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MDGs 4 5: The challenge of reducing maternal and child mortality

MDGs 4 and 5. GOAL 5 Reduce by three quarters, the maternal mortality ratio between 1990 and 2015TargetsMaternal mortality ratioProportion of births attended by skilled health personnelAchieve universal access to reproductive health . GOAL 4 Reduce by two-thirds, the under-five mortality rate

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MDGs 4 5: The challenge of reducing maternal and child mortality

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    2. MDGs 4 and 5 GOAL 5 Reduce by three quarters, the maternal mortality ratio between 1990 and 2015 Targets Maternal mortality ratio Proportion of births attended by skilled health personnel Achieve universal access to reproductive health

    4. 68 priority countries for MDGs 4 & 5 with 97% maternal and child deaths

    6. Nepal, B’desh, Indonesia, China, Brazil, Egypt, Mexico, Philippines, Bolivia, Eritrea, Guatemala, Laos, Morocco, Peru, Haiti, Turkmanistan

    9. SEAR contribution to maternal deaths in the year 2006 The 11 member countries of the South East Region (SEAR) together contribute a population of 1.7 billion, amounting to about a quarter of the world’s population of 6.6 billion. Almost a third of all maternal deaths occur in the Region. Of the 536,000 maternal deaths in the world in 2005, the countries in South East Asia accounted for 170,000 (32%) of them. There were 9.7 million under 5 child deaths globally in the year 2006. The Region contributed 2.7 million (28%) of them. The 11 member countries of the South East Region (SEAR) together contribute a population of 1.7 billion, amounting to about a quarter of the world’s population of 6.6 billion. Almost a third of all maternal deaths occur in the Region. Of the 536,000 maternal deaths in the world in 2005, the countries in South East Asia accounted for 170,000 (32%) of them. There were 9.7 million under 5 child deaths globally in the year 2006. The Region contributed 2.7 million (28%) of them.

    10. SEAR contribution to under 5 deaths in the year 2006 The 11 member countries of the South East Region (SEAR) together contribute a population of 1.7 billion, amounting to about a quarter of the world’s population of 6.6 billion. Almost a third of all maternal deaths occur in the Region. Of the 536,000 maternal deaths in the world in 2005, the countries in South East Asia accounted for 170,000 (32%) of them. There were 9.7 million under 5 child deaths globally in the year 2006. The Region contributed 2.7 million (28%) of them. The 11 member countries of the South East Region (SEAR) together contribute a population of 1.7 billion, amounting to about a quarter of the world’s population of 6.6 billion. Almost a third of all maternal deaths occur in the Region. Of the 536,000 maternal deaths in the world in 2005, the countries in South East Asia accounted for 170,000 (32%) of them. There were 9.7 million under 5 child deaths globally in the year 2006. The Region contributed 2.7 million (28%) of them.

    11. The Region is Heterogeneous

    12. U5MR

    13. MMR

    14. Bangladesh

    15. Indonesia

    16. Myanmar

    17. Nepal

    18. India

    19. MMR in India

    22. Where are we? IMR in 2015 will be ~43/1000 live births This will be 13 points higher than the expected goal of <30/1000 live births for 2015

    23. IMR Goal of 30 is elusive and inequitable

    26. Program implementation in key countries is poor because of weak health systems

    28. Implementation is weak because of weak health systems

    29. Health expenditure in 2006: Too low in key countries; and the Region as a whole

    30. Doctors,nurses and midwives are not enough in SEAR..

    31. .. and most of the developing world

    32. Equity

    34. Huge inequities in SEAR: SBA

    35. FP, immunization, MN care, sick child careFP, immunization, MN care, sick child care

    36. - High coverage can be achieved without improving coverage among the poor. - MDGs can be achieved without benefitting the poor - Equity will happen with conscious effort favoring the poor In both, dely rate goes up from 525% to 75%In both, dely rate goes up from 525% to 75%

    37. Grim scenario for the poor if the health system does not proactively addresses equity

    39. Scaling up of primary health care Pr Health Centre in each village Focus on MCH, FW, infections Emphasis on health education, sanitation Doubling of community hospitals Provision of essential drugs Improved financial accessibility Insurance coverage for the poor No user charges

    40. Some approaches to enhance equity Equity driven program objectives and monitoring No user fees Community-based approaches Targeting Demand side financing

    41. Conclusions MDGs 4 and 5 are elusive in most of the high burden countries Global MDGs depend on progress in SEAR, in particular, in India In SEAR, MDG 4 progress appears ‘better’ than MDG 5

    42. Conclusions Key countries must address health systems deficiencies Highly prevalent inequities mandate special efforts in favour of the poor India must put up a better show!

    43.

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