Transcript MDG 4 and 5 – What News from Lao PDR?

MDG 4 and 5
What News from
Lao PDR–?
Della R Sherratt
International Skilled
Birth Attendance (SBA)
Coordinator
UNFPA Mission
• UNFPA, the United Nations Population Fund, is
an international development agency that
promotes the right of every woman, man and
child to enjoy a life of health and equal
opportunity. UNFPA supports countries in
using population data for policies and
programmes to reduce poverty and to ensure
that every pregnancy is wanted, every birth is
safe, every young person is free of HIV/AIDS,
and every girl and woman is treated with dignity
and respect.
COUNTDOWN TO 2015 REPORT 2008 DATA, PAINTS
POSITIVE PICTURE FOR CHILD HEALTH
HTTP://WWW.COUNTDOWN2015MNCH.ORG
But for Lao Newborns, not
such a positive trend
Why do we not have data on
newborns?
MATERNAL HEALTH =
SERIOUSLY “OFF-TRACK” ?
All pregnant women are at risk
• Each year, more than 350,000 women die
from pregnancy or delivery-related causes
and the vast majority of these deaths occur
in developing countries.
• Each pregnancy puts a woman at risk of
maternal death, but women who have
induced abortions, miscarriages or
stillbirths have been found to be at a higher
risk of maternal mortality than those who
have live births.
Causes of maternal deaths
Regional estimates for Asia,
1997-2002
Reducing MMR – 3 Pillars
Family Planning
SBA
All Births
EmONC
• Timing
• Number
• Early Onset
• Skilled Personnel –
(Midwife) PLUS ...
• Drugs, equipment,
supplies, policy
(Functioning
strong Health
system & Political
Commitment)
• Referral system
• Transport
Community Empowerment and mobilization
Links between Maternal &
Child Health
• Mother Newborn dyad: Chances of
survival of child to 5, if mother dies is poor
• Newborn Deaths = large proportion of
under five child Deaths
• (Many) causes Newborn deaths, illness
and disability are same as Maternal
• Nutrition of mother impacts fetal & Child
Same Interventions Needed
Mother
• FP = can reduce 20%
MMR
• STI Prevention and
Treatment: Postpartum
Infection, Sepsis, Death
• Partograph – prevent
Prolonged Obstructed
labour
Newborn Survival
/Child Health
• FP = Increased BF
duration,
• STI prevention treatment
esp,Congenital Syphilis,
and Blindness (Gonn),
Pnemonia (Chlamydia)
• Prevent fetal distress, birth
asphyxia (brain injury)
death = prevent prolgned
obstructed labour
Increased Access to Modern
Contraceptives and Family Planning for
Maternal and Child Health
• Too many pregnancies, too closely spaced births,
are detrimental to women's reproductive health
and can result in complicated pregnancies,
example fistula (major disability), but also other
injuries or death.
• FP can reduce maternal deaths and injuries by at
least 20 per cent (more in adolescent girls).
• Increase length of breastfeeding
• Under-five Child Development improved
• Benefits to Family health and wellbeing
What is Lao
PDR doing
to improve
the health of
mothers and
children?
Policies and Plans
 2009 Approved National
Strategy for Integrated Package of
MNCH Services
 National Plan for Skilled Birth
Attendance 2009-2013
 2010 National Nutrition Policy
 2010 Free Childbirth Care for poorest
Policy
19 May 2011 - Lao PDR announces
Commitment to UN Sec General
Initiative for Women and Children at
WHA
 Implement Free Birth Policy
 Train and accredit 1,500 Midwives
 Reduce unmet need for FP
 90 % Children fully immunized
Technical &
Financial Support
And ADB and
many others
NGO
Progress - but still a long
way to go
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CBDs/VDRFs(ªÒ)
PS
CBDs/VDRFs areas
LNT
BK
2
ODX
LPB
HP
XK
SYB
Getting
Family
Planning
Services to
most Rural
Communities
VTE
BLK
VTE capt.
KM
SVK
SRV
CPX
SK
ATP
Upgraded rural health centres
Old HC / Somboun &
Namouang
Lao - Belgium Cooperation Project
New HC and
delivery room
Maternity Waiting Home
and delivery sites [Silk Home Project and others]
There has been some
success in getting women to
health care in remote areas
–but sustainability can be a
problem
Key to successful
HR Development
• Recruitment - link to where needs
• Train - competency-based; focus on skills
required including to save lives (must
critical thinking and decision making); train
close to where they live and work
• Accredit
• Deploy - where needed
• Retain – incentives (financial and none financial).
Career pathways, status; Supportive Supervision
Creating Skilled Attendants
(SBA) to keep Mothers & Babies Safe
Creating Skills laboratories
Creating awareness and
identify - A national uniform for
midwives - so communities can
recognize them
Access to EmONC
is very Limited
currently undertaking
National Needs
Assessment
Strategy Vision
Implementing the integrated Maternal,
Neonatal and Child mortality reduction
strategy will achieve universal
coverage of an essential package of
interventions for all mothers and
children in Lao PDR regardless of
gender, geographical, socio-economic
and ethnic differences
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Thank You
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Sok Dee
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