The Countdown to 2015 started in 2005 as an initiative from the team that published the Lancet Series on Child Survival 1 in 2003. Cesar Victora, one of the authors, was also a co- founder of the Countdown to 2015: Maternal, Newborn and Child Survival initiative, aimed at monitoring population coverage with effective interventions against the leading causes of death among women and children in low- and middle-income countries.
Countdown to 2015 was a multi-stakeholder initiative aimed at monitoring progress toward the Millennium Development Goals numbers 4 (Child Survival) and 5 (Maternal Health). Different from other initiatives, health equity was paramount to their monitoring effort. Standardized health indicators stratified by all relevant equity dimensions were needed for that.
In 2009, Cesar Victora presented Aluisio Barros with a big challenge: reanalyzing all available MICS and DHS surveys to produce stratified estimates of the MDG indicators. The challenge was accepted, and the International Center for Equity in Health (ICEH) was born as a key Countdown partner.
In a few months, the analysis platform designed to deal with all survey specificities was working, and estimates were being produced. Those estimates were the base for the Countdown Decade Report (2000-2010) published in 2010.
Since then, the ICEH has grown in size and remit, taking a central role in Countdown, supporting its research, training, and dissemination activities. In 2015, Countdown wasrebranded to Countdown to 2030 for Women’s, Children’s & Adolescents’ Health when the Sustainable Development Goals were launched. Currently, Countdown’s focus is on groundwork, developing monitoring activities with 25 African countries, along with capacity strengthening through a fellows program for young researchers, and multicountry studies on regional health priorities. Visit the Countdown website for more information, reports, publications and health equity analysis tools.
Collection of CD2015 reports in the MDG period
Lives Saved Tool is a mathematical modeling tool developed to estimate the impact of scaling up specific maternal, newborn, child, and nutritional (MNCH&N) interventions in child and maternal mortality. By estimating the number of lives saved in various scenarios, it helps policy makers prioritize investments in health. LiST was created and is maintained by a team based at the Johns Hopkins Bloomberg School of Public Health led by Neff Walker.
Since 2013, the ICEH has been working with the LiST team to provide custom-tailored disaggregated health-related indicators that are essential to the tool. Currently, the ICEH provides over 15,000 estimates per survey analysed, covering antenatal care, breastfeeding, child development, child health, delivery care, feeding practices, fertility, gender, malaria, mortality, nutritional status, sexual and reproductive health, among others.
Gavi, the Vaccine Alliance is an initiative born out of the necessity for progress in international immunization and for making vaccines more accessible to low-income countries. Currently, Gavi vaccinates more than half of the world’s children, as a result of its efforts in negotiating vaccine prices for the poorest nations and funding part of their costs in vaccine implementation.
In order to help Gavi in its mission to save lives by increasing equitable and sustainable use of vaccines, Gavi and ICEH started to work together in 2018. Throughout the years, a team from both institutions has worked in multiple analyses trying to identify drivers of vaccination uptake and inequalities in low- and middle-income countries. Using a global health perspective, the team has worked with a wide range of topics – always connected to vaccination – including religious affiliation, ethnicity, women's empowerment, multiple deprivation, and vaccine cards.
This partnership has already resulted in 25 equity-focused analyses, also producing 8 peer-reviewed publications. The main findings of the articles published demonstrated:
Combined, ICEH and Gavi help to identify determinants that can be used to target unvaccinated children and tailor interventions that are more likely to reach children, families, and communities that are currently being left behind. More information about GAVI is available here, and about ICEH publications here
Countries supported by GAVI
The International Center for Equity in Health (ICEH) has been actively engaged in collaboration with the World Health Organization (WHO) and the Pan American Health Organization (PAHO) as a designated WHO Collaborating Centre for Health Equity Monitoring since 2017. Under the leadership of Professors Aluisio Barros, Cesar Victora, and Dr Fernando Wehrmeister, this partnership has been instrumental in advancing global efforts to monitor health equity. The ICEH's designation, denoted as collaborating center BRA 84, was initially conferred from 2017 to 2021. This collaboration was successfully renewed in 2021, reaffirming ICEH's commitment to assist the WHO in addressing health disparities and promoting equitable health outcomes on a global scale. As a collaborating center, our activities are related to providing technical assistance on health inequality monitoring for the WHO Member States.
The collaboration's core activity is maintaining an updated WHO global database of disaggregated data on reproductive, maternal, and child health. Data from nationally representative surveys, especially DHS and MICS, are re-analyzed to provide a large number of indicators disaggregated by several dimensions of inequality.These datasets publicly available through the Health Equity Assessment Toolkit (HEAT) and the Health Inequality Data Repository.
Additional activities include data analysis, products, development, and training and education to strengthen countries' capacity for health equity monitoring. Several outputs from this collaboration are disseminated through scientific manuscripts and technical reports. Some examples include but are not limited to, an analysis of zero-dose immunization, the development of a new equity stratifier called Socioeconomic Deprivation Status (SDS), and inequalities in adolescent childbearing in Latin America and the Caribbean. On the various pages of this website, an array of our tools, products, and outputs are presented, explained, and made available where applicable.
More on the WHO Collaborating Centres can be found here.
Umane, a civil society organization that finances public health projects, and the ICEH established a partnership in 2024 to expand the analysis of Brazilian data on health inequalities among women, children, and adolescents. The collaboration strengthens the monitoring of health indicators in Brazil and other low- and middle-income countries by integrating national information into a global database that includes 122 nations.
The joint work focuses on monitoring inequalities in Brazil through data analyses; identifying vulnerable populations and geographical areas to support the tailoring of public policies; contributing to the 2030 Agenda by supporting multilateral agencies such as the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO); and capacity strengthening, providing training on health inequalities analyses. Since the partnership was established in the second half of 2024, it has already produced scientific publications and presentations at both national and international conferences.
As part of the initiative, the ICEH created a dedicated page on the Umane Public Health Observatory that compiles analyses on priority topics in accessible language to managers, health professionals, researchers, and the broader public. The page currently features studies on timely antenatal care and adolescent motherhood in Brazil, reinforcing the partnership's role in translating scientific findings into actionable evidence. This effort supports the formulation of more effective and equitable public policies.