A failure in critical health care

Leading global health experts, policymakers and parliamentarians are convening in Cape Town from 17th to 19th April at the Countdown to 2015 conference to address the urgent need for accelerated progress to reduce maternal, newborn and child deaths.

According to the 2008 report, Tracking Progress in Maternal, Newborn & Child Survival, released today, few of the 68 developing countries that account for 97% of maternal and child deaths worldwide are making adequate progress to provide critical health care needed to save the lives of women, infants and children.

More than 10 million women and children still die each year from causes that are largely preventable and treatable. The majority of maternal and child deaths occur in Africa and South Asia, with sub-Saharan Africa increasingly bearing the global burden of mortality. One in five children are born in sub-Saharan Africa, yet some 50% of all child deaths globally occur in the region, as do half of maternal deaths worldwide. In Niger, for example, women have a 1-in-7 lifetime risk of dying in pregnancy or childbirth.

The report highlights the rapid progress that many of the 68 countries are making in providing vaccinations, Vitamin A supplementation coverage and insecticide-treated mosquito nets to prevent major killers, such as measles and malaria.

Nonetheless, treatment for potentially fatal illnesses and other vital health services fail to reach the majority of women and children, according to the findings. Such services depend on strong health systems that can provide 24-hour care within the community, at health clinics, and through a functioning referral system when more serious intervention is necessary. Access to these services is most critical at the time of birth and during the first two weeks of life, which are riskiest for mother and infant.

Tracking Progress in Maternal, Newborn & Child Survival identifies a series of missed opportunities to save lives:
• Family planning: The unmet need for contraceptives is high. Only one third of women in the 68 priority countries are using a modern method - a proven means of boosting maternal and infant survival;
• Skilled care at birth: Only around half of women and newborns benefit from a skilled birth attendant at the time of birth, and even fewer receive care in the critical days and weeks after childbirth;
• Clinical care for sick children: Only about one third of children with pneumonia - the biggest single killer of children - receive treatment;
• Nutrition: Under-nutrition is the underlying cause of 3.5 million child deaths annually, and as many as 20% of maternal deaths.

Making progress

Despite these missed opportunities, the report also notes that a number of countries, including China, Haiti, Turkmenistan and several countries in sub-Saharan Africa, have made demonstrable progress in reducing deaths of children under five in the past three years. Sixteen of the 68 Countdown priority countries are now ‘on track' to achieve Millennium Development Goal 4, while only three have a low maternal mortality.

To pave the way for a well-functioning ‘continuum of care', governments and their partners must address obstacles such as weak health systems, funding shortages, and inequalities in access to care, according to the report. The findings show poor families missing out twice: on skilled care at birth and on care for newborns and children when they are ill. Other barriers include armed conflict and a high HIV prevalence, which together have erased any gains in child survival in at least 12 African countries.

Overall funding from donor governments for maternal, newborn and child health has increased in recent years, with official development assistance rising from $2.1bn to almost $3.5bn between 2003-2006, a 64% increase. This investment has resulted in significant health gains, notably to boost immunization levels and prevent malaria. Nonetheless, health systems for maternal, newborn and child health remain grossly under-funded compared to the needs of priority countries. Total donor funding for maternal, newborn and child health still represents just 3% of total donor aid disbursements.

What role?

Parliamentarians attending the 118th Assembly of the Inter-Parliamentary Union in Cape Town will join global health experts and policy makers at the Countdown to 2015 conference to discuss the role they can play in accelerating action to achieve Millennium Development Goals 4 and 5, on reducing child death and improving maternal health, respectively.

The Tracking Progress in Maternal, Newborn & Child Survival findings are also the subject of a special issue of the medical journal The Lancet.

UNFPA comments on the Countdown to 2015 report

“Tracking progress in Maternal, Newborn & Child Survival reveals an enormous lack of access to basic health care such as skilled attendance at birth and family planning. This is unacceptable.

“We will not achieve the Millennium Development Goals unless the health and rights of women and children are made a priority. When women die, children, families and nations suffer. Accelerated and coordinated action is needed NOW.

“Saving the lives of women and newborns requires strengthened health systems that can deliver for women when women are ready to deliver. Sustained investment in health services and human resources is urgently needed.

“No woman should die giving life.” - Purnima Mane, Deputy Executive Director, UNFPA.

Article courtesy of African Press Organisation