Transcript REDUCE BURKINA FASO

ACT TO SAVE
MOTHERS AND NEWBORNS
BURKINA FASO
REDUCE
DSF/ MINI SANTE
WHO
In collaboration with
•
•
•
•
•
•
•
INSD
CONAPO
APAC
IMMPACT / MURAZ
CRSN
AQUASOU
CNLS/IST
BURKINA FASO
•
•
•
•
•
•
•
JHPIEGO
AED
UNFPA
SOGOB
ABSF
ABSP
CEFOREP (Senegal)
REDUCE
IN BURKINA FASO
• 1 woman dies
Every 3 hours...
from pregnancy
related
complications
• 7 newborns die
BURKINA FASO
REDUCE
WHAT IS MATERNAL
MORTALITY ?
« …Any death that
occurs during
pregnancy,
delivery or within
the 42 days
following the end
of pregnancy. »
BURKINA FASO
REDUCE
WHAT WOMEN ARE DYING
FROM DURING PREGNANCY
AND DELIVERY?
BURKINA FASO
REDUCE
CAUSES OF MATERNAL
MORTALITY
Indirect
Causes
20%
Hemorrhage
24%
Other direct
causes
8%
Sepsis 15%
Obstructed
labor 8%
Eclampsia
12%
BURKINA FASO
Unsafe
Abortion
13%
REDUCE
THE THREE DELAYS
1st Delay
3rd Delay
Decision making
Access to care
services
2nd Delay
Access to Health
Facilities
BURKINA FASO
REDUCE
1st DELAY: DECISION MAKING
• Lack of information
and inadequate
knowledge about
signs of
complications of
pregnancy and
danger signals
during labor
• Women’s low status
BURKINA FASO
REDUCE
2nd DELAY: INABILITY TO ACCESS
HEALTH FACILITIES
• Long Distances to
Health Facilities
• Poor roads and
communication network
• Poor community
support
BURKINA FASO
REDUCE
3rd DELAY: ACCESS TO CARE
• Lack of skilled
attendants
• Inadequate
equipment and
supplies
• Low motivation of
care providers
BURKINA FASO
REDUCE
IN WHICH CONTEXT DOES
THIS DRAMA TAKE PLACE?
BURKINA FASO
REDUCE
BURKINA: A STEADY ECONOMIC
GROWTH
182 000
121 495
1998
BURKINA FASO
2002
REDUCE
AND YET, POVERTY IS STILL
PRESENT
From 1998 to 2003 the proportion of poor
increased from 45% to 46.5%
Poverty touches mainly women
BURKINA FASO
REDUCE
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%
BURKINA FASO
REDUCE
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
• FP unmet needs
BURKINA FASO
6,2
29%
REDUCE
DELIVERY BY CEASARIAN
Kenya 2003
Ghana 2003
Mozambique 2003
Nigeria 2003
Mali 2001
Madagascar 2003
Burkina Faso 2003
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Rate in percentage
Source : EDS
BURKINA FASO
REDUCE
PLACE OF DELIVERY
Health facilities
38%
Home
62%
BURKINA FASO
REDUCE
United Nations Human
Development Index
BURKINA FASO
REDUCE
DESPITE THIS DIFFICULT
CONTEXT
We know what to do!
We can do it!
We just have to act!
BURKINA FASO
REDUCE
MATERNAL MORTALITY
2004-2015
Maternal deaths/100 000 LB
600
484 deaths
100 000 LB
121deaths
100 000 LB
339 deaths
100 000 LB
Without action
Program Impact
242 deaths
100 000 LB
0
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
BURKINA FASO
REDUCE
MATERNAL MORBIDITY
1 Maternal Death
20-30 cases of
maternal
Morbidity
BURKINA FASO
REDUCE
TYPES OF MORBIDITY
• Uro-genital fistulas
• Genital prolapsus
• Anemia
• Infertility
• Urinal incontinence
• Back pains
BURKINA FASO
REDUCE
INFANT MORTALITY
Any child death occuring
before the first birthday
BURKINA FASO
REDUCE
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
BURKINA FASO
REDUCE
Estimating the Consequences of
Poor Maternal and Newborn Health
Data on Maternal and Neonatal
Health
Socio-economic Data
REDUCE
Impact on survival & productivity
BURKINA FASO
REDUCE
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)
BURKINA FASO
REDUCE
ASSUMPTIONS
2004 - 2015
• Strategic Plan for Maternal Mortality Reduction
• Vision 2010
• Millenium Development Goals
• PNDS
• CSLP
BURKINA FASO
REDUCE
MATERNAL DEATHS 2004 - 2015
No interventions
44 600 maternal deaths
BURKINA FASO
REDUCE
MATERNAL MORBIDITY
2004 - 2015
No interventions
1 600 000 women will suffer
– 747 000
Pelvic infections
– 560 000
Urinal incontinence
– 250 000
Infertility
– 33 000
Severe anemia
– 8 900
Fistulas
BURKINA FASO
REDUCE
PRODUCTIVITY LOSSES FROM
MATERNAL DEATHS/MORBIDITY
The loss of productivity
133 billion F CFA
due to
Maternal deaths
: 12,5 billion F CFA
Maternal morbidity
: 120 billion F CFA
CFA
BURKINA FASO
REDUCE
NEONATAL DEATHS 2004 - 2015
No interventions
97 000 neonatal deaths resulting
from their mothers’ deaths
BURKINA FASO
REDUCE
SAVED LIVES (2004 – 2015)
Interventions
Saved lives of mothers
Maternal morbidities avoided
Saved lives of newborns
BURKINA FASO
20 000
745 000
52 800
REDUCE
ECONOMIC GAINS
Interventions
GAINS : 59.7 Billion F CFA
BURKINA FASO
REDUCE
BENEFITS OF THE PROGRAMME
70
Amounts (billions of F CFA)
59.7
42
0
Cost
BURKINA FASO
Gains
REDUCE
THREE CONDITIONS NEEDED
• Recognition of maternal mortality
reduction as key development factor
• Actual political commitment
• New investment strategies to reduce
maternal and neonatal mortality
BURKINA FASO
REDUCE
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
BURKINA FASO
REDUCE
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 ...
BURKINA FASO
REDUCE
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
BURKINA FASO
REDUCE
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
BURKINA FASO
REDUCE
REFERRAL SYSTEM
• RAC (walkie
talkie), mobile
telephones
• Ambulances
• Quality roads
BURKINA FASO
REDUCE
FINANCIAL ACCESSIBILITY
• Offer free preventive
services
• Subsidize EONC
services
• Adopt a cost
sharing system
BURKINA FASO
REDUCE
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
BURKINA FASO
REDUCE
COMMUNITY ACTIONS
• Encourage male
involvement in FP
• Make advance
preparations for
delivery
• Raise awareness of
the danger signs
• Promote payment
alternatives
BURKINA FASO
REDUCE
COORDINATION
• Have periodic meetings
between partners
• Develop a single
planning framework
• Develop a single
coordination system
• Develop a single
evaluation system
BURKINA FASO
REDUCE
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%
BURKINA FASO
REDUCE
LET’S ACT TOGETHER !
Our commitment is important !
Everybody at any level should commit himself
BURKINA FASO
REDUCE
Maternal and
Neonatal Health
A Worthy Investment!
BURKINA FASO
REDUCE