MDGs 4 and 5: Where We Are Now, and

How Can HCP Associations Contribute to

Improve the Situation?

Andres de Francisco, MD, PhD

Team Coordinator, PMNCH

17 December, 2009

The State of Global MNCH

Child Death Distribution

(Black et al 2003)

Maternal Death Distribution

per 100 000 live births(World Health Report 2005)

Newborn Death Distribution

per 1000 live births(World Health Report 2005)

Maternal Mortality ratio estimates:

1990 and 2005

(Hill et al, 2007)

Under 5 mortality:

Projection of trends to 2015

(Ahmad OB, Lopez AD & Inoue M. 2000)

0

2 5

50

75

10 0

12 5

150

175

2 0 0

6 0 6 5 70 75 8 0 8 5 9 0 9 5 0 0 0 5 10 15

Un

der

-fiv

e m

ort

ali

ty p

er 1

00

0

If recent trends

continue

To achieve

MDG

Year

MNCH and Health worker presence:

A direct link

Global Presence of health workers

(World Health Report 2006)

Skilled birth attendants and maternal

and newborn mortality

(World Health Report 2005)

Health Worker Density & Mortality

0

1

2

3

4

5

6

7

8

9

0 1 2 3 4 5

Density (workers per 1,000, log)

Mo

rta

lity

(p

er

1,0

00

, lo

g)

Maternal

Infant

Under-5

JLI, 2004

Why such trends?

Coverage of the known MNCH

effective interventions is low and

inequitable

Human resource shortage

Inadequate use of exiting resources

Lack of political advocacy

Partnership on the continuum of care

Multilateral

organizations

Research and

academic institutions

Partner

countries

Donors and

foundations

Professional

associations

Non-governmental

organizations

Community

MNCH

Continuum of care

Pregnancy ChildbirthAdolescence

pre-pregnancyNewborn Childhood

Partnership areas of work

1. Knowledge management (UA-AKU)

2. Effective interventions (WHO-HCPA)

3. Commodity management (UNFPA/UNICEF)

4. Human resources strengthening -WHO/HCPA

HR analyses

Capacity building

5. Advocacy (FCI-WHO)

6. Accountability (WB).

Role of health care professionals

Health care professionals as front line service providers play a role in:

Providing high quality health services

Educating communities on behaviour

Curriculum development and training

But also on:MNCH policy making

High level advocacy

However…

Health care professionals are rarely involved in the latter

The HCPA workshop

Workshop goals:

Identify practical ways to increase HCPA contribution to national planning for MNCH

Promote the definition of a common vision, mission and actions from HCPAs as they relate to MDGs 4 and 5

Share best practices among countries in the region

Strengthen links between regional and national associations

Measurable outputs of past regional workshops

Burkina Faso (2008)

Niger: Development of an all inclusive HCPA

network with legal statutes, supported by the

WHO

Burkina Faso: Signing of MoU between HCPAs

and MoH, advocacy to first lady and MoH.

Measurable outputs of past regional workshops

Bangladesh (2008)

India: signing of MoU with MoH, strengthened

regional midwifery links

Pakistan: regular HCPA network meetings,

implementation of workplan in 2 districts

(common advocacy strategy and priority areas of

intervention)

Afghanistan: First HCPA encounter resulted in

increased collaboration and joint advocacy

So what?

The success of this workshop will be based

on:

Ownership of the resulting workplan by the

participants

Strengthened collaboration between & among

health care professional associations

Measureable action and progress.

Thank you

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