Progress in improving maternal, newborn, child, and adolescent health outcomes is stalling. Maternal mortality is disproportionately high in Sub-Saharan Africa and South Asia, underscoring the need for regional support. In HMICs, structural racism means black women are more likely to die during childbirth. Deaths resulting from unsafe abortion and restrictive laws remain a serious concern, as does discrimination against gender nonconforming people. Gender discrimination undermines maternal health by contributing to adolescent pregnancy, anemia, and violence against women. The report is silent on all this. Many of the proposed strategies fail to adopt a comprehensive health systems approach. Targeted interventions are necessary but insufficient without investment in broader systems including emergency obstetric and newborn care, reliable transport and referral services, adequate blood supply, and a well-supported health workforce.