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The Politics of MDG5. Professor Wendy J Graham. DSA Scotland Mini-conference: Aberdeen, 14 th October 2011. Millennium Development Goals (MDGs). Goal 1: Eradicate extreme hunger and poverty Goal 2: Achieve universal primary education Goal 3: Promote gender equality and empower women
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The Politics of MDG5 Professor Wendy J Graham DSA Scotland Mini-conference: Aberdeen, 14th October 2011
Millennium Development Goals (MDGs) • Goal 1: Eradicate extreme hunger and poverty • Goal 2: Achieve universal primary education • Goal 3: Promote gender equality and empower women • Goal 4: Reduce child mortality • Goal 5: Improve maternal health • 5a: 75% reduction in maternal mortality 1990-2015 • 5b: University access to comprehensive reproductive health services • Goal 6: Combat HIV/AIDS, malaria and other diseases • Goal 7: Ensure environmental sustainability • Goal 8: Develop a global partnership for development
~0.8% occur in developed countries ~99.2% occur in developing countries Estimated third of a million maternal deaths annually* An estimated 98% of maternal deaths are avoidable * Source: United Nations, 2010
Lifetime risk of maternal death Map 3 Scotland ~1 in 5,000 Sierra Leone ~1 in 20 V
450 400 350 300 250 Maternal deaths per 100 000 live births 200 150 100 50 0 1990 1995 2000 2005 2010 2015 Millennium Development Goal 5a is off-target X X X X MM Target Source: UN, Sept 2010
“Maternal mortality is much more than a medical issue” Ban Ki-moon United Nations Secretary General 2009
“A Millennium Development goal which cannot be monitored cannot be met or missed.” Johansson and Stewart, UNDP, 2002
Do we really know what works? .... to reduce maternal mortality at a population level
MATERNAL MORTALITY: Scotland
Three direct points to take women off the “Road to Death”: • Prevention of pregnancy: Family Planning • Prevention and management of complications: Skilled Care especially during delivery • Prevention of death by timely management of life-threatening complications: Emergency Obstetric Care
WHAT NEEDS TO BE DONE? • Renewed focus on family planning, skilled care at delivery, & emergency obstetric care Combined with: 2. More health professionals 3. Greater financial resources 4. Robust tracking of progress & accountability 5. Sustained political commitment
Do we really know what works? .... Yes, technically...... .... No, politically....
A call to action: we all have a role to play Business community UN agencies Civil society Women and children Health care workers Donors Academic /research institutions Gov / Policy makers
What are the key elements of the Global Strategy for Women’s & Children’s Health ? • Country-led health plans • Comprehensive package of essential interventions and services • Integrated care • Health systems strengthening • Health workforce capability building • Coordinated research and innovation • Accountability at all levels http://www.who.int/pmnch/activities/jointactionplan/en/index.html
Accountability Framework: Parameters • Applicable at all levels – national and global • Links results and resources • Three building blocks: Monitor, Review, Act • All partners accountable for the commitments they make and the health policies and programmes they design and implement • Builds on and strengthens existing mechanisms
Knowledge actors Identify knowledge gap Gather & synthesize new knowledge Translate & communicate Knowledge actors Knowledge actors
THREE BIG QUESTIONS What are we (as knowledge actors) accountable for? To whom are we accountable? How can we hold ourselves accountable?