Strategies for Achieving the Health Millennium Development Goals (MDGs) in Your Country

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1 Strategies for Achieving the Health Millennium Development Goals (MDGs) in Your Country Stephanie Ferguson, PhD, RN, FAAN Associate Professor and Director, Community Nursing Organization School of Nursing Virginia Commonwealth University Richmond, Virginia, USA

2 NURSES AND MIDWIVES: DRIVING BETTER HEALTH Nurses and Midwives must seize the opportunity for better health at all levels for all populations Better health is: Healthy children, families and communities Growing economies, stable societies, regional peace and global prosperity The key to progress in the struggle for development

3 Health Millennium Development Goals Overview MDG 4: reduce the mortality rate of under five year olds by two thirds MDG 5: reduce maternal mortality ratio by three quarters and achieve universal access to reproductive health MDG 6: halt and reverse the spread of HIV/AIDS, malaria and other diseases

4 MDG SHORTCOMINGS Only 10 out of 67 countries with high child mortality rates are on schedule to achieve the MDG 4 target 350,000 women continue to die from pregnancy or childbirth complications short of the MDG 5 target to reduce maternal mortality by 5.5%

5 MDG 4: Reduce Child Mortality Target: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate Status: Child deaths are falling, but not quickly enough. Source: United Nations. We Can End Poverty

6 Global Statistical Overview : -UN: Death rate for children under 5 years of age has decreased from 100 to 72 deaths per 1,000 live births -World Bank: Mortality rate for children under 5 years of age has decreased from 92 to 63 per 1,000 live births Approximately nine million children under age 5 die annually worldwide Sub-Saharan Africa contains the highest child mortality rates: 1 out 7 children under age 5 die annually in this region Only 10 out of the 67 countries having high child mortality rates are on a path to achieve the MDG target. Source: United Nations. We Can End Poverty Factsheet: GOAL 4 Reduce Child Mortality

7 Direct Image from: UN Millennium Development Goals 2010 Report (p.26)

8 Direct Image from: Save the Children. A Fair Chance at Life. p.15, 2010.

9 Achievements: Mortality Rate for children under 5 years of age in developing countries: 1990: 100 deaths per 1,000 live births 2008: 72 deaths per 1,000 live births Total number of children under 5 years of age who annually die in the world: 1990: 12.5 million 2008: 8.8 million Source: United Nations. The Millennium Development Goals Report p.26.

10 Critical Assessment of Achievements Global figures on progress towards achieving MDG 4 mask significant disparities between and within countries and regions. In short, while there has been some progress towards MDG 4, this has often been concentrated in the wealthiest fifth of the population (the top quintile), in some cases leaving the poorest fifth of the population (the bottom quintile) no better or even worse off. Source: Save the Children. A Fair Chance at Life. P

11 Direct Image from: UN Millennium Development Goals 2010 Report (p.27)

12 The Success of MDG 4 is Linked to the Success of MDG 5: Motherless newborns are three to ten times more likely to die than those with mothers who survive. Source: UNFPA. State of the World Population Reproductive Health: A Measure of Equity. Ch.4. Source:

13 MDG 5: Improve Maternal Health Target: 1.Between 1990 and 2015, reduce the maternal mortality ratio by three quarters 2. By 2015, achieve universal access to reproductive health Status: We acknowledge that much more needs to be done in achieving the Millennium Development Goals as progress has been uneven among regions and between and within countries. In particular, we express grave concern over the slow progress being made on reducing maternal mortality and improving maternal and reproductive health. Source: United Nations General Assembly: Sixty-fifth session. Agenda items 13 and 115, p.3, September <

14 MDG 5: Improve Maternal Health The world has failed to invest enough in the health of women, adolescent girls, newborns, infants, and children. As a result, millions of preventable deaths occur each year, and we have made less progress on MDG 5, improving maternal health, than any other. Source: United Nations. Global Strategy for Women and Children s Health p.2. UN MDG 2010 Report Conclusion: the rate of reduction is still well short of the 5.5 per cent annual decline needed to meet the MDG target. Source: United Nations. The Millennium Development Goals Report 2010.

15 MDG 5: Improve Maternal Health Direct Image from: UN. Millennium Develop Goals Report p.31.

16 Major Challenges to achieving MDG 5 as identified by the UN: -Measuring maternal mortality -Rural-urban gap in skilled care during childbirth -Halt in Decreasing Teenage pregnancies -Decreased progress in expanding access to contraceptives -Disparities in access to contraceptives: Very low contraceptive prevalence rates in Sub-Saharan Africa and Oceania Source: United Nations. MDG 2010 Report, p.32

17 MAJOR MDG ACHIEVEMENT MDG 6: Decreased morbidity and mortality from HIV and AIDS: from 2.1 million in 2004 to 1.8 million in 2010 Drivers for change: increase in the availability of antiretroviral therapy improved care and support for people living with the disease continuing decrease in incidence

18 Nursing Leadership and Practice: A Vector for Progress 3 key factors allowing progress against HIV and AIDS: Effective implementation of health policies on the ground Quality care and follow up Education and counseling All 3 fall within the scope of nursing practice

19 Achieving Health MDGs: Invest in Nursing and Midwifery Strategies to achieve the Health MDGs in your country: STRATEGY 1: Invest in and strengthen nursing and midwifery education, professional development and research STRATEGY 2: Empower nurses and midwives within health care environments STRATEGY 3: Strengthen nursing and midwifery leadership at all policy making levels

20 OUR ROLE «We must not fail the billions who look to the international community to fulfill the promise of the Millennium Declaration for a better world. Let us keep the promise.» --UN Secretary-General Ban Ki Moon

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