1. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

2. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Structure of this Presentation Way Forward Coverage of key interventions Coverage of key interventions Facts on MNH

3. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

4. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 4 Very Little Progress Towards Achieving the MDG 5 Goal of Reducing Maternal Mortality Maternal mortality ratio (per 100,000 live births)

5. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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 2 Countries are on track 20 Countries making progress 13 Countries have insufficient progress 7 Countries have no progress No data/unclassified No AFRO

6. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 75% of maternal deaths are due to direct obstetric complications Causes of maternal death in the African Region, 2004 Underlying causes  Delay in decision making at home;  Delay in transportation to facility; and  Delay in getting the appropriate treatment at H/Facility

7. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Causes of Under five Deaths, WHO/AFRO, 2008 Source: World Health Organization. The Global Burden of Disease: 2004 update. World Health Organization, Geneva, 2008.

8. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Coverage of key MNH Interventions, African Region, 2000-05 and 2006-08 Source: WHO-World Health Statistics 2006, 2007 and 2010 The hours and days of highest risk have lowest coverage

9. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

10. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Access to Skilled Care at Birth by urban and rural areas (N=34, DHS 2001-2006)

11. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Skilled Birth Attendant by women's socioeconomic status

12. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa No data Unmet need for Family Planning (%) Source: WHO-World Health Statistics 2010

13. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Geographical Disparity in Delivery at Health facilities

14. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Percentage of births in facilities by region: Ethiopia

15. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa

16. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa

17. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Global and Regional Commitments In 2000 MDGs 4 and 5In 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 2004Roadmap 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 launchedThe CARMMA-23 countries launched WHO/AFRO Strategic Directions 2010-2015WHO/AFRO Strategic Directions 2010-2015 –SD 3 -Putting the health of Mothers and Children first The UN SG Global Strategy for Women and Children-The UN SG Global Strategy for Women and Children- AU Head of State Meeting July 2010 in Kampala- commitment on MNCHAU 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

18. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

19. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Way Forward we know… …what we must do… …who is at risk… …where they live… …and how to do it.

20. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

21. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

22. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa The higher the proportion of deliveries attended by skilled attendant in a country, the lower the country’s maternal mortality ratio % skilled attendant at delivery Maternal deaths per 1000000 live births

23. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa 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

24. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Care for everyone… … and by everyone

25. Africa Regional Meeting on Interventions for Impact in EmOC 21-23 Feb 2011, Addis Ababa Thank you