the role of knh/uon in accelerating the achievement of mdgs 5 and 4 1 mnch symposium 10 january 2013...
TRANSCRIPT
The Role of KNH/UON in Accelerating the Achievement of MDGs 5 and 4
1
MNCH Symposium
10 January 2013
Dr. Gathari Ndirangu
Reproductive Health
MDG 5 in Kenya
• MDG 5 is off target – MMR target: 147/100,000 live births by 2015– Universal access to RH – Current MMR: 488/100,000 live births*, up from 414 in 2003**
• Newborn part of MDG 4 has stagnated– Neonatal mortality rate 31/1000 live births*– 60% of IMR
• Commendable progress in the other MDGs (especially 1, 2, 3)
*KDHS 2008-09**KDHS 2003
Socioeconomic Determinants of Maternal Mortality
• Illiteracy, poverty and poor women empowerment
• Pregnancy too soon, too frequent, too many
• Inadequate access to RH/MNH/FP services
• Delivery under unskilled care
• Limited accountability at all levels
Policy Environment
KNH’s Strengths to Accelerate Achievement of MDG5
• Strategic objectives to fulfil national mandate, vision and mission– To improve quality specialized reproductive healthcare
– To reduce maternal and perinatal morbidity and mortality
– To enhance training and research
– To contribute to national RH planning and policy formulation
– To strengthen institutional linkages and collaboration
– To contribute to corporate social responsibility and improve on hospital image
MNH Strategic Objectives
• Reduce maternal and perinatal morbidity/mortality– Service provision from primary to tertiary care– PMTCT program
• Training and research– Graduate and undergraduate levels, paramedical– Vibrant and respected research community– Translation of research into policy and practice
• Contribute to national RH planning and policy formulation• Institutional linkages and collaboration, including PPP
Challenges
• Heavy client load (outstrips capacity)– Non-booked ANC clients (~60%)
– Late referrals
• High MMR– 1223/100,000 LB (Jan-Nov 2012)
• High NMR 116/1000 LB (Jan-Dec 2012)– Prematurity
– NN Sepsis
– Term RDS
– Birth asphyxia
KNH’s Opportunities for Improving MNH Indicators
• Highly trained workforce• Favorable policy environment
– National referral hospital
– Devolved governance
– Strengthen lower tier health care facilities
– Effective knowledge and skill transfer
– Mentorship
– Timely and supportive feedback to referring HCFs
– Satellite health care facilities
– Modern technology
KNH’s Opportunities for Improving MNH Indicators
• Proactively creating modalities to realize full potential in MNH services– Advocacy– Participation in national RH planning including MPDSR – Training– Research– Collaboration including PPP
• Provision of full range of FP services (LAPM)
• Timely reporting to the national HMIS for national planning
Threats
• Political interference and uncertainty
• Poverty
• Inadequate financial resources
• Commodity insecurity/inadequate equipment
• Increased litigation
• Industrial strife
• Inadequate health workforce
National Vision 2030 MNH target
• MMR- 113/100,000 LB (77% reduction)– From 1223 to 281/100,000 LB
• NMR- 13/1000 LB (59% reduction)– From 116 to 47/1000 LB
• Together, we are up to the task!