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A big challenge …Globally every year…
•7,6 million children die before their 5th birthday– 3,2 million newborn babies in the first month of life– 2,4 million infants between 1 – 12 months
•356 000 women die due to complications of pregnancy and childbirth– 15 million women develop long-term consequences due
to pregnancy and childbirth
Child nutrition and MDGs• In 2010, globally, an estimated 27% of children
younger than 5 years were stunted• Undernutrition continues to be high and delays
progress toward reaching Millennium Development Goals
• Extremely poor breastfeeding and complementary feeding practices
• Micronutrient deficiencies (iodine, iron deficiency ) still a serious problem and obesity on the rise….
The way forward…
By 2015:
• Saving 16 million lives of women and children
• Preventing 33 million unwanted pregnancies
• Protecting 88 million children from stunting
• Protecting 120 million children from pneumonia
Goal 5: Improve maternal healthTarget 5A: Reduce by three quarters,
between 1990 and 2015, the maternal mortality ratio
Target 5B: Achieve, by 2015, universal access to reproductive health
• Maternal mortality ratio
• Proportion of births attended by skilled health personnel
Goal 4: Reduce child mortalityTarget 4A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
• Under-five mortality rate
• Infant mortality rate• Proportion of 1 year-old children
immunised against measles
• Contraceptive prevalence rate
• Adolescent birth rate
• Antenatal care coverage • Unmet need for family planning
Targets and indicators for monitoring MDG 4 and 5
World Health Assembly
WHO ConstitutionExecutive Board, DGResolutions and decisions http://apps.who.int/gb/or/
Executive Board
WORLD HEALTH ORGANIZATION
Regional Committees
10-13 September 2012 Malta
Standing Committee of RC - only in WHO/Europe
Good progress in achieving MDG 4 in the WHO European Region
In 2009 11 countries achieved MDG 4 target
Source: WHO European Region estimates; WHO, 2011
Probability of dying before age 5 years per 1 000 live births
0
10
20
30
40
50
60
70
1980 1990 2000 2010
European RegionEuropean Union
Commonwealth of Independent States
Central Asian Republics
However big discrepancies between countries
Source: WHO/Europe Health for all Database
Deaths among children under-five
Neonatal deaths
Source: Major causes of under five and neonatal deaths, European Region, 2008; WHO The World Health Statistics 2011
Neonatal deaths50%
Pneumonia(postneonatal)
11%
Diarrhoeal diseases
(postneonatal)5%
HIV/AIDS1%
Other 14%
Noncommunicable diseases
(postneonatal)14%
Injuries (postneonatal)
5%
Prematurity and low birth weight
35%
Birth asphyxia and birth trauma
15%
Neonatal infections 12%
Congenital anomalies
22%
Other 16%
Major causes of deaths are known
average annual decline of 3.8%
5.5% required to achieve MDG5
Source: Trends in Maternal Mortality: 1990 to 2008; WHO, 2010
Good progress in maternal health – MDG5 WHO European Region
44
2720
05
101520253035404550
1990 2005 2010
Estimted maternal mortality ratio
0
10
20
30
40
50
60
70
1980 1990 2000 2010
Maternal deaths per 100000 live births
European Region
European Union
Commonwealth of Independent States
Central Asian Republics
Every two years WHO secretariat develops a progress report based on the filled in questionnaires received from the WHO Member States and presents it to the World Health Assembly (2006,2008, 2010, 2012,
2014!)
Questionnaires will be sent to countries in 2013
European strategy for child and adolescent health and development (2005)
Tools for implementation
Guidelines and tools available
Effective Interventions exist…
3
3
4
4
5
6
7
13
0 2 4 6 8 10 12 14
Antenatal steroids
Water, sanitation, hygiene
Clean delivery
Hib vaccine
Zinc
Continued BF with complementary feeding
Insecticide treated materials
Exclusive breastfeeding
Source: Lancet Child Survival Series 2003
Inte
rve
nti
on
expected % of reduction in U5M
From recommendations to actions
1 Monitoring results & CRVS 2 11 core indicators & equity
3 Digital health & innovation
4 Financial indicators tracked5 Comprehensive reporting6 Capacity for NHA
7 National Accountability mechanisms
8 Transparency
9 MNCH specific reporting
10 Expert Review Mechanism
COMMISSION RECOMMENDATIONS
Country assessment &Roadmap
Globalactions
Birth and death registration
Monitoring of results
Maternal death surveillance & response
NHA & MNCH tracking
ehealth & innovation
Country review processes
Advocacy and action
Monitoring results
Tracking resources
Global review (iERG)
To accelerate progress …
• Tackle inequities by addressing the determinants of maternal and child health through cross-sector and gender-right based approach
• Strengthen health
• Strengthen health information
• Implement new vaccines and develop immunization service delivery strategies
• Address the links between noncommunicable diseases and MDGs
Health 2020: a European policy framework supporting action across government and society for health and well-being
Proportion (%) of children exclusively breastfed at 3 and 6 months, 2005-2010
Albania
Armen
ia
Azerb
aijan
Belaru
s
Belgium
Bosnia
and
Her
zego
vina
Bulgar
ia
Croat
ia
Cypru
s
Czech
Rep
ublic
Finlan
d
Germ
any
Greec
e
Hunga
ry
Icela
nd
Irelan
dIta
ly
Kazak
hsta
n
Kyrgy
zsta
n
Luxe
mbo
urg
Mon
tege
gro
Nethe
rland
Norway
Poland
Portu
gal
Mald
ova
Russia
Slovak
ia
Slovan
iaSpa
in
Sweden
Switzer
land
Tajiks
tan
Mac
edon
ia
Ukrain
e
United
King
dom
0
10
20
30
40
50
60
70
80
90
100
3 Months6months
Sources: National Surveys
Accelerated actions to achieve MDG 4 and 5
• Developing clear policies and action plans from a life-course and multi-sectorial perspective
• Improved data collection, analysis and evidence-based decision making
• Supported and monitored implementation of evidence based health interventions
• Improving access and quality of care; trained health professionals with right skill mix
• Involvement of communities and civil society