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Co-chairs:
- Philip O'Brien, Director, Fundraising + Partnership, UNICEF
- H.E. Dr Jamela Saleh Al Raiby, Deputy Minister for Public Health and Population
"Deliver for women when women are ready to deliver."
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Ms Purnima Mane, Deputy Director UNFPA
Introduction to the conference
Pointing to the inclusive focus of the 2008 conference for
maternal, newborn and child health, Ms Mane reviewed the conference
objectives: to take stock of progress towards achieving MDGs 4 &
5, to accelerate that progress, and identify ways to improve
monitoring to identify gaps and better allocate resources
The focus of this year’s Countdown is the "continuum of
care" for mothers, newborns and children (MNC), ensuring a range of
health interventions throughout the lifecycle in different settings
within the health system. "The ultimate test of any health system is to
deliver for women when women are ready to deliver.” Adequate data and
effective monitoring tools, she pointed out, are key to strengthening
health systems. Ms Mane called for MNC data to be a funding priority,
more predictable and long-term.
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Message: Dr Margaret Chan, Director-General, WHO
“I want us to be judged by the impact we have on the health of the people of Africa, and the health of women.” |
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Ms Daisy Mafubelu, Assistant Director, World Health Organization
What progress and how fast?
While the 2008 Countdown focuses on MDGs 4 and 5, Mrs Mafubelu
encouraged delegates to not lose sight of the rest of the MDGs that
will also determine the outcome of 4 and 5: This includes MDGs 1, 3,
and 6 for poverty eradication, gender equality and HIV/AIDS and malaria
respectively. Mrs Mafubelu drew attention to progress regions and
countries are making to reaching MDGs 4 and 5, but admitted that much
more needs to be done. She noted that none of the top performing MNCH
countries are in sub-Saharan Africa.
"It is not all doom and gloom scenario. Lessons can be learned from all countries and rapid progress is possible,"
said Mrs. Mafubelu. She pointed to countries like Tanzania, with
considerable reduction in child mortality since 2000 and countries such
as Malaysia, Sri Lanka, Thailand, which have seen results from
increased resources and commitment to health systems.
"It is possible to meet the MDGs but
we must remember that this is not a race to get to the finish line
first, but rather a matter of racing to the finish line together and
not leaving anyone behind." |
Session co-chaired by
- H.E. Robinson Jean-Louis, Health and Family Planning Minister, Madagascar; and Andre Lalonde, Executive Vice-President, Society of Obstetricians and Gynecologists of Canada (SOGC)
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Dr Tessa Wardlaw and Dr Jennifer Bryce
Dr Wardlaw and Dr Bryce gave a joint presentation on the Countdown 2008 report and the progress in the 68 priority countries.
Dr Wardlaw provided an overview of the Countdown to 2015
including its focus on coverage and its importance as a collaborative
initiative aimed at assisting countries in their efforts to attain MDGs
4 and 5. She also described the major data sources used for the
Countdown 2008 report, and the range of data included on each priority
country’s profile.
Dr Bryce followed Dr Wardlaw’s presentation with an in-depth
review of the methods used to analyze the data found in the country
profiles, and a presentation of the major findings of the Countdown
2008 report. In her review of the findings, Dr Bryce started with the
mortality data outlining progress for child survival (MDG4) and
maternal survival (MDG5). She concluded her presentation by
stressing the need for all of us to re-double our efforts in the next 2
years for MNCH. She pointed out that progress has been made in
increasing coverage of care that can be scheduled--immunization,
Vitamin A and malaria bednets. However, little if any progress has
been made in scaling up care that is required 24 hours a day. The major gaps in the "continuum of care" are contraceptive use, care during childbirth, postnatal care and care for sick children.
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Professor Zulfiqar Bhutta
New Frontiers for this Countdown: Continuum of Care
Professor Bhutta explained that implementing the continuum of care
involves the seamless delivery of services across the life-course, and
across “care pathways” (which includes places of delivery and health
programs). Professor Bhutta pointed out that many of maternal, newborn,
and child deaths occur at home. This alarming figure starkly
underscores the need to involve communities in advocacy work to improve
health seeking behaviours and link with facilities. Importantly,
Professor Bhutta emphasized that as communities are mobilized to seek
care, the health care system must be able to respond to increasing
demand. Health system strengthening and the greater involvement of
communities in improving MNCH must be parallel and complementary
processes rather than competing priorities. Professor Bhutta concluded
his speech by suggesting that: “In addressing the challenges of MNCH,
the next Countdown should be focussed on issues that go way beyond
survival.”
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Dr Cesar Victora,
Understanding Coverage Gaps and Equity
Dr Victora presented an overview of the equity analysis done
for the Countdown 2008 report, explaining the methods used to develop
the coverage gap measure and the major findings. He noted that the
overall coverage gap in the 54 countries with available data is 43%.
This means the 43% of families in these countries do not receive the
whole package of reproductive, maternal, newborn and child care. The
coverage gap differed widely between the priority countries ranging
from less than 20 to over 70%, and across the various types of MNCH
interventions. He also explained that countries are characterized by
different patterns of inequity, with some experiencing ‘top inequity’
where only the wealthy are receiving good coverage, and others
experiencing ‘bottom inequity’ where the poorest groups are
disproportionately disadvantaged. Dr Victora stressed: "There are
concrete things we can and should do for moral and practical reasons to
address inequities such as encouraging countries to match their budgets
to the disease burden, ensuring that equity considerations are a key
factor driving program implementation, and that financial barriers to
care are removed."
"If we don’t measure inequities, if we
don’t monitor equity, there is little we can do to improve the lives of
the most vulnerable women." |
All images © WHO/Giacomo Pirozzi
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