1 Why focus on MCH? Vulnerable socially and biologically Impact on adult health Sensitive indicator of societal health Deaths are largely preventable

Determinants Disease endemicity—e.g. HIV/AIDS, malaria Access to prevention and treatment interventions Education, especially maternal education Empowerment of women Disparities across ethnic and racial groups Rural/urban disparities Absolute poverty Relative poverty/income inequality

Some socio-political-economic factors and policies that impact health GNI, Economic Growth Country level priorities / investment in MCH Human resource shortages Weak health systems Aid –Fluctuations, donor driven –Disease and technology focus Debt International economic policies –Austerity measures, structural adjustment policies, “poverty reduction initiatives”, conditionalities Trade policies Conflict Research priorities World food crisis—decreasing availability (e.g., diversion to biofuels, animal feed), increasing cost Climate change