Strengthening and integrating MNCH. Partners forum Meeting April,17-21/2007 Dar es Salaam,Tanzaniay

Transcription

1 Ethiopia

2 Strengthening and integrating MNCH Partners forum Meeting April,17-21/2007 Dar es Salaam,Tanzaniay

3 Outline 1. Back ground Key demographic data How many die? National progress to MDG 4 and 5 Causes of MNC deaths 2. MNCH policies, strategies and programmes Road Map and/or other key strategies Coverage of MNCH services along the continuum of care and missed opportunities Lives saved 3. Key opportunities and gaps for MNCH 4. Major Achievements 5. Partnership 6. Lessons learned 7. Way forward

4 Key National demographics Total population: 77.4 million (85% Rural) % ANC 48% Skilled Delivery 12.5% Health service coverage : 72% Per capita Health expenditure : US$ 5.60 (2000)

5 Financing for MNCH Gross national income, per capita: US$110 Government spending on health, per capita: US$3 Government spending on health (Abuja target 15%): 10% Out-of-pocket spending on health: 33% No user fee protection for women and children

6 How many die? Mothers Maternal mortality ratio per 100,000 live births Annual number of maternal deaths ,000 Babies Stillbirth rate per 1,000 total births Annual number of stillbirths Neonatal mortality rate per 1,000 live births Annual number of neonatal deaths , ,500 Children Under 5 mortality rate per 1,000 live births Annual under 5 deaths Annual number of postnatal deaths Neonatal mortality as percentage of under 5 mortality , ,400 32%

7 Causes of Maternal Death* Others 15% Haemorrhage 10% Sepsis 12% Abortion 32% Obstructed labor 22% Hypertention 9% *Facility based, Ethiopia

8 500,000 Ethiopian children under-5 5 dying each year Ranking 6 th in the world in number of deaths 72 % preventable Other, 2% Measles, 4% Diarrhea, 20% AIDS, 1% Malnutrition 57% Neonatal, 25% HIV/AIDS 11% Pneumonia, 28% Malaria, 20%

9 Causes of newborn deaths Pretern, 17% Congenital, 4% Other, 7% Tetanus, 7% Infection, 36% Infections and tetanus account for 43% of neonatal deaths in Ethiopia Diarrhoea, 3% Asphyxia, 25% Low birthweight rate: 15%

10 How can we best make a big difference for Ethiopia s mothers, newborns and children the nation s future?

11 Lives can be saved If essential interventions reached 90% of women and newborns in Ethiopia, up to 85,600 newborn lives could be saved

12 Acceleration to reach MDG 4 (1,5,6) No business as usual Under 5 Mortality Rate HSDP I 140 II Years Current Trend MDG Trend

13 National progress to MDG NMR U5MR IMR MDG Target Year 32% of child deaths are newborns. MDG 4 cannot be met without addressing neonatal deaths.

14 National progress on MDG Year No change in maternal care Improved maternal care Maternal deaths per 100,000 live births

15 Major Achievements RH/FP,AYRH and Child survival strategy fully incorporated into the 3 rd Health Sector development Programme RH Strategy and AYRH nationally endorsed and Launched Improved coordination, harmonization and programmatic alignment of in-country partners Health Services Extension Program identified as the principal tool for delivery of essential evidencebased Maternal and Child Survival interventions Expansion of Midwifery schools

16 Achievements cont To address maternal death from Unsafe abortion, Ethiopia has revised the criminal law. The law is still restrictive, but we have exceptions for pregnancy following rape, incest, and when the pregnant is minors or having medical illness that is aggravated by continuation of pregnancy.

17 Experience of working in partnership Different types of partnership exist Since 1996 HPN, ICC, GAVI, Child survival Working Group; RH Task Force Joint RH/CS Working Group (PMNCH) Consists of Gov t, UN Agencies, Bilaterals, NGOs - Private Sector (GSK) - Professional Societies, Universities

18 Major Roles of the partnership Mechanism for Coordination & Collaboration Creates shared vision and shared plan Advise MOH on policy issues Advocacy for MNCH issues Mobilize resource Provide Technical Assistance Implementation of Best Practices (IBP) Monitoring and evaluation

19 Acceleration strategy Primary Health Care and staff Expansion Plan Health Services Extension Programme : 32,500 women health workers by 2008, paid by government, two per 5000 people at the village level, supported by 20 volunteer community health workers Empowering caretakers, families and communities Institutionalization and standardization of village health care delivery, Increased access and utilization of promotional, preventive and essential curative care services, Reduction of opportunity cost for families, enhanced participation.

20 LESSONS LEARNT The formation of the National TF on RH and Child Survival Technical Working Group has been very useful for coordinating activities and resource mobilization from related programs _ (PMNCH) The MNCH/TW has facilitated joint planning and implementation It has been a good link with the global partnership to disseminate information in both ways. The CS interventions should be part of the overall district health plan but not separate/vertical CS coordinating/management system with decision making capacity is vital for effective implementation of the CS interventions

21 Key Challenges Shortage of financial and human resources Other computing priorities

22 OPPORTUNITIES Favorable policy environment and commitment at all levels Health Extension Program (HEP) The MDGs and PASDEP focusing on maternal and child survival HSDP-III aiming to accelerate PHC, incorporating both RH & child survival strategy Strong partnership with stakeholders (PMNCH)

23 The way forward Strengthen coordination/partnership o for tracking resource flows o in technical support, and o overseeing issues of RHCS in the regions Advocacy and resource mobilization Capacity building and technical resources development Implementation of Best Practices Integration of resources and activities (child survival interventions) to achieve MDGs Eliminate, measles by 2010 and NNT by 2008

24 The way forward Focus more on community based maternal, newborn and child survival interventions with special support to the HEP Establish a system of networking for maternal, newborn and child survival within and out side the country

25 Focus to women and children is a Test of Good Governance to the African Leaders Thank you