Maternal, Newborn and Child Health in ECOWAS Member States. Let us join hands to save the mother and the newborn child

Transcription

1 Maternal, Newborn and Child Health in ECOWAS Member States Let us join hands to save the mother and the newborn child Dr. Placido CARDOSO DG WAHO Obudu, October, 23rd, 2009

2 Outline Introduction A few statistics on maternal, neonatal and child mortality Why do women die during pregnancy and childbirth? Why do new-born babies and children die? What can be done to reduce these deaths and attain MDG4 and MDG5? Conclusion 2

3 Introduction Mother, newborn and child health, a matter of concern in Sub-Saharan Africa particularly in the ECOWAS region One woman out of 16 in sub-saharan Africa runs the risk of dying during pregnancy or childbirth and one child out of four risks dying before its fifth birthday Attaining health related MDGs still remains a big challenge 3

4 A few statistics on maternal, neonatal and child mortality

5 THE ISSUE OF DATA IN ECOWAS MEMBER STATES Only 8 countries out of 15 provided current data on the situation of maternal and child health All the data presented here come from different sources (EDS, MICS, Stat. World: WHO, UNICEF, UNFPA, WB) The analysis of these data gives the general trends 5

6 Maternal mortality ratio (sources EDS, MICS and MS) Sierra Leone 2005 Liberia 2007 Guinee 2005 Nigeria 1999 Niger 2006 Gambie 2006 Côte d'ivoire 1999 Burkina 2003 Togo 1998 Mali 2006 Ghana 2007 Guinee Bissau 2006 Senegal 2005 Benin 2006 Cap vert ,

7 Neonatal, child and underfives mortality rate Neonatal Mortality Child mortality Mali EDS IV Mali EDS IV Cote D'Ivoire EDS III Niger EDS Cote D'Ivoire EDS III Niger EDS 2006 Burkina Faso EDS 2003 Togo EDS 1998 et MICS Cape Verde MS ,9 31 Senegal EDS IV 2005 Cape Verde MS , Underfives mortality rates in 7 ECOWAS Member countries Niger EDS Mali EDS IV Burkina Faso EDS Cote D'Ivoire EDS III Togo EDS 1998 et MICS 3 Senegal EDS IV Cape Verde MS ,

8 Rates of neonatal and child mortality in underfives mortality in 7 ECOWAS Member countries Niger EDS 2006 Mali EDS IV 2006 Burkina Faso EDS 2003 Cote D'Ivoire EDS III Togo EDS 1998 et MICS Néonatale Infantile TMM5 Senegal EDS IV 2005 Cape Verde MS % 20% 40% 60% 80% 100% 8

9 MDG 4: Reducing newborn and child mortality by two thirds: Progress made by African regions Average Annual Regression Rate (AARR) of the U5s from 1990 to 2006 and requirement for to attain OMD4 (Source UNICEF, 2008) Observed Required Progress Northern Africa Right track East Africa Insufficient Southern Africa No progress Central Africa No progress 9 West Africa Insufficient 9

10 On track Insufficient progress No progress Cape Verde Mali Niger The Gambia Guinea Bissau Sierra Leone Senegal Guinea Ivory Coast Burkina G h a n a B e n i n Nigeria Liberia Togo Progress Regression TMM5, ECOWAS Countries (source UNICEF, 2007) 10

11 What kills women during pregnancy and childbirth? 11

12 Causes of maternal deaths Hémorragie 24,8% Infection 14,9% Eclampsie 12,9% Travail dystocique 6,9% Avortement à risque 12,9% Autres causes directes 7,9% Causes indirectes 19,8% MNH BCC workshop, 16-17, 04,08 12

13 JHPIEGO/MNH/Koupela/Burkina THE FOUR DELAYS MODEL 1. Delay in recognizing the problem 2. Delay in deciding to consult health services 3. Delay in arriving at the health centre 4. Delay before receiving an adequate treatment 13

14 Other factors Weak contraceptive prevalence High aggregate fertility index Early fertility

15 What kills newborns and children? 15

16 Direct causes of Neonatal Mortality Complications of Prematurity 27% 7% Others Neonatal tetanus 7% Congenital malformations 7% Low Birthweight Sepsis/ Pneumonias 26% Diarrhea 3% Infections 36% Birth asphyxia & trauma 23% MNH BCC workshop, 16-17, 04,08 16

17 WAHO s CONTRIBUTION IN THE AREA OF MNCH- 1 Development of policy documents : a strategy document for maternal and neonatal mortality reduction; a strategy document for reproductive health commodities security An advocacy tool for resource mobilisation <REDUCE ALIVE> Promotion of Demonstration Centres Initiation and support to date to 11 demonstration sites in 10 Countries for the promotion of community management of mother, newborn and child health and the continuum of care through collaboration between the central level of health and secondary and tertiary structures. 17

18 WAHO s CONTRIBUTION IN THE AREA OF MNCH- 2 Human resource capacity building for MNCH management Harmonization and Integration of some training modules to be taught in Schools of Basic training and Faculties in the Countries: These modules include: Emergency Obstetric and neonatal care EONC, Prevention of mother to child transmission of HIV, PMTCT, Postpartum monitoring, Family Planning, Newborn care, Securing reproductive health commodities 18

19 WAHO s contribution in the area of MNCH- 3 Continued implementation (through its strategic plan ) of interventions targeting maternal, perinatal, neonatal and child mortality through: harmonization and coordination of policies; research and promotion of best practices; development of health data collection and management systems; development of human resource in health; and the promotion of new financing mechanisms; development of the strategy for accelerating maternal, perinatal, neonatal and child mortality reduction 19

20 What can be done to reduce these deaths and attain MDG4 and MDG5? 20

21 Proven Interventions for the Prevention of U5 Deaths Child survival Interventions Overall % of avoidable deaths if coverage were 99% Oral rehydration therapy 15% Exclusive breastfeeding 13% Use of ITNs 7% Adequate complementary feeding 6% Antibiotic treatment for pneumonia 6% Antimalarial treatment 5% Correct delivery delivery attended by skilled person 4% Antibiotic treatment for dysentery 3% Maintaining the newborn temperature 2% Measle immunization 1% Vitamine A supplementation <1% Preventive Intermittent Antimalarial Treatment <1% TOTAL 64% 21

22 Percentage of budget allocated to health in national budgets, ECOWAS Countries in 2005 (Source WHO) Cape Verde Senna Mali Niger 0-5 5, ,01-15 Gam bia Guinea Bissau Gall Sierra Leone Guinea Liberia Ivory Coast Burkina Faso G T h o a g n o a Nigeria 15 22

23 CALL FOR ACTION Extraordinary AHM, October,

24 Call for Action -1 Government Leadership and development partnership Availability, Accessibility, Scaling up of proven interventions Extraordinary AHM, October,

25 Call for Action -2 Devote 15% of the national budget to health Create a budget line for RH Allocate at least 5% of the health budget to RH, including: 25% for EONC 5% for securing contraceptive products 25

26 Call for Action -3 Ensure the integration of EONC into training curricula Advocate for raising girls minimum age for marriage to 18 years 26

27 CONCLUSION WE NEED TO TAKE ACTION NOW

28 Thank you Merci Obrigado