Published on March 7, 2008
Slide1: ACT TO SAVE MOTHERS AND NEWBORNS In collaboration with: In collaboration with INSD CONAPO APAC IMMPACT / MURAZ CRSN AQUASOU CNLS/IST JHPIEGO AED UNFPA SOGOB ABSF ABSP CEFOREP (Senegal) WHO IN BURKINA FASO: Every 3 hours... IN BURKINA FASO 1 woman dies from pregnancy related complications 7 newborns die WHAT IS MATERNAL MORTALITY ?: WHAT IS MATERNAL MORTALITY ? « …Any death that occurs during pregnancy, delivery or within the 42 days following the end of pregnancy. » Slide5: WHAT WOMEN ARE DYING FROM DURING PREGNANCY AND DELIVERY? CAUSES OF MATERNAL MORTALITY: CAUSES OF MATERNAL MORTALITY THE THREE DELAYS: THE THREE DELAYS 3rd Delay Access to care services 1st Delay Decision making 2nd Delay Access to Health Facilities Slide8: Lack of information and inadequate knowledge about signs of complications of pregnancy and danger signals during labor Women’s low status 1st DELAY: DECISION MAKING Slide9: Long Distances to Health Facilities Poor roads and communication network Poor community support 2nd DELAY: INABILITY TO ACCESS HEALTH FACILITIES Slide10: Lack of skilled attendants Inadequate equipment and supplies Low motivation of care providers 3rd DELAY: ACCESS TO CARE IN WHICH CONTEXT DOES THIS DRAMA TAKE PLACE?: IN WHICH CONTEXT DOES THIS DRAMA TAKE PLACE? BURKINA: A STEADY ECONOMIC GROWTH: BURKINA: A STEADY ECONOMIC GROWTH AND YET, POVERTY IS STILL PRESENT: From 1998 to 2003 the proportion of poor increased from 45% to 46.5% Poverty touches mainly women AND YET, POVERTY IS STILL PRESENT UNSATISFACTORY VITAL HEALTH STATISTICS: UNSATISFACTORY VITAL HEALTH STATISTICS Infant mortality rate 81/1000 LB Under-five mortality rate 184/1000 LB HIV prevalence 1.8% Without access to safe water 48% Without access to improved latrines 60% Non-enrolled children 48% WOMEN’S SITUATION ALWAYS UNFAVORABLE: Median Age at 1st Marriage 16 years Median Age at 1st delivery 17 years Contraceptive Prevalence Rate 15% Total Fertility Rate 6,2 FP unmet needs 29% WOMEN’S SITUATION ALWAYS UNFAVORABLE Slide16: DELIVERY BY CEASARIAN Source : EDS PLACE OF DELIVERY: PLACE OF DELIVERY United Nations Human Development Index: United Nations Human Development Index 175 out of 177 DESPITE THIS DIFFICULT CONTEXT: DESPITE THIS DIFFICULT CONTEXT We know what to do! We can do it! We just have to act! MATERNAL MORTALITY 2004-2015: MATERNAL MORTALITY 2004-2015 MATERNAL MORBIDITY: MATERNAL MORBIDITY 1 Maternal Death 20-30 cases of maternal Morbidity TYPES OF MORBIDITY: TYPES OF MORBIDITY Uro-genital fistulas Genital prolapsus Anemia Infertility Urinal incontinence Back pains INFANT MORTALITY: INFANT MORTALITY Any child death occuring before the first birthday MATERNAL DEATH Relatedto INFANT DEATH: MATERNAL DEATH Related to INFANT DEATH RISK OF DYING BEFORE 1 YEAR 15 TIMES HIGHER for a child whose mother is dead than for those with living mothers CRS Nouna Estimating the Consequences of Poor Maternal and Newborn Health: Data on Maternal and Neonatal Health Estimating the Consequences of Poor Maternal and Newborn Health Socio-economic Data DATA SOURCES MODEL REDUCE / ALIVE: DATA SOURCES MODEL REDUCE / ALIVE EDS BF-II et III : 1998 et 2003 Enquête Burkinabé sur les conditions de vie des ménages 2003 (INSD) Annuaire Statistique 2004 (DEP/Mini Santé) Global burden of disease report 1996-1998 (OMS) Plan stratégique de la SR 1998-2008 (DSF) Projection de la population Burkina Faso Horizon 2025 (CONAPO, 2005) ASSUMPTIONS2004 - 2015: ASSUMPTIONS 2004 - 2015 Strategic Plan for Maternal Mortality Reduction Vision 2010 Millenium Development Goals PNDS CSLP MATERNAL DEATHS 2004 - 2015: MATERNAL DEATHS 2004 - 2015 No interventions 44 600 maternal deaths MATERNAL MORBIDITY 2004 - 2015: MATERNAL MORBIDITY 2004 - 2015 1 600 000 women will suffer 747 000 Pelvic infections 560 000 Urinal incontinence 250 000 Infertility 33 000 Severe anemia 8 900 Fistulas No interventions PRODUCTIVITY LOSSES FROM MATERNAL DEATHS/MORBIDITY: PRODUCTIVITY LOSSES FROM MATERNAL DEATHS/MORBIDITY The loss of productivity Maternal deaths : 12,5 billion F CFA Maternal morbidity : 120 billion F CFA CFA 133 billion F CFA due to NEONATAL DEATHS 2004 - 2015: NEONATAL DEATHS 2004 - 2015 No interventions 97 000 neonatal deaths resulting from their mothers’ deaths SAVED LIVES (2004 – 2015): SAVED LIVES (2004 – 2015) Saved lives of mothers 20 000 Maternal morbidities avoided 745 000 Saved lives of newborns 52 800 Interventions ECONOMIC GAINS: ECONOMIC GAINS GAINS : 59.7 Billion F CFA CFA Interventions BENEFITS OF THE PROGRAMME: BENEFITS OF THE PROGRAMME THREE CONDITIONS NEEDED: Recognition of maternal mortality reduction as key development factor Actual political commitment New investment strategies to reduce maternal and neonatal mortality THREE CONDITIONS NEEDED NATIONAL COMMITMENT FOR SAFE MOTHERHOOD: NATIONAL COMMITMENT FOR SAFE MOTHERHOOD Road Map of the African Union Abuja Commitment = 15% allocated to health Millenium Development Goals Vision 2010 Adoption of the persons and family code National follow up committee URGENT BUDGETARY ACTIONS: URGENT BUDGETARY ACTIONS Allocate 15% of the national budget to the health sector Increase the share of maternal and neonatal health to 25% of the health budget Increase the contribution of maternal and neonatal health partners by 25% In order to ... PRIORITY ACTIONS: PRIORITY ACTIONS Make quality EONC services available and accessible Promote FP Improve women’s status Improve adolescent RH Reinforce the community capacity Coordinate stakeholders actions at all levels QUALIFIED AND MOTIVATED ATTENDANTS: QUALIFIED AND MOTIVATED ATTENDANTS Place midwives at all levels Train physicians in emergency surgery Increase number of gyneco-obstetricians and anesthesists Develop motivation policy for attendants REFERRAL SYSTEM: REFERRAL SYSTEM RAC (walkie talkie), mobile telephones Ambulances Quality roads FINANCIAL ACCESSIBILITY : FINANCIAL ACCESSIBILITY Offer free preventive services Subsidize EONC services Adopt a cost sharing system REVITALIZE FP AND IMPROVE WOMEN’S STATUS: REVITALIZE FP AND IMPROVE WOMEN’S STATUS Pass budget line item for contraceptive commodities Adopt RH model law and related regulatory texts Ensure youth friendly RH Services COMMUNITY ACTIONS: COMMUNITY ACTIONS Encourage male involvement in FP Make advance preparations for delivery Raise awareness of the danger signs Promote payment alternatives COORDINATION: COORDINATION Have periodic meetings between partners Develop a single planning framework Develop a single coordination system Develop a single evaluation system LET’S ACT NOW !: LET’S ACT NOW ! Health Budget = 15% of national budget Share of maternal and neonatal health increased to 25% of health budget Partner contribution for MNH programmes increased by 25% LET’S ACT TOGETHER !: LET’S ACT TOGETHER ! Our commitment is important ! Everybody at any level should commit himself Maternal and Neonatal HealthA Worthy Investment!: Maternal and Neonatal Health A Worthy Investment!