2015 is approaching. For some, it’s just another year. For those in the global development community, it marks a year of evaluation, compelling us to look back to see how far we have, or haven’t, come. In 2015, we must confront the Millennium Development Goals (MDGs), which challenged the global community to combat the major issues facing our world today such as universal education, gender equality, and poverty. To take a closer look at our progress in improving maternal, newborn, and child health, on May 2nd representatives from MCHIP spoke at InterAction in Washington, D.C. on where we stand and what we still need to do to reach our goals.
At a workshop entitled "Countdown to 2015: A closer look at how far we have come in improving maternal, newborn and child health and what we need to do to reach our goals," Barbara Deller, Senior Technical Advisor for Maternal and Newborn Health at MCHIP, opened the conversation with an overview of MDG 5 and where we stand in reaching this goal of reducing maternal mortality by 3/4. Deller pointed out that although we have seen a 34% reduction in maternal mortality from 1990 to 2008, few countries are on track for meeting MDG 5.
While maternal mortality remains unacceptably high, low-tech, inexpensive interventions exist for preventing – or preventing most deaths from – the major causes of maternal death, such as hemorrhage, eclampsia, sepsis, unsafe abortion, and obstructed labor. Also, most of these interventions can be implemented by a front-line healthcare worker such as a midwife or nurse or non-specialist doctor. Access to a skilled birth attendant is associated with a decrease in maternal, as well as newborn, mortality. In fact, trained community health workers can implement most life-saving newborn care. Frontline healthcare workers need policy and health systems support to prevent this needless loss of life.
With respect to MDG4, reducing the mortality rate for children under five years-old by 2/3, MCHIP’s Technical Lead on Health Systems Strengthening, Alex Ergo, presented on the current state of global child health. Ergo reported that half of child deaths take place in sub-Saharan Africa and a third in South Asia, and that pneumonia and diarrhea, often aggravated by malnutrition, are the main killers. He then showed the wide variations in the coverage of interventions that can effectively prevent or treat these two conditions, and argued that better coordination between programs is needed to take full advantage of the synergies that exist between these interventions.
To highlight one aspect of global child health, Robert Steinglass, MCHIP’s Immunization Team Leader, emphasized the importance of routine vaccination. He reported that approximately 20% of current child deaths could be prevented through vaccination and highlighted that new and effective vaccines exist against pneumonia and diarrhea. And while routine immunization coverage rates hover around 80% at the national level, Steinglass challenged the audience to consider whether 80% coverage is truly sufficient, stressing that efforts must be made to sustain uniformly high coverage across all geographic units and to reach those who are marginalized due to economic class, gender, or ethnicity. To close the equity gap, we must reach the poor better, since they are at greatest risk from vaccine-preventable diseases.
Moreover, Steinglass spoke to the importance of not only focusing on introducing new vaccines, but also on sustaining existing routine immunization programs, whose past accomplishments will not continue without direct investment. “Strengthening routine vaccination services so that all eligible populations receive potent, safe and timely vaccination services of good quality is fundamentally a developmental challenge in which civil society has a major role to play,” said Steinglass.
But the question remains: what can we be doing better to reach our goals? Leo Ryan, MCHIP’s Private Voluntary Organization/Nongovernmental Organization (PVO/NGO) Support Team Leader, gave insight into one strategy – USAID’s Child Survival and Health Grants Program, which supports PVOs/NGOs to engage with local partners in-country to address important community health issues. Ryan highlighted the advantages of using PVOs and NGOs – they are already “woven into the fabric of the community” and are flexible in executing a wide portfolio of projects in their community. Describing how this community-centered approach allows for capacity building and focus on specific health challenges in that area, Ryan reminded us that “health begins at home.”
All of these health experts emphasized that in order to reach our MDG goals, we must see the synergies of integrating interventions to achieve the greatest impact. We must also look at local contexts to see what is really working well in that area, learn those best-practices, and then scale up the efforts in that region.
MCHIP Strategic Communications