International health programs have greatly reduced death and sickness worldwide over the past two decades but there is still a long way to go. The United Nations General Assembly will meet later this month to assess progress — impressive in some areas, halting in others — toward achieving the United Nations’ Millennium Development Goals, which were adopted in 2000 and are supposed to be reached by the end of 2015.

For instance, great strides have been made in reducing the maternal mortality rate related to childbirth, which has declined to 210 maternal deaths per 100,000 live births in 2010 from 400 deaths per 100,000 births in 1990. Still, that is far short of the Millennium target of 100 deaths per 100,000 live births by 2015. Many countries with high maternal death rates continue to struggle with lack of prenatal care; skilled assistance from a midwife, nurse or doctor for women during childbirth; and broad contraceptive use to prevent unwanted pregnancies, especially among adolescents.

Another goal is a reduction of death rates for children under the age of 5. That rate dropped significantly over two decades, to 51 deaths per 1,000 live births in 2011 from 87 in 1990. Even with the gains, some 6.9 million children under age 5 died in 2011, mostly from preventable diseases.

The overwhelming majority of these deaths, according to the United Nations, occurred in the poorest countries of the world, with the toll especially high in sub-Saharan Africa, where one in nine children die before age 5, and in southern Asia.