Maternal Health in Arab States

Transcription

1 Maternal Health in Arab States

2 Improving Maternal Health Improving maternal health is MDG number 5 and it has two targets Target A that measures reduction in maternal mortality ratio (MMR) and attended births with skilled personnel Target B that measures universal access to reproductive health services and particularly the strength of family planning programs (CPR, unmet need, adolescent fertility, ANC)

3 Every year it is estimated that 350,000 women die of causes related to pregnancy and delivery mostly in the African continent It is estimated that 11 countries world wide have MMR above Almost all of them are in Africa (Somalia, Sudan, Sierra Leone, CAR, Chad, Niger--)

4 Why are we still talking about maternal mortality Many countries around the world are struggling with the achievement of MDG5. The progress to date is slow. Among the middle and low income countries in the Arab region it is not expected that any country will succeed to achieve MDG5 although some are progressing better than others We know how to reduce maternal mortality. The interventions are costeffective and go beyond saving the life of the mother

5 Global Trends in MMR Number of Births per 100,

6 Average MMR by Arab Country Groups Number of births per 1000, /8 LDC Maghreb Mashreq GCC

7 Maternal Mortality Ratio, Arab States 2008 MMR Above 550 Source UNFPA Progress on MDG 5 has been generally slow for Arab countries. Collectively, the Arab States region will not achieve reduction of maternal mortality by 75% by the year 2015.

8 Trends in MMR in the Arab Region Current trends and Expectations for current trend expected goal 150 Gap

9 Percentage of Births Attended by Skilled Personnel Among Arab Countries Yemen Somalia Sudan Mauritania Comoros Morocco Lebanon Egypt Iraq Djibouti Syria Tunisia Algeria Saudi Arabia OPT Oman Bahrain UAE Qatar Libya Kuwait Jordan 27, ,9 56, ,5 78, ,5 95, Births Attended by Skilled Health Staff % (Latest figures available)

10 Adolescent Fertility Rate (estimates are from ) Early marriage and pregnancy are some of the main factors contributing to the high maternal mortality in the Arab countries. The high adolescent fertility rate is linked the traditional preference for early marriage

11 Competing Priorities The health system, at all levels and particularly at the primary care level is facing many challenges including emerging diseases that contribute to mortality and to lowering life expectancy of the population Those include reproductive and non-reproductive health diseases 12

12 Mortality and Incidence from Cervix Cancer among Women in Selected Arab Countries 25 Mortality Incidence 23,6 Annual rate per 100,000 persons at risk ,7 1,4 1,5 2,4 2 3,6 6,3 7,8 4,8 5,9 18,9 0 Saudi Arabia Qatar Oman Egypt Tunisia Somalia

13 Breast Cancer Mortality and Incidence among Women in Selected Arab Countries 30 Annual Rate per 100,000 persons at risk Mortality Incidence 5 0 Saudi Arabia Qatar Oman Egypt Tunisia Somalia

14 Reducing Maternal Mortality and Improving Health 15

15 Maternal Mortality Direct Causes Bleeding Infection Unsafe abortion Eclampsia Prolonged obstructed labor Indirect Causes Nutrition status Causes of 1 st delay Repeated unspaced pregnancy Unsupervised home birth Age, access to care Age at 1 st pregnancy/ marriage HIS RHCS & FP Health Policies Referral system and EMOC Health systems issues Resources (human, financial) 3 rd delay Root Causes Gender discrimination Population growth Poverty Tradition and cultural barriers General laws and policies Conflict and Wars Causes of 2 nd delay

16 Factors affecting maternal health 17

17 Home Births by Education: Illiterate and Literate Yemen Tunisia Sudan Syria Morocco Libya Lebanon Literate Illiterate Djibouti Algeria % of women who gave birth in the house

18 Percentage of Prenatal Coverage (4+ visits) in Arab Countries ( ) % of prenatal care coverage

19 Prenatal Care by Socio-Economic Determinants Prenatal Care % by Income Level % of Prenatal care , ,4 23,3 15,3 17,2 12,6 8,5 3,2 2,8 Algeria Morocco Syria Tunisia Yemen LOW HIGH Prenatal Care % by Location % of women receiving prenatal care ,1 75,3 69,7 49,3 39,3 Algeria Morocco Yemen URBAN (RUAL) 20

20 Prenatal Care by Socio-Economic Determinants Prenatal Care % Based on Education of Mother ,6 81,4 below elementary 80 75,3 71, ,5 % prenatal care ,2 elementary or Jr. High 30 high school or higher Algeria Morocco Yemen

21 Prenatal Care By Birth Order 100 birth order of child birth order of child 2-3 % of prenatal care birth order of child Algeria Morocco Yemen

22 Postnatal Care by Income Level: Low and High 60 57,1 LOW 50 HIGH % of postnatal care , ,3 18,9 25,7 38, ,3 10 7,4 0 Algeria Morocco Syria Tunisia Yemen

23 Can it be Done? Yes. How long should it take? It depends on the commitment that we put there 24

24 Maternal Mortality Can be Reduced by Half in less than 10 years

25 350 Progress towards achieving MDG5 Morocco MMR 1997 MMR2004 MMR2008 MMR2010 MMR2015

26 The world reached the alarming figure of 7 Billion inhabitants The resources are declining The technology is improving, we know that saving women s lives during pregnancy and delivery is doable and affordable Collaborate and learn from each other, we all have experiences Strengthen the health system and at every health system block ensure that MDG 5 is fully integrated Address the other determinants of maternal health We just simply need to continue our efforts to advocate for mothers, to make sure that maternal health is a priority in our national health plans and ensure that we are making the best of our resources 27

27 Thank You 28