Now, the global pandemic is making a bad situation even worse, as some countries divert resources away from essential services.
There have been mass closures of sexual and reproductive health services, including HIV testing and post-abortion care, and supply shortfalls, including for contraceptives.
Constraints in accessing maternal health services during lockdowns are compounded by health workers being diverted from maternity services to COVID-19 units.
With school closures, 370 million children are missing out on school meals and adolescents are suffering from social isolation and mental health problems. And domestic violence has increased, with many more emergency calls reported in several countries.