Plan International Germany developed the first Global Girls Health Index in partnership with the Institute for Peace Support Operations and Humanitarian Law at Ruhr University Bochum. The index makes the health situation of nearly 971 million girls and young women aged 5 to 19 comparable across countries and decades for the first time.
Progress shows in mortality rates. In 2000, roughly one in 800 girls died worldwide on average; by 2023, that fell to one in 1,700. The likelihood of girls having children also declined globally by a third, from an average of one in 31 girls in 2000 to one in 48 in 2023.
What the index measures
The Global Girls Health Index combines five indicators: girls' mortality, adolescent fertility, maternal mortality, anemia, and sexually transmitted infections. Researchers compiled data from UN population forecasts and the Global Burden of Disease study, combining the five metrics into a scale of zero to 100, with higher values indicating better health. The global average rose from 45.16 in 2000 to 51.07 points in 2023. The index currently focuses on health; a fuller version including education, protection, and opportunity is planned for 2028.
Wide regional disparities persist
Health improved in 178 of 192 countries studied. Sub-Saharan Africa showed the strongest gains, rising 9.77 points on average, followed by South Asia at 9.32 points. Yet nearly 290 million girls, almost one in three globally, live in 66 countries with low or very low scores. Fewer than 10 percent of girls live in the 51 highest-scoring countries. In 2023, average scores were 30.83 in Sub-Saharan Africa, 71.64 in Europe, 65.26 in East Asia, and 64.25 in North America. On average in 2023, nearly five girls and young women died hourly from pregnancy or childbirth complications, more than half in countries with very low health scores.
Rwanda, Ethiopia, and Burundi lead recovery
At the country level, Rwanda saw the strongest gains between 2000 and 2023, with a 33.07-point rise, followed by Ethiopia at 29.78 and Burundi at 27.52 points. The index does not directly reveal the causes of global improvements. In Cambodia, maternal mortality fell significantly after midwife training programs. In Bangladesh, a scholarship program for girls cut early pregnancies in half.
Petra Berner, chair of Plan International Germany's board, said, "The results show that investment works, that political will moves the dial, and that progress is possible." The priority now is securing gains already made and reaching girls who have yet to benefit. Pierre Thielbörger, executive director of the IFHV, said the health focus makes gains visible while exposing concerning gaps, opening investigation into where and why conditions lag behind human rights guarantees and state obligations.
Data gaps hide the most vulnerable
According to Plan International Germany, health data often lack breakdown by age, gender, disability, origin, or social class, leaving disadvantaged girls invisible in policy decisions. Data remain sparse on mental health, vaccination rates, access to care, and sexual autonomy.