Interview mit Dr. Natasha Azzopardi-Muscat

Weltgesundheitstag 2025:„Healthy beginnings, hopeful futures“

Unter dem Kampagnenmotto „Healthy beginnings, hopeful futures“ widmet die Weltgesundheitsorganisation (WHO) ab dem Weltgesundheitstag am 7. April ihre ganzjährige Kampagne der Gesundheit von Müttern und Neugeborenen. Dazu ein Interview mit Dr. Natasha Azzopardi-Muscat, Direktorin der Abteilung Gesundheitspolitik und Gesundheitssysteme der Länder, WHO Europa.

Porträt Dr. Natasha Azzopardi-Muscat, Director of the Division of Country Health Policies and Systems at WHO’s Regional Office for Europe

Noncommunicable diseases (NCDs) such as obesity, cardiovascular disease, and maternal mental illness can lead to complications during pregnancy and childbirth, and may also negatively affect the child’s health. In Germany, for example, around 40 percent of pregnant women are overweight or obese. One in ten pregnant women suffers from high blood pressure, which often goes undetected until late in pregnancy. Up to 20 percent of expectant mothers experience depression, and up to 25 percent suffer from anxiety disorders. Elevated blood pressure can cause organ damage and lead to preeclampsia. Studies show higher rates of stillbirths and neonatal deaths among overweight and obese pregnant women.

What recommendations is WHO/Europe putting forward for World Health Day 2025 to improve maternal and newborn health?

Noncommunicable diseases (NCDs) relevant to pregnancy encompass a wide range of medical conditions affecting multiple organ systems. These include hypertension, chronic rheumatic heart disease, diabetes, hypo- and hyperthyroidism, mental health conditions, neoplasms, anemia, and more.

Medical and obstetric complications are often closely interconnected. For example, chronic hypertension and obesity are linked to obstetric outcomes such as an increased likelihood of cesarean section, which carries the risks associated with surgery and anesthesia. These complications can affect not only the current pregnancy but also future pregnancies and the long-term health of the mother. Increasing evidence suggests that pregnancy complications have intergenerational effects, impacting the development and health of both the child and future generations.

Risk factors such as tobacco and alcohol use also play a significant role during pregnancy. Ensuring adequate nutrition and physical activity before, during, and after pregnancy is equally essential.

Poor maternal nutrition at the earliest stages of life - during fetal development and early infancy - can lead to both short- and long-term effects, including an increased risk of obesity and NCDs later in life.

Maternal mortality has declined significantly over the past 25 years, primarily due to improved management of obstetric complications. To date, efforts have rightly focused on maternity services and emergency care. However, increasing attention is now being paid to severe maternal morbidities, to which NCDs significantly contribute. The growing burden of NCD-related maternal ill-health is part of the broader „obstetric transition“- a shift marked by reduced maternal deaths from direct obstetric causes and an increasing share of indirect causes linked to NCDs, older maternal age, and rising use of healthcare services for maternity care.

This transition raises critical questions: Are we overlooking an opportunity to address NCDs during pregnancy? Are we prepared to meet evolving health needs? Have we evaluated the benefits of managing NCDs in pregnancy - not just for immediate outcomes, but for lifelong and intergenerational health? These considerations point to the importance of adopting a life-course approach to women's health.

A life-course perspective examines social, behavioral, and biological influences from early life through adulthood, pregnancy, and beyond. It emphasizes continuity and connections across an individual's lifespan and into future generations. This approach supports early interventions to reduce disease risks and allows for better anticipation of healthcare needs, making it particularly useful in public health planning.

Applied to pregnancy and NCDs, the life-course perspective creates opportunities for early prevention. For instance, women who experience gestational diabetes or hypertensive disorders are at higher risk of cardiovascular disease and diabetes later in life.

What’s needed is individualized, integrated care across reproductive stages and throughout life. Priority must be given to prevention and early intervention, with health systems offering seamless care across community, primary, and referral levels, and across specialties and social services. Because medical conditions vary by context and individual, a one-size-fits-all solution won’t work. Even in high-income countries, fragmented services often fall short of delivering person-centered care.

Public health efforts must also target improved nutrition in the preconception and postpartum periods. Governments should implement national strategies to create supportive environments for healthy eating and physical activity - especially for those facing the dual challenge of over- and undernutrition due to poor diets and sedentary lifestyles. Clear, consistent national guidelines - available in all local languages - are crucial, but must be backed by supportive policies and societal action. For example, strategies should empower women to enter pregnancy at a healthy weight through good nutrition and regular exercise.

While we can expect maternal mortality to keep declining through continued investment in what works- quality maternity services, prevention of communicable diseases, and access to family planning and abortion care - the emergence of NCDs as a dominant risk factor means we must be ready for the „obstetric transition“. Unfortunately, many health systems in the WHO European Region remain unprepared, with fragmented services still largely focused on acute emergencies.

Ongoing efforts to better monitor and assess the burden of NCDs in pregnancy will be essential. Building a compelling case for action requires moving beyond a narrow maternal health lens to embrace the life-course approach. Ultimately, maternal health is the gateway to improving not just the lives of women today, but those of future generations.

What are the specific aims of the campaign?

The campaign, Healthy Beginnings, hopeful Futures, is focused on improving the health of women and babies, with the primary goal of accelerating progress in maternal and newborn survival. Launched at a critical moment for global health, it promotes effective healthcare interventions and aims to provide essential health information for women and families across the pregnancy, childbirth, and postnatal continuum. In the face of shrinking humanitarian aid that threatens key lifelines for millions, the campaign also calls for renewed global collaboration - emphasizing the power of collective action to secure better futures for women, babies, children, and societies as a whole.

Breastfeeding supports both maternal and child health. Breastfed infants are less likely to develop infections or acute otitis media. It also reduces the risk of sudden infant death syndrome (SIDS). The nutrients in breast milk help build the baby’s immune system, and breastfeeding has long-term benefits, such as lowering the risk of obesity and diabetes. Mothers benefit too - breastfeeding reduces their risk of ovarian and breast cancer as well as cardiovascular disease. It also strengthens the maternal bond. How can breastfeeding promotion and motivation be improved in the WHO European Region?

Breastfeeding plays an important role in the health of mothers and - children, though rates vary across the 53 Member States of the WHO European Region. A coordinated, multisectoral approach can help create an environment where breastfeeding is supported and encouraged.

a. Policies and legislation
Aligning with the „International Code of Marketing of Breast-milk Substitutes“ can help limit the impact of formula marketing. Policies that support paid maternity leave and provide breastfeeding-friendly workplaces - such as lactation breaks and designated spaces - can also make a difference.

b. Healthcare systems
Integrating breastfeeding support into prenatal and postnatal care helps improve outcomes. Training for healthcare workers and wider adoption of the „Baby-Friendly Hospital Initiative“ can offer consistent support across maternity care settings. Community-based support, including lactation consultants and peer networks, also plays a valuable role.

c. Public awareness and education
Sharing accurate information about breastfeeding and its benefits - through digital platforms, media, and school-based programs - can help build supportive social norms.

d. Workplace and community support
Workplaces that offer flexibility and dedicated lactation spaces contribute to a more supportive environment. At the community level, initiatives like mother-to-mother support groups and breastfeeding-friendly public areas can foster inclusion and encouragement.

e. Data and monitoring
Tracking breastfeeding trends and understanding barriers helps inform effective programs. Investing in reliable data systems supports evidence-based decisions and continuous improvement.

What actions are planned for the campaign period from April 7th, 2025 to April 6th, 2026?

The campaign will capitalize on key moments throughout the year to emphasize the importance of maternal and newborn health - from occasions like Mother’s Day to high-level international events such as the World Health Assembly.

Country-level activities will be supported through the Every Woman Every Newborn Everywhere initiative, which works with over 60 high-burden countries to accelerate progress in maternal and newborn survival. WHO will also launch several important technical resources, covering areas such as midwifery care, NCDs in pregnancy, postpartum hemorrhage, preterm birth interventions, and more.

In addition, families will be encouraged to engage through our upcoming One Mother to Another social media series - creating space for open, honest conversations about maternal health at every stage.

WHO is calling for a global commitment to improve healthy pregnancies, safe births, and better maternal and newborn health after birth. How can the „healthy beginnings, hopeful futures“-campaign be supported?

For policymakers, the key message is clear: investing in maternal and newborn health is an investment in human capital. It fuels economic development and builds healthier, happier societies. We are advocating for high-impact investments - ensuring access to quality, safe care; addressing underlying health risks to mothers and babies; and promoting access to family planning and other sexual and reproductive health services - essential foundations for improved outcomes.

For the general public, there are many ways to support the campaign:

Spread Awareness: Share campaign messages using hashtags like #HopefulFutures and #HealthForAll.
Participate: Join global events to learn more about how to end preventable maternal and newborn deaths.
Donate: Support the WHO Foundation, which helps protect mothers and babies around the world.
Share Your Story: Share your pregnancy and birth experiences, or recognize those who provided quality care, via your own channels.

If someone you know is pregnant or has recently given birth, small gestures - checking in, offering support, or simply listening - can go a long way in making a difference.

Die Fragen stellte Ulrike Meyer-Funke, Bundesvereinigung Prävention und Gesundheitsförderung e.V. (BVPG).

Weitere Informationen zum Weltgesundheitstag 2025 finden Sie auf der englischsprachigen Internetseite der WHO.
Das Statistische Bundesamt hat auf seinem Portal Gesundheitsberichterstattung des Bundes ausgewählte Informationen zum diesjährigen Schwerpunktthema zusammengestellt.
Bei Rückfragen wenden Sie sich bitte an weltgesundheitstag@bvpraevention.de.

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Dr. Natasha Azzopardi-Muscat | Director of the Division of Country Health Policies and Systems at WHO’s Regional Office for Europe. Originally from Malta, she is a medical doctor, specialist in public health, and the author of several publications in public health and European health policy. Before joining WHO in 2020, Dr. Azzopardi-Muscat served as President of the European Public Health Association (EUPHA) from 2016 to 2020, and prior to that she occupied various senior positions in the Ministry of Health in Malta, including that of Chief Medical Officer.

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