Task Force reports access, not technology, poses greatest challenge in effort to save lives in world’s poorest countries
17 January 2005, New York—Developing countries must focus on scaling up and strengthening their health systems in order to save the lives of millions of children and hundreds of thousands of mothers who die every year of easily preventable or treatable conditions, according to the UN Millennium Project’s Task Force on Child and Maternal Health. The task force report—Who’s Got the Power?: Transforming Health Systems for Women and Children—released today is part of a detailed global action plan for fighting poverty, disease and environmental degradation in developing countries.
Approximately 10.8 million children under age 5 and about 530,000 women of reproductive age die every year. A woman living in sub-Saharan Africa has a 1 in 16 chance of dying in pregnancy or childbirth. This compares with a 1 in 3,700 risk for a woman from North America. Moreover, comparison between richest and poorest groups within countries reveals enormous disparities in child and maternal mortality and in access to key life-saving interventions.
The team of experts was led by Dr. Allan Rosenfield, Prof. Lynn Freedman and Prof. Ronald Waldman of the Mailman School of Public Health at Columbia University, and Dr. A.Mushtaque R. Chowdhury, Deputy Executive Director of BRAC (Bangladesh), one of the largest indigenous nongovernmental organizations in the world. Though child mortality has declined steadily in the last two decades, progress on key indicators is now slowing, and in parts of sub-Saharan Africa, child mortality is rising. According to the task force, progress has been even more elusive for maternal mortality.
“The need for existing technology and specific health interventions, such as oral rehydration therapy for children and access to emergency obstetric care for women, is essential for preventing many deaths,” the report said. “Yet, even when the technology is available, the central challenge is to tackle the problem of implementation and of ensuring access to these interventions.”
The Task Force advances a comprehensive set of recommendations, including the following:
- Policies should be changed to strengthen health systems, treating them as core social institutions, where patients are regarded as citizens with the right to quality health services that are provided free at the basic level.
- International development agencies and national overnments should place a priority on healthcare systems as part of a strategy to reduce poverty in developing countries and develop ways of retaining skilled health workers in local public health systems.
- Child health interventions, including breastfeeding and oral rehydration,must be scaled up to ensure 100% coverage, with increased attention to reducing deaths amongst newborns.
- Reduction of maternal deaths depends on creating functional health systems that ensure access to emergency obstetric care and to skilled attendants at delivery.
- Universal access to sexual and reproductive health services, information and education should be guaranteed as an intrinsic part of strategies to reduce child deaths and improve maternal health.
The report gives voice to the importance of addressing the healthcare needs of mothers and children in meeting commitments forged in 2000 at the Millennium Summit, where world leaders agreed to make the fight against poverty—and all of its faces—in developing countries their priority. The summit inspired the Millennium Development Goals, which are built on the recognition that, from health to the environment, from education to gender equality, a growing list of development issues can no longer be managed solely within the boundaries of a single nation.
The task force recommendations for reducing child mortality and improving maternal health are part of the UN Millennium Project, which was commissioned by the UN Secretary-General in 2002 to develop a practical plan of action for enabling developing countries to meet the Millennium Development Goals and reverse the grinding poverty, hunger and disease affecting billions of people. As an independent advisory body directed by Professor Jeffrey D. Sachs, the UN Millennium Project submitted its final recommendations
in January 2005.
The Task Force on Child and Maternal Health is one of 10 UN Millennium Project Task Forces that together comprise some 265 experts from around the world, including members of parliament; researchers and scientists; policymakers; representatives of civil society; UN agencies; the World Bank; International Monetary Fund; and the private sector. The UN Millennium Project Task Force teams were challenged to diagnose the key constraints to meeting the Millennium Development Goals and present recommendations for overcoming the obstacles to get nations on track to achieving them by 2015. |