only a 50% reduction, failing to meet the goal. In 2015, the global maternal mortality rate was 216 per 100,000 live births, down from 380 per 100,000 in 1990. Despite this progress, around 800 women still die daily from maternal causes, with 86% of these deaths occurring in sub-Saharan Africa and South Asia.

Maternal deaths can be prevented through proper education and healthcare services, but in many cases, women die due to complications such as excessive bleeding or infections because they do not receive medical care during pregnancy and childbirth. In developing countries, early marriage, early pregnancies, excessive pregnancies, and nutritional deficiencies during adolescence pose serious risks. Pregnancies and childbirth among adolescent girls, especially those under 15 who are classified as high-risk, directly impact their own lives as well as the health and survival of their fetuses and infants. Despite the efforts of many organizations and countries to achieve MDG 5, which aims to improve maternal health, most international health initiatives have excluded girls by setting the target age for reproductive health programs at 18 and older. While there are many reasons for not achieving MDGs 4 and 5, our research team believes that the lack of maternal health programs specifically targeting adolescent girls is one of the contributing factors.

In most developing countries, healthcare services for adolescents, particularly girls, are extremely limited. Even when health centers are available, they often lack the facilities or resources to address the specific health issues faced by adolescents, making these services inaccessible to many. Additionally, adolescents, including girls, may fear being stigmatized as having physical or sexual problems if they visit health centers, or they may face logistical challenges such as distance or inconvenient operating hours that restrict their access to services. Girls experience inequality in accessing reproductive health and related medical services compared to adult women. Existing research indicates that girls in less developed countries have significantly lower rates of prenatal care and contraceptive use compared to adult women.

Therefore, it is urgent to provide healthcare services specifically for girls to improve their health, as well as to analyze and address the social factors that threaten their health. Mitigating health inequalities faced by girls in developing countries can help address broader social issues related to girls' health in the long term. In particular, reducing inequalities in sexual and reproductive health can prevent early marriage, pregnancy, and childbirth among girls, thereby improving their health and advancing the MDG goals that were not fully achieved, such as MDG 4 ("Reduce child mortality") and MDG 5 ("Improve maternal health").