Although advances have been attained since the inception of the millennium development goals, maternal and child health challenges remain critical, particularly in sub-Saharan Africa.
For example, worldwide data estimates that 86% (2.31 M) of neonatal deaths in 2015 (total estimate = 2.68 M) occurred in low and middle-income countries . Furthermore, sub-Saharan Africa and Southeast Asia still experience the highest burden of child deaths under five. “Four out of every five deaths of children under age five occur in these regions” . In addition to child deaths, pregnant women face high rates of disease and complications due to changes in their immune system during pregnancy .
Some of the common conditions with which pregnant mothers struggle include:
- Group B streptococcus (GBS)
- Urinary tract infections
- Bacteremia 
Many of the deaths and complications among both pregnant mothers and children under age 5 may be mitigated by addressing immunization opportunities among both populations.
Vaccines are safe, efficient, and cost-effective public health interventions that are used to great effect across the world. Vaccines have decreased the burden of infectious diseases, reduced complications, and prevented deaths. Although vaccines have been widely distributed to positive effect, a gap of 18.7 million unvaccinated infants remains .
The development of appropriate and effective maternal and child health initiatives is imperative. Two key opportunities to leverage the use of vaccines with great impact. This includes addressing the gap in unvaccinated infants and ensuring that mothers are immunized.
Maternal immunization protects the mother and offers the potential for mother-to-child protection. This is for infants still too young to begin a regular immunization schedule. Vaccines included:
- Vaccination for influenza (licensed)
- Pertussis (licensed)
- GBS (in the final stage of development)
- Respiratory Syncytial Virus (RSV) (also in the final stage of development)
These intervene for conditions that are known to cause complications for both mothers and their children under five .
Although data supports the use of maternal immunization and more robust infant immunization interventions. The data from low- and middle-income countries is considerably less complete. Therefore, it is important to build on the growing evidence base among developed countries for maternal immunization. It is also important to broaden infant immunization by capturing more LMIC-specific data that address:
- Cultural acceptability of these types of vaccination programs
The pursuit of these two opportunities aligns with the sustainable development goals (SDG) released on September 25, 2015, under the UN Resolution “Transforming our world: the 2030 Agenda for Sustainable Development” (UN Resolution/A/RES/70/1) . This provided insights on the global vision for improving lives over the next 15 years.
This type of initiative intersects heavily with Goal 3: “ensure healthy lives and promote well-being for all at all ages” . Alignment also exists with several other SDGs: End poverty in all forms everywhere (SDG 1), Gender equality (SDG 5), Reduce inequality both within and among countries (SDG 10) [8-10].
This type of initiative also falls under the umbrella of the Global Vaccine Action Plan , which focuses on equitable access to vaccines for all people.
It is imperative to assess what gains have been made in the effort to reach millennium development goals and develop an appropriate roadmap. In order to make effective gains in these four target areas for both maternal and child health. Also to make progress towards the other previously mentioned goals.
It is imperative to assess what gains have been made in an effort to reach the millennium development goals . In addition, it is important to understand the types of programs that create a positive impact and opportunities for future effective intervention.
It is also necessary to capture primary data from current “on-the-ground” realities. In combination, these sources of information will allow for the development of informed, practical, and impactful strategies. This will help to improve maternal and child health.