Maternal and Newborn Health in the African Region

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Maternal and Newborn Health in the African Region

Africa Regional Meeting on Interventions for
Impact in Essential Obstetrics and Newborn
Care 21-23 February 2011 Addis Ababa Dr P.
Mongi
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Structure of this Presentation
Facts on MNH
Coverage of key interventions
Way Forward
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Maternal Health Situation In Africa

• Each year in Africa at least 30 million women
  become pregnant
• Every year 204,000 African mothers die of causes
  related to pregnancy and childbirth- 3/5 of the
  global figure
• Each year 1.16 million newborn babies are dying
  in the first month of life
• There are strong links between maternal deaths,
  stillbirths and newborn deaths
• Majority of these deaths could be easily prevented

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Very Little Progress Towards Achieving the MDG 5
Goal of Reducing Maternal Mortality
Maternal mortality ratio (per 100,000 live births)
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Very Little Progress Towards Achieving the MDG 5
Goal of Reducing Maternal Mortality

• MMR in the African Region (2008)
• 620 per 100,000 live births
• MDG 5 target 228

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75 of maternal deaths are due to direct
obstetric complications

• Underlying causes
• Delay in decision making at home
• Delay in transportation to facility and
• Delay in getting the appropriate treatment at
  H/Facility

Causes of maternal death in the African Region,
2004
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Causes of Under five Deaths, WHO/AFRO, 2008
Source World Health Organization. The Global
Burden of Disease 2004 update. World Health
Organization, Geneva, 2008.
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Coverage of key MNH Interventions, African
Region, 2000-05 and 2006-08
The hours and days of highest risk have lowest
coverage
Source WHO-World Health Statistics 2006, 2007
and 2010
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Countries and within country level- high
inequality in the coverage of interventions

• Geographical disparity
• rural versus urban
• Social/Economic disparity
• Rich versus poor,
• Education status
• Adolescents

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Access to Skilled Care at Birth by urban and
rural areas(N34, DHS 2001-2006)
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Skilled Birth Attendant by women's socioeconomic
status
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Geographical Disparity in Delivery at Health
facilities
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Percentage of births in facilities by region
Ethiopia
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Global and Regional Commitments

• In 2000 MDGs 4 and 5
• Roadmap adopted by all MOH Ministers of the
  Africa Region by resolution AF/RC/54/R9 at the
  54th session in 2004
• The CARMMA-23 countries launched
• WHO/AFRO Strategic Directions 2010-2015
• SD 3 -Putting the health of Mothers and Children
  first
• The UN SG Global Strategy for Women and Children-
• AU Head of State Meeting July 2010 in
  Kampala-commitment on MNCH
• Despite all efforts and commitment of governments
  and partners, very few countries have the
  necessary resources and support to fully
  implement their MNH Road Maps towards universal
  access to key interventions

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The Challenge

• Governance and Leadership
• Weak health systems
• Human resource crisis.
• Inadequate infrastructure, medicines and
  equipment.
• Inadequate funds for universal coverage of
  interventions.
• Inadequate management and use of health
  information.
• Poor Coordination

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Way Forward
what we must do
we know
who is at risk
and how to do it.
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Scale up effective interventions

• Access to skilled attendants at birth, combined
  with prompt referral in case of complications
• Scaling up emergency obstetric newborn care
• Strengthening Family Planning
• Reducing pregnancy in adolescents
• Stronger links between HIV/AIDS and reproductive
  health
• Stronger links between malaria and maternal
  health-can reduce 10 MMR
• Empowering women, families, and communities to
  make timely decisions

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Key Interventions for newborn survival

• Many Newborn lives could be saved by use of
  simple low technological interventions like
• Supporting breastfeeding
• Providing adequate warmth
• Ensuring good hygiene and cord care
• Recognizing early signs of danger providing
  prompt treatment
• Giving extra care to small babies and
• Having skilled health care attendance for mothers
  and babies at delivery and immediate post-partum
  period

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The higher the proportion of deliveries attended
by skilled attendant in a country, the lower the
countrys maternal mortality ratio
Maternal deaths per 1000000 live births
skilled attendant at delivery
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As, WHO what is our role to scale up these high
impact interventions

• Advocacy
• For increased domestic and external funding and
  better utilization of existing funds
• For important policy decisions (task shifting,
  women empowerment )
• Policy Strategy development
• Decentralization reaching vulnerable population
  
• Health care financing social protection
• Integrated MNCH service delivery
• Human resource development (skilled birth
  attendance)
• Capacity building
• Skilled birth attendance
• Emergency Obstetric Newborn Care

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Care for everyone
and by everyone
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Thank you