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ACT TO SAVE MOTHERS AND NEWBORNS. INSD CONAPO APAC IMMPACT / MURAZ CRSN AQUASOU CNLS/IST. JHPIEGO AED UNFPA SOGOB ABSF ABSP CEFOREP (Senegal). DSF/ MINI SANTE. In collaboration with. WHO. IN BURKINA FASO. 1 woman dies from pregnancy related complications 7 newborns die.
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ACT TO SAVE MOTHERS AND NEWBORNS
INSD CONAPO APAC IMMPACT / MURAZ CRSN AQUASOU CNLS/IST JHPIEGO AED UNFPA SOGOB ABSF ABSP CEFOREP (Senegal) DSF/ MINI SANTE In collaboration with WHO
IN BURKINA FASO • 1 woman dies from pregnancy related complications • 7 newborns die Every 3 hours...
WHAT IS MATERNAL MORTALITY ? « …Any death that occurs during pregnancy, delivery or within the 42 days following the end of pregnancy. »
THE THREE DELAYS 1st Delay Decision making 3rd Delay Access to care services 2nd Delay Access to Health Facilities
1st DELAY: DECISION MAKING • Lack of information and inadequate knowledge about signs of complications of pregnancy and danger signals during labor • Women’s low status
2nd DELAY: INABILITY TO ACCESS HEALTH FACILITIES • Long Distances to Health Facilities • Poor roads and communication network • Poor community support
3rdDELAY: ACCESS TO CARE • Lack of skilled attendants • Inadequate equipment and supplies • Low motivation of care providers
AND YET, POVERTY IS STILL PRESENT • From 1998 to 2003 the proportion of poor increased from 45% to 46.5% • Poverty touches mainly women
UNSATISFACTORY VITAL HEALTH STATISTICS • Infant mortality rate 81/1000 LB • Under-five mortality rate 184/1000 LB • HIV prevalence 1.8% • Without access to safe water 48% • Without access to improved latrines 60% • Non-enrolled children 48%
WOMEN’S SITUATION ALWAYS UNFAVORABLE • Median Age at 1st Marriage16 years • Median Age at 1st delivery17 years • Contraceptive Prevalence Rate15% • Total Fertility Rate 6,2 • FP unmet needs 29%
DELIVERY BY CEASARIAN Source : EDS
United Nations Human Development Index 175 out of 177
DESPITE THIS DIFFICULT CONTEXT We know what to do! We can do it! We just have to act!
MATERNAL MORBIDITY 1 Maternal Death 20-30 cases of maternal Morbidity
TYPES OF MORBIDITY • Uro-genital fistulas • Genital prolapsus • Anemia • Infertility • Urinal incontinence • Back pains
INFANT MORTALITY Any child death occuring before the first birthday
MATERNAL DEATH Relatedto INFANT DEATH RISK OF DYING BEFORE 1 YEAR 15 TIMES HIGHER for achild whose mother is dead than for those with living mothers CRS Nouna
REDUCE Impact on survival & productivity Estimating the Consequences of Poor Maternal and Newborn Health Data on Maternal and Neonatal Health Socio-economic Data
DATA SOURCES MODEL REDUCE / ALIVE • EDS BF-II et III : 1998 et 2003 • Enquête Burkinabé sur les conditions de vie des ménages 2003 (INSD) • Annuaire Statistique 2004 (DEP/Mini Santé) • Global burden of disease report 1996-1998 (OMS) • Plan stratégique de la SR 1998-2008 (DSF) • Projection de la population Burkina Faso Horizon 2025 (CONAPO, 2005)
ASSUMPTIONS2004 - 2015 • Strategic Plan for Maternal Mortality Reduction • Vision 2010 • Millenium Development Goals • PNDS • CSLP
MATERNAL DEATHS 2004 - 2015 No interventions 44 600 maternal deaths
MATERNAL MORBIDITY 2004 - 2015 1 600 000 women will suffer • 747 000 Pelvic infections • 560 000 Urinal incontinence • 250 000 Infertility • 33 000 Severe anemia • 8 900 Fistulas No interventions
PRODUCTIVITY LOSSES FROM MATERNAL DEATHS/MORBIDITY The loss of productivity • 133 billion F CFA • due to Maternal deaths : 12,5 billion F CFA Maternal morbidity : 120 billion F CFA CFA
NEONATAL DEATHS 2004 - 2015 No interventions 97 000neonatal deaths resulting from their mothers’ deaths
SAVED LIVES (2004 – 2015) Saved lives of mothers 20 000 Maternal morbidities avoided 745 000 Saved lives of newborns 52 800 Interventions
ECONOMIC GAINS Interventions GAINS:59.7 Billion F CFA CFA
THREE CONDITIONS NEEDED • Recognition of maternal mortality reduction as key development factor • Actual political commitment • New investment strategies to reduce maternal and neonatal mortality
NATIONAL COMMITMENT FOR SAFE MOTHERHOOD • Road Map of the African Union • Abuja Commitment = 15% allocated to health • Millenium Development Goals • Vision 2010 • Adoption of the persons and family code • National follow up committee
URGENT BUDGETARY ACTIONS • Allocate 15% of the national budget to the health sector • Increase the share of maternal and neonatal health to 25% of the health budget • Increase the contribution of maternal and neonatal health partners by 25%In order to ...
PRIORITY ACTIONS • Make quality EONC services available and accessible • Promote FP • Improve women’s status • Improve adolescent RH • Reinforce the community capacity • Coordinate stakeholders actions at all levels
QUALIFIED AND MOTIVATED ATTENDANTS • Place midwives at all levels • Train physicians in emergency surgery • Increase number of gyneco-obstetricians and anesthesists • Develop motivation policy for attendants
REFERRAL SYSTEM • RAC (walkie talkie), mobile telephones • Ambulances • Quality roads
Offer free preventive services Subsidize EONC services Adopt a cost sharing system FINANCIAL ACCESSIBILITY
Pass budget line item for contraceptive commodities Adopt RH model law and related regulatory texts Ensure youth friendly RH Services REVITALIZE FP AND IMPROVE WOMEN’S STATUS
Encourage male involvement in FP Make advance preparations for delivery Raise awareness of the danger signs Promote payment alternatives COMMUNITY ACTIONS
Have periodic meetings between partners Develop a single planning framework Develop a single coordination system Develop a single evaluation system COORDINATION
LET’S ACT NOW ! • Health Budget = 15% of national budget • Share of maternal and neonatal health increased to 25% of health budget • Partner contribution for MNH programmes increased by 25%
Our commitment is important ! Everybody at any level should commit himself LET’S ACT TOGETHER !