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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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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." |
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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)
The Countdown Report
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."
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All images © WHO/Giacomo Pirozzi
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