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Programming for MNCH and nutrition. Jerker Liljestrand Copenhagen, 18 January, 2013. Under 5 mortality, global. UNICEF 2009. Under 5 mortality, global. In 2010, newborn mortality was 23/1000...................... UNICEF. The rule of two thirds. Of infant mortality, 2/3 is in first month
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Programming for MNCH and nutrition Jerker Liljestrand Copenhagen, 18 January, 2013
Under 5 mortality, global UNICEF 2009
Under 5 mortality, global In 2010, newborn mortality was 23/1000......................UNICEF
The rule of two thirds • Of infant mortality, 2/3 is in first month • Of those, 2/3 are in first week • Of those, 2/3 are in first 24 hours
Life expectancy at birth, global Source State of the World´s Children 2009, UNICEF
Total fertility rate, TFR, global (”average number of children”)
Interventions for Maternal Health In Cambodia • Peace, growth, education • Roads, phones • Health centers, midwives Source: National Health Statistics MoH 2002-2011. Mainly public sector
Interventions for Maternal Health In Cambodia • Peace, growth, education • Roads, phones • Health centers, midwives • Removing financial barriers: • - Health equity funds, vouchers • - Live birth incentive ($15) Source: National Health Statistics MoH 2002-2011. Mainly public sector
Now, 4 perspectives… • Programmatic • Health system • Development (society) • Partnership (what can we do?)
Conclusions (1) • Programs: work in technical areas • Try to integrate • Multipronged approach • Spend time on partnerships
Conclusions (2) • Health system: work in “horisontal area”, cross-cutting • Broader approach to address commonalities • => MNCH can be health system strengthening
Conclusions (3) • Development context: • Need to link programs to community approaches • = demand side • Mobilize community, more in maternal and newborn health
Huge improvements in MNCH/FP in low income countries It can be done!
Achievements, Cambodia • Met MDG 4 (child health) • May meet MDG 5 (maternal health) • Met MDG 6 (HIV)
Challenges, Cambodia • Improve newborn survival – stagnant since >5 yrs • Improve nutrition - 35% of 2-5 year olds are stunted or wasted. Stagnant >5 yrs
MNH Challenges, Cambodia • Improve links HCs <=> hospitals • Improve quality of care • Regulate private sector • Increase FP availability