Expanding the Agenda National Policy Dialogue 20th July, Islamabad

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Expanding the Agenda National Policy Dialogue
20th July, Islamabad
MDGs

• Yasmeen Sabeeh Qazi
• Senior Program Advisor
• Packard Foundation

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Goal 5 Improve Maternal Health

• Facts at a glance
• Every minute one woman dies from complications
  related to pregnancy, childbirth, and the post
  partum period, almost all of them in developing
  countries
• Maternal Mortality statistics reflect the largest
  disparity between the developing developed
  world of any health indicator
• One out of 17 compared to one out of 4,000
  women
• Maternal Mortality- a shameful failure of
  development

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Existing Target 6

• Reduce by three quarters, between 1990 and 2015,
  maternal mortality
• Indicators MMR of births attended by
  skilled health personnel
• Proposed Target 6
• Reduce by three quarters, between 1990 and 2015,
  rates of unwanted pregnancies, unsafe abortion,
  maternal mortality morbidity

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Additional Indicators
Proposed

• Maternal mortality rate by age and income
  quintile
• Proportion of birth attended by skilled and
  trained health professionals.
• Percentage of women aged (15 45) with anemia,
  obstetric fistula and uterine prolepses by income
  quintile
• Proportion of women dying due to the unsafe
  abortion and its complications by income quintile

• Proportion of women men by age having access to
  public (comprehensive, affordable, quality) SRHR
  services and information at the Primary and
  Tertiary Level. (contraceptive services, ANC,
  EmOC, PNC, safe abortion, post-abortion and
  STD/RTI services)
• of women expressing unmet need for
  contraception
• Adolescent fertility rate

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Existing Indicators Approved by GOP

• Maternal mortality ratio
• Proportion of births attended by skilled birth
  attendants
• Contraceptive prevalence rate
• Total fertility rate
• Proportion of women 15-49 years, who have given
  birth during the last 3 years, who had attended
  at least one antenatal care consultation
• Ensuring provision of quality health services
  including Maternal Health and well being of women
  in line with recommendations of ICPD
  Priorities for Development Assistance in Pakistan
  MDG Progress Report 2003

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Why we need to expand MDG 5

• MMR 300 700 / 100,000
• Incidence of unsafe abortion 1 million/year
• Maternal Mortality Rate per Year
• 76 births at homes attended by untrained health
  personnel
• High incidence of morbidities
• High unmet need for FP (33)

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Realities

• Demographic Missing Women
• Biological Adolescent females (15 to 19 yrs)
  twice likely to die as women in 20s
• Political A woman dying in childbirth is a
  silent emergency, happening outside the public
  eye
• Geographical MMR one of the highest in the
  region
• Service Delievery poor, inefficient non
  responsive
• Social low literacy, empowerment status of
  women
• Policy Right based framework missing

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Safe Motherhood

• Safe Motherhood is a human right. We must
  empower women and ensure choices Our task and
  the task of many like us, is to ensure that in
  the next decade safe motherhood is not regarded
  as a fringe issue, but as a central issue

James D. WolfensohnPresident World Bank
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• We know the causes.
• We have the solutions.
• We can make a difference.
• Joy Phumaphi
• Assistant Director General,
• WHO