Exemplars in Global Health

Every year, an estimated 12 million girls are married before the age of 18, putting them at greater risk of leaving school early, experiencing domestic abuse, economic hardship, and the serious health consequences of early pregnancy. Findings from ASRHR Exemplars research show that where child marriage declines, so do adolescent birth rates and maternal and newborn deaths.

Overview Digital technologies—such as data platforms, user-facing applications, and emerging AI tools—are reshaping how health systems plan for, manage, and deliver care. When designed and deployed appropriately, these tools can help countries overcome persistent challenges such as limited access, fragmented information, and inefficient and sub-quality service delivery, accelerating progress toward stronger primary health care systems.

CONTENTS Peru’s government and civil society organizations collaborated to develop a deliberate, multi-sectoral strategy to reduce stunting that spanned across all levels of government. The evidence-based and targeted nature of interventions made them particularly effective. Childhood stunting prevalence in Peru declined by 15 percent in eight years—from 28 percent in 2008 to 13 percent in 2016. Economic growth contributed to this decline but was not the primary driver.

The primary research findings suggest additional contextual factors that contributed to U5M reductions in Ethiopia that were outside of the health system interventions. These include women’s empowerment, increased use of family planning and decreased fertility rates, improvements in water, sanitation and hygiene, and economic growth. IHME DECOMPOSITION RESULTS 3% of the reduction in under-five mortality is attributed to improvements in WASH and air quality. Methodology

Key Points More than 130,000 CHW, most of them women, have been trained to provide a growing basket of critical services – shifting the status of women in rural Bangladesh and connecting them with the formal health system for the first time. CHW programming has mobilized communities to demand, support, and utilize CHWs. A total 13,000 community clinics across the country have helped institutionalize CHW programming and connected communities with the formal health system.

Quick Facts on Child Stunting Child stunting is associated with significant and lasting consequences for children and societies: 2-4X Stunted children are two to four times more likely to die before age five than their peers 11-point Stunting is associated with delayed cognitive development and up to an 11-point reduction in expected IQ 13% At the societal level, stunting reflects limitations in a country’s ability to compete in the knowledge economy; it correlates with costs of as much as 13...

CONTENTS Senegal’s impressive progress in curbing the mortality rate for children under the age of five has been the result of an identifiable group of policies and programs, all of which are potentially replicable in other countries. Senegal’s highly successful comprehensive vaccination programs were among the main catalysts of its progress against U5M.

Key Points Starting with Female Community Health Volunteers (FCHVs), Nepal created a health care system capable of reaching its remote population. Investment in basic and primary health care, through health worker training, maternal health programs like the Safe Motherhood Program and Aama, and Community-Based Integrated Management of Childhood Illness, paid off in the form of earlier breastfeeding, reduced sickness, improved treatment, and better outcomes for children and women.

Quick facts Climate change is reshaping the determinants of health worldwide, by driving increases in heat-related illness, vector-borne disease, and food and water insecurity. It is straining already fragile health systems, especially in low- and middle-income countries. 2 million Deaths worldwide between 1970 and 2021 are attributed to climate events. 44 million People at risk of falling into poverty by 2030 due to climate-related health impacts.

OVERVIEW The Exemplars in Adolescent Sexual and Reproductive Health and Rights (ASRHR) research examined successful strategies to reduce adolescent fertility and advance ASRHR by studying positive outlier countries that achieved sustained progress. This cross-country synthesis describes high-level insights from our research in five Exemplar countries: Cameroon, Ghana, Malawi, , and Rwanda. Results from India are expected and will be integrated in 2026.