This is a story of long-term commitment. A story of health providers who continued serving, of midwives who remained beside women and families at the moments that matter most, of ethnic health staff who returned to serve their own communities, and of young people whose trust, courage and participation helped shape a more responsive health system. It is also a story of continuity, carried in different ways over the years by Ms. Sally Sakulku, Dr. Bounfeng Phoummalaysith and Mr. Thomas Lammar, whose paths remained connected to the same broader purpose: advancing health, dignity and rights in the Lao PDR.

What makes this shared journey meaningful is not only who they are, but what their connection represents. Long before results became visible, there were years of planning, coordination, advocacy, technical work and partnership-building behind them. Through the Joint Programme supported by Luxembourg and implemented with the Ministry of Health, UNICEF, UNFPA and WHO over two decades, the Lao PDR did not build a short-term project or a one-time activity, but a sustained pathway of reform in reproductive, maternal, newborn, child and adolescent health. This work moved from policy to practice, from national strategy to provincial implementation, from training institutions to health centres, from supply systems to counselling rooms, and from leadership tables to the bedside of a woman in labour.

The strength of this journey lies in the fact that it was never reduced to one intervention, one team or one level of the system. It rested on government leadership, technical guidance, sustained investment and, equally importantly, human trust. Over time, one of the most significant shifts in Lao PDR was the recognition that access alone was not enough. It was not enough for a service to exist on paper if a woman arrived and the provider was not fully prepared. It was not enough for a building to stand if the facility lacked equipment, referral systems or standards to manage complications. It was not enough for adolescents to be told that services were available if they still feared judgement, silence or embarrassment. The deeper question became not only whether care existed, but whether it was good, respectful and worthy of trust, and whether it could truly fulfil sexual and reproductive health and rights. This shift helped shape some of the most important improvements in the health sector, particularly in midwifery, facility readiness, family planning and counselling.

One of the clearest examples of this long-term vision is the investment in midwives. Well-trained midwives can prevent up to two-thirds of all maternal and neonatal deaths, and their care reduces unnecessary medical interventions such as caesarean sections, improving safety. In Lao PDR, strengthening midwifery was never simply about increasing personnel; it was about building a profession strong enough to save lives. Earlier assessments highlighted the need to develop midwifery education pathways, improve teaching capacity, expand clinical training opportunities, and strengthen competencies for skilled birth attendance and emergency obstetric and newborn care. Over time, this evolved into stronger standards, clearer competency frameworks and accreditation requirements aimed at improving the quality and consistency of training. A better-trained midwife means safer childbirth, stronger counselling, earlier identification of danger signs and greater confidence for women and families at one of the most vulnerable moments of life.

There is something deeply human in this kind of investment. It reflects the belief that women in remote districts deserve the same quality of care as anyone else. It shows that standards matter, that training cannot be rushed, and that the person standing beside a mother in labour must be equipped not only with compassion, but also with the right skills. It is also a tribute to the many midwives who have remained in the profession, continuing to serve through the years and carrying this responsibility with quiet strength. Much of this story belongs to them.

The same long-term commitment can be seen in efforts to strengthen health facilities and service delivery. A skilled provider also needs a functioning environment in which to work. Over the years, the partnership supported stronger service delivery, subnational capacity and infrastructure, including equipment and systems that improved facilities’ ability to respond to emergencies. The retraining and deployment of community midwives and skilled attendants, including ethnic health staff who understood local languages, helped transform the use of health centres. Facilities that once handled very few deliveries began supporting many more, not by chance but because women gradually gained confidence that care would be available and meaningful. This is why the contribution of health providers across the country deserves recognition: they helped turn policy into care, and care into confidence.

Another important part of this journey is the effort to make reproductive health services more relational and respectful. The couples’ counselling initiative supported in Lao PDR reflects a more human-centred approach to healthcare. It promotes user-friendly, non-discriminatory and confidential services that support couples’ wellbeing. Reproductive health is no longer reduced to instructions delivered in rushed encounters; it becomes a conversation, a space where partners can ask questions, discuss contraception, understand reproductive choices and make decisions together with confidence. Such care is not only technically sound but also dignified.

The same spirit extends to adolescent- and youth-friendly services. The Lao PDR’s health journey increasingly recognises that young people need more than information campaigns. They need services designed around their realities – spaces where confidentiality is respected, questions are welcomed, and providers engage without judgement. These approaches matter because they influence whether a young person delays a risky pregnancy, seeks help early, feels safe enough to ask for advice, or learns that the health system can be a place of support rather than fear. When health services become more youth-friendly, they become more equitable and just. In this sense, young people are not only beneficiaries of progress; they are also drivers of a more responsive and humane system.

What makes the connection between Sally, Dr Bounfeng and Thomas so meaningful is that none of them remained fixed in one role, yet the thread between them never broke. One remained closely linked to technical coordination and reproductive health. One rose through national health leadership. One moved from the United Nations system to represent a partner country whose support remained steady over the years. Their story reflects the contributions of many others whose names may be less visible but whose roles were essential: midwives at the centre of services, health providers working across the country, ethnic staff returning to their communities, and young people who reminded the system to listen more carefully.

On World Health Day, this shared journey reminds us that progress in health is rarely built through a single defining moment. More often, it is built by people who continue the work even when the spotlight fades. It is built on patience, trust and respect for the people it is meant to serve. In the lives of women seeking safer childbirth, adolescents seeking guidance without shame, and communities placing greater confidence in care, the impact of such commitment becomes real.

KPL