Overall, although there was a regression from the baseline, countries achieved or are on track to achieve this outcome indicator to improve children's health and development. Some countries have a national strategy on maternal and newborn health under implementation, but improved monitoring and alignment of these strategies with the WHO/UNICEF Framework are needed. Strategies for moving forward include adoption and implementation of the WHO frameworks Parenting for Lifelong Health and Global Scale for Early Childhood Development in the region.

Through implementation of the EMTCT Plus Initiative, PASB has been working with national health authorities to strengthen national responses to syphilis and congenital syphilis, toward the achievement of elimination targets. The coverage of syphilis treatment among infected pregnant women has been historically high in Latin America and the Caribbean, reaching 89% in 2023. Eleven countries have been validated for the dual EMTCT of HIV and syphilis, and additional countries have shown progress and may be ready to seek validation in the near future.

PASB will continue supporting at-risk countries in conducting follow-up campaigns to update the vaccination status of unvaccinated children under 5 years of age. This should improve MMR-1 and MMR-2 vaccination coverage by the end of 2023. Countries report 2023 data in the first quarter of 2024 via the PAHO-WHO/UNICEF electronic Joint Immunization Data Reporting Form (eJRF).

The countries of the Region have made great efforts to incorporate the vaccine into their national vaccination schedules; as of December 31, 2023, only 4 countries had not introduced the HPV vaccine. 26 countries in the Region are vaccinating children and 12 countries have switched to a single-dose schedule.

Following the technical specification of the indicator, PASB recognizes that 28 countries have established capacity and effective processes to eliminate dog-mediated human rabies, showcasing significant progress in the region. PAHO contributions, including provision of standards, generation of data, and technical cooperation, have been instrumental in these achievements. Successful strategies include comprehensive dog vaccination campaigns, public awareness initiatives, and robust surveillance systems. However, several countries continue to report canine rabies, with some also reporting human cases. Lessons learned highlight the importance of sustained vaccination efforts, enhanced surveillance, and accessible post-exposure prophylaxis. Continued support and commitment are essential to address these challenges and achieve the complete elimination of dog-mediated human rabies across the region.

In the 2022-23 biennium, progress was made toward strengthening country capacity for all-hazards health emergency and disaster risk management. As of the latest assessment, 22 countries fully meet or exceed minimum capacities to manage public health risk associated with emergencies, with another 15 on track to do so. PASB's technical support, including the development of assessment tools and coordinator meetings, remains essential for achieving the 2025 target of 37 countries. Continuous monitoring and emphasis on gender-sensitive disaster preparedness, supported by tools such as the Preparedness Index for Health Emergencies and Disasters and the monitoring survey for the Plan of Action on Disaster Risk Reduction, are critical for maintaining and building on the progress made.

To achieve this indicator, a State Party must have improved its scores or maintained them (where the score is higher than 0%), for at least 12 of the 15 core capacities, as compared to the previous year. Three countries did not comply with the State Party Self-Assessment Reporting Tool in 2021, precluding comparison with results for the past biennium. PASB is working closely with the countries to strengthen and maintain their core capacities under the IHR, which contribute directly to global health security.

Twelve countries achieved the indicator by the end of 2023, and another 21 were on track to do so by 2025. This indicator aims to measure and track the capacity of countries and territories to respond to major epidemics and pandemics and to ensure a rapid exchange of information about impending public health threats and, as a result, to increase confidence and trust among all parties.
PASB provided technical cooperation to improve disease surveillance systems and train health workers to strengthen preparedness for epidemics and pandemics, notably by strengthening national and regional surveillance networks and implementing the Strategy on Regional Genomic Surveillance for Epidemic and Pandemic Preparedness and Response.