1. MNCH& Disability Seminar ‘Taking Next Steps with Confidence’ Vientiane, Laos May 23-27, 2011

2. Frames ► Millenium Development Goals ► ‘Accord-Cadre’ HIB-DGD ► ‘Accord Cadre’ HILux-MAE Lux ► Countries Strategies (National + HI..)

3. Frames MDG 5: Improve maternal health 5.1 Maternal mortality ratio 5.2 Proportion of births attended by skilled health personnel 5.3 Contraceptive prevalence rate 5.4 Adolescent birth rate 5.5 Antenatal care coverage (at least one visit and at least four visits) 5.6 Unmet need for family planning MDG 4: Reduce Child Mortality 4.1 Under-five mortality rate 4.2 Infant mortality rate 4.3 Proportion of 1 year-old children immunised against measles

4. Frames ► Decrease the number of avoidable disabilities, and minimize the impact of disabilities among pregnant women and children, through the development of reproducible model for early detection, referral and care of the mother and child impairments.

5. Frames ► Sustainable strategies and systems are implemented or strengthened, for preventing disabling situations and / or for the care of Disabled persons.

6. Where are we ► In our countries Regarding Prenatal issues / MDG 5

7. Where are we ► In our countries Regarding Delivery & postpartum / MDG 5

8. Where are we ► In our countries Regarding Newborn and Childhood / MDG 4

9. Where are we ► Handicap International Mali MCH Nica Early detection Burundi FistulaeHappy ChildNica Early detection Laos MCH Welcome to Life Congenital Diff SMI Kin Congenital Diff SMI Kin Congenital Diff SMI KinCongenital Diff SMI Kin Prenatal Delivery & Postpartum NewbornEarly childhoodPolicies

10. Where are we ► Handicap International / Prenatal issues Obstacles : -Difficult implementation of preconception care services -Unclear links between MCNH and Disability -Accessibility to prenatal care services in remote areas -Difficult to assess the impact Opportunities : -Existing networks -Motivation of Health personnel and authorities -Interest of women

11. Where are we ► Handicap International / Delivery & postpartum issues Obstacles : -Accessibility for women in remote area -Cultural beliefs (delivery at home..) -Difficulty for refferal of complicated cases Opportunities : -Available health staff at all levels -Good cooperation with other organizations

12. Where are we ► Handicap International / Newborn care Obstacles : -Lack of human resources (time consuming) -Poor collaboration between Maternity and Pediatric departments -Detection not followed by an appropriate treatment -High tech, difficult to decentralize Opportunities : -Motivation of the parents -Visible impact

13. Where are we ► Handicap International / Early childhood issues Obstacles : -Stigma limitates detection -Quality of trainings -Difficulty to spread appropriate technical skills in the community Opportunities : -Linkages between community and specialized services -Strong experience

14. Where are we ► Handicap International / Policies Obstacles : -Requests important means -Difficult to demonstrate impact Opportunities : -Experience in establishing models -MCNH often a national priority

15. Where do we go ?