Category Archives: SRHR

Urban population boom poses massive challenges for Africa and Asia

The UN predicts that two-thirds of the world will live in cities by 2050, with 90% of growth taking place in the global south

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Two-thirds of the world's population will live in cities by 2050, posing unique infrastructural challenges for African and Asian countries, where 90% of the growth is predicted to take place.

The planet's urban population – which overtook the number of rural residents in 2010 – is likely to rise by about 2.5 billion to more than 6 billion people in less than 40 years, according to a UN report. Africa and Asia "will face numerous challenges in meeting the needs of their growing urban populations, including for housing, infrastructure, transportation, energy and employment, as well as for basic services such as education and healthcare", it adds.

Future development targets should focus on creating inclusive cities with adequate infrastructure and services for all residents, said John Wilmoth, director of the UN's population division. "Managing urban areas has become one of the most important development challenges of the 21st century," he said. "Our success or failure in building sustainable cities will be a major factor in the success of the post-2015 UN development agenda."

The report says rapid urbanisation will bring opportunities for governments to improve access to important services. "Providing public transportation, as well as housing, electricity, water and sanitation for a densely settled population is typically cheaper and less environmentally damaging than providing a similar level of services to a predominantly rural household," it says.

Africa is projected to experience a 16% rise in its urban population by 2050 – making it the most rapidly urbanising region on the planet – as the number of people living in its cities soars to 56%.

The report predicts there will be more than 40 megacities worldwide by 2050,each with a population of at least 10 million. Delhi, Shanghai and Tokyo are predicted to remain the world's most populous cities in 2030, when each is projected to be home to more than 30 million people.

"Several decades ago most of the world's largest urban agglomerations were found in the more developed regions, but today's large cities are concentrated in the global south," the UN says. "The fastest growing urban agglomerations are medium-sized cities and cities with fewer than 1 million inhabitants, located in Asia and Africa."

The world's 3.4 billion-strong rural population will start to decline as urbanisation becomes more common, the report says. The UN projects that rural populations will increase in only a third of countries between 2014 and 2050, as states with large rural communities will take longer to urbanise. "In general, the pace of urbanisation tends to slow down as a population becomes more urbanised," the report says.

The UN cautions that sustainable urbanisation requires cities to generate better income and employment opportunities, and "expand the necessary infrastructure for water and sanitation, energy, transportation, information and communications; ensure equal access to services; reduce the number of people living in slums; and preserve the natural assets within the city and surrounding areas".

Urbanisation has historically taken place in wealthy countries, but such expansion is now happening most rapidly in upper-middle-income countries, where gross national income per capita is between $1,046 and $4,125.

Source: http://www.theguardian.com/global-develop​ment/2014/jul/10/urban-population-growth-africa-asia-united-nations

Post-2015 Agenda: Organized Chaos or Hot Mess?

Sexual and Reproductive Health in Trouble as Goals Move Forward 

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The latest version of the zero draft report from the Open Working Group developing the Sustainable Development Goals (SDGs) hit the internet late Monday evening. This is the final draft that member states will have a chance to respond to before the final report is produced and shared with the Secretary General prior to the United Nations General Assembly in September. It is fairly similar to the last draft in that it still has the same 17 goals, with small semantic differences. Overall, there are fewer targets, but both the targets and the process are becoming increasingly convoluted.

 

This draft misses the integration, aspiration, transformation and sustainability that were meant to drive the post-2015 agenda.  We see important targets missing in this lengthy draft, but we have yet to really see the difficult trade-offs that a final set of implementable goals would require.

 

How have sexual and reproductive health and rights fared?

 

Sexual and reproductive health has disappeared from the Health Goal. While a target on sexual and reproductive health was previously included under both the Health and Gender goals, it now only appears under the Gender goal as “ensure universal access to sexual and reproductive health and reproductive rights in accordance with the Programme of Action of the ICPD and the Beijing Platform for Action.” This is problematic for two reasons:

 

1.    Without SRH under the health goal, family planning is in jeopardy of not being recognized in this new development framework. SRHR is a major component of overall health not only for women and girls, but also for men and boys. It is therefore critical to be included within a discussion of health.

 

2.    The qualifier of ICPD and Beijing is unnecessary and weakens the human rights frame of the target. Nowhere else in the Open Working Group’s draft document is such a caveat introduced. As such, it undermines the principle of arriving at a forward-looking set of SDGs. There is no need to qualify universal access to sexual and reproductive health or reproductive rights. With a reference to ICPD and Beijing already in the introduction, we hope to see this qualifier removed.

 

What are other notable points?

 

  • It is good to see that in proposed Goal 6  (Ensure availability and sustainable use of water and sanitation for all), the following target remained: “By 2030, achieve adequate sanitation and hygiene for all, paying special attention to the needs of women and girls.” This is critical to mainstreamed access to reproductive health.
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  • Comprehensive sexuality education also remains absent from the latest document and should be inserted, ideally under the education goal.
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  • Equity has been and will continue to be a prevailing narrative in the post-2015 agenda.

 

What’s next?

 

In New York for the Open Working Group session last week, you could see will, desire, and investment on the faces of delegates, civil society, co-chairs. But you could also see the fatigue. This has been a long and intensive exercise that has lasted nearly two years already. Now is the time point to put words down on paper and respond to drafts in order to rescue the jumbled mess that the draft goals have become.

 

The final round of informal discussions by the Open Working Group takes place July 14 to 18. The co-chairs (from Kenya and Hungary) will incorporate this final feedback from member states into a final report submitted to the Secretary General in August. A report will simultaneously be submitted by the Intergovernmental Committee of Experts on Sustainable Development Financing. The Secretary General will then take these inputs, among others, and produce his own report, and full negotiations are expected to start in January 2015. The co-chairs of the post-2015 summit (September 21 to 23) are Denmark and Papua New Guinea.

 

By A. Tianna Scozzaro, Population and Climate Associate - 

3 July 2014

Source: http://www.populationaction.org/blog/2014/07/03/post-2015-agenda-organized-chaos-or-hot-mess/#sthash.VKfcdhBU.dpuf

UN warns some MDG targets may be missed

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There is a risk that Millennium Development Goals aimed at improving child and maternal mortality and expanding access to sanitation will be missed, the United Nations has warned.

 

With a little over a year to go to ensure the eight MDG targets are met, the UN this week issued a progress report, which showed that goals on poverty reduction, improving drinking water sources, improving the lives of slum dwellers and achieving gender parity in primary schools had already been met.

 

Progress was also being made on MDGs covering hunger, debt relief and malaria, tuberculosis and HIV treatment.

 

‘However, some MDG targets related to largely preventable problems with available solutions, such as reducing child and maternal mortality and increasing access to sanitation, are slipping away from achievement by 2015, despite major progress,’ the UN said.

 

‘The report calls on all stakeholders to focus and intensify efforts on the areas where advances have been too slow or not reached all.’

 

More reliable statistics were needed for monitoring development, the report said. It noted that the number of member states submitting progress reports on HIV/Aids increased from 102 in 2004 to 186 in 2012, helping galavanise global efforts. Funding for HIV programmes more than tripled in this period and 9.5 million people living with HIV were accessing antiretroviral treatment in 2012.

 

UN member states are currently considering a new set of development goals that can replace the MDGs in 2015. These are likely to be agreed in September next year.

 

UN secretary general Ban-Ki Moon said: ‘Our efforts to achieve the MDGs are critical to building a solid foundation for development beyond 2015. At the same time, we must aim for a strong successor framework to attend to unfinished business and address areas not covered by the eight MDGs.

 

‘Tackling growing inequality, in rich and poor countries alike, has become the defining challenges of our times. Our post-2015 objectives must be to leave no one behind.’

By Vivienne Russell

9 July 2014

http://www.publicfinanceinternational.org/news/2014/07/un-warns-some-mdg-targets-may-be-missed/

 

Poverty, child, maternal deaths high in India: UN report.

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United Nations: India continues to battle poverty, child and maternal deaths, according to a United Nations report on the Millennium Development Goals that said while several key global targets have been met, more sustained effort is needed to cover disparities by the 2015 deadline.

The 'Millennium Development Goals Report 2014', launched by UN Secretary-General Ban Ki-moon here yesterday, said many global MDG targets on reducing poverty, increasing access to improved drinking water sources, improving the lives of slum dwellers and achieving gender parity in primary schools have already been met.

Many more goals are within reach by their 2015 target date, the report said, adding that if current trends continue, the world will surpass MDG targets on malaria, tuberculosis and access to HIV treatment.

The report is the most up-to-date "global scorecard" on efforts to achieve the eight mostly anti-poverty goals agreed by world leaders at a UN summit in 2000.

It, however, said that some MDG targets related to largely preventable problems with available solutions, such as reducing child and maternal mortality and increasing access to sanitation, are slipping away from achievement by 2015, despite major progress.

"We know that achievements have been uneven between goals, among and within regions and countries, and between population groups," Ban said, adding that unless imbalances are addressed through bolder and more focused interventions, some targets will not be met, including in key areas such as childbirth, maternal mortality, universal education, and environmental sustainability.

The overwhelming majority of people living on less than 1.25 dollars a day belong to Southern Asia and sub-Saharan Africa, with one third of the world's 1.2 billion extreme poor living in India alone in 2010.

While Southern Asia has made "strong and steady" progress in reducing child deaths by more than halving its under-five mortality rate, yet nearly one in every three deaths still takes place in the region.India also had the highest number of under-five deaths in the world in 2012, with 1.4 million children dying before reaching their fifth birthday.

Despite progress in all world regions, the maternal mortality ratio in developing regions ? 230 maternal deaths per 1,00,000 live births in 2013 ? was 14 times higher than that of developed regions, which recorded only 16 maternal deaths per 1,00,000 live births in 2013.

Highlighting the extreme differences in maternal mortality among countries, the report said that almost one-third of all global maternal deaths are concentrated in the two populous countries – India and Nigeria.

India has an estimated 50,000 maternal deaths (17 per cent) while Nigeria has an estimated 40,000 maternal deaths (14 per cent).

The report further stated that despite a large increase in sanitation coverage, with an additional two billion people gaining access to an improved sanitation facility, it seems unlikely that the MDG target of 75 per cent coverage will be met by 2015.

"In 2012, a billion people still resorted to open defecation, a practice that needs to be brought to an end, as it poses a huge risk to communities that are often poor and vulnerable already," the report added.

"Open defecation is most prevalent in Southern Asia, Oceania and sub-Saharan Africa. The vast majority ? 82 per cent ? of people practicing open defecation now live in middle-income, populous countries, such as India and Nigeria," it said, adding that nearly 60 per cent of the one billion people practicing open defecation live in India.

With the 2015 deadline for achieving the landmark goals less that 550 days away, the report said many of MDGs have been met or are within reach. Among the targets that have been met is that the world has reduced extreme poverty by half.

In 1990, almost half of the population in developing regions lived on less than 1.25 dollars a day. This rate dropped to 22 per cent by 2010, reducing the number of people living in extreme poverty by 700 million.

Efforts in the fight against malaria and tuberculosis have shown results with an estimated 3.3 million deaths from malaria being averted between 2000 and 2012 due to the substantial expansion of malaria interventions.

The intensive efforts to fight tuberculosis have saved an estimated 22 million lives worldwide since 1995.

"If the trends continue, the world will reach the MDG targets on malaria and tuberculosis," it said.

Access to an improved drinking water source became a reality for 2.3 billion people and the target of halving the proportion of people without access to an improved drinking water source was achieved in 2010, five years ahead of schedule.

In 2012, 89 per cent of the world's population had access to an improved source, up from 76 per cent in 1990.

Hunger also continues to decline, but immediate additional efforts are needed to reach the MDG target, the report said.

The proportion of undernourished people in developing regions decreased from 24 per cent in 1990?1992 to 14 per cent in 2011?2013. However, progress has slowed down in the past decade.

"Meeting the target of halving the percentage of people suffering from hunger by 2015 will require immediate additional effort, especially in countries which have made little headway, the report added.

Launching the final push towards the United Nations targets, Ban appealed to member states that the global post-2015 objective must be to "leave no one behind".

Ban said the world is "at a historic juncture, with several milestones before us."

Citing gains made in the fight against malaria and tuberculosis and access to HIV treatment, Ban underscored that the report makes clear "the MDGs have helped unite, inspire and transform…And the combined action of Governments, the international community civil society and the private sector can make a difference."

"Our efforts to achieve the MDGs are critical to building a solid foundation for development beyond 2015. At the same time, we must aim for a strong successor framework to attend to unfinished business and address areas not covered by the eight MDGs," said the UN chief.  

PTI

 

First Published: Tuesday, July 08, 2014, 08:44

Source: http://zeenews.india.com/news/health/health-news/poverty-child-maternal-deaths-high-in-india-un-report_28670.html

World leaders review progress on Maternal health

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Prime Minister Erna Solberg of Norway, Co-chair of the MDG Advocates Group, and Graça Machel, Chair of The Partnership for Maternal, Newborn & Child Health (PMNCH), joined world leaders and the reproductive, maternal, newborn and child health (RMNCH) community to review progress toward achieving the  Millennium Development Goals focused on women and children’s health, and to identify targets for healthy women and children for the post-2015 sustainable development agenda.

 

The high-level panel of the MDG Advocates—a group of eminent personalities working to focus attention on the need to deliver on the vision for the Millennium Development Goals (MDGs) and to end poverty by 2030—met in Johannesburg at the 2014 PMNCH Partners’ Forum, cohosted by the Government of South Africa, PMNCH, Countdown to 2015, A Promise Renewed, and the independent Expert Review Group.  The Panel discussed several new reports released at the Forum, including the Countdown to 2015 report for 2014, which tracks progress in the  75 countries that account for the vast majority of maternal and child deaths, and the Success Factors for Women’s and Children’s Health report, which analyzes 10 countries that have made rapid progress toward the MDGs.

 

“Globally, we have made good progress on the MDGs,” said Prime Minister Solberg. “But more can and must be done. With fewer than 550 days until the Millennium Development Goals deadline, time is of the essence to scale up our efforts on behalf of women, children and adolescents.”

 

The leaders called for the new sustainable development agenda to be rights-based, equity focused and to place healthy women, children and adolescents at its core.  Leaders called for the new framework, which will be debated by the UN General Assembly in September, to focus on ending preventable maternal, newborn and child mortality, and to  ensure sexual and reproductive rights, including universal access to quality sexual and reproductive services.

 

Since 1990, both maternal and child mortality have halved and 50 million more children go to school each year. But many challenges remain and further rapid progress on health outcomes will require addressing the multiple determinants of health. For instance, every year 14 million girls are forced into marriage, and in many countries, women and girls still do not have access to adequate education.

 

“Across the world, the rights of women and girls continue to be grossly violated. The burden of poverty on women is ever present.” said Graça Machel.  “Every woman should have access to resources and gain space to assert her aspirations. Nobody should die in child birth. All girls should go to school with their brothers and master the tools for a productive life. ”

 

The Panel also previewed the PMNCH Partners’ Forum Communiqué, which will focus on working across sectors—including education, infrastructure, and economic development—to ensure a comprehensive, broad-based approach to improving women’s and children’s health. The Communique, which was endorsed by the MDG Advocates, called for this comprehensive response to be enshrined in specific new global development goals.

 

“We proved that Innovative Financing can help us to reach the MDGs” said Philippe Douste-Blazy, United Nations Special Advisor on Innovative Financing for Development. “New partners are uniting in South Africa to commit energy and resources towards innovation and saving lives.”

 

Dr. Carole Presern, Executive Director of PMNCH,  said, “Today, we leave with renewed energy to make sure that women, newborns, children and adolescents do not die from easily preventable causes; that sexual and reproductive health and rights are respected and that everyone, everywhere should be able to look forward to a healthy, happy and productive life..”

 

Source: http://www.spyghana.com/world-leaders-review-progress-maternal-health/

International leaders and public health experts call for women and children to be at the centre of the post-2015 development agenda

More than 800 leaders and public health experts from around the world opened a landmark two-day meeting in Johannesburg to review new data and call for accelerated action to improve maternal, newborn and child health. The Partnership for Maternal, Newborn & Child Health (PMNCH) 2014 Partners' Forum was opened by Graça Machel, Chair of PMNCH and African Ambassador for Committing to Child Survival: A Promise Renewed, who is making her first public appearance since the end of her mourning period after the death of her husband, Nelson Mandela.

"The world has made remarkable progress to improve health and expand opportunities over the past 14 years. Despite all efforts, there is still much more to be done," said Graça Machel. "Women and children have not been covered adequately. We must ensure that all women, adolescent girls, children and newborns, no matter where they live, are able to fulfill their rights to health and education, and realize their full potential."

In support of the UN Secretary-General's Every Woman Every Child movement, the Partners' Forum builds on two months of high-level meetings in Toronto, Prague, and Washington, DC, where global leaders and health experts met to discuss strategies to promote the health of women and children. At this Forum, leaders discussed steps to assist countries that have lagged behind in efforts to improve reproductive, maternal, newborn and child health, and made specific recommendations for how to maintain the focus on women and children within the post-2015 development agenda. Notably, participants also pledged their financial and policy support and a range of new resources to support the implementation of the new Every Newborn action plan (ENAP), a roadmap to improve newborn health and prevent stillbirths by 2035.

"We are privileged as a country to host this important meeting about the urgent need to improve women's and children's health. This global gathering gives us the opportunity to learn from each other's successes and challenges, and to identify new approaches," said Dr. Aaron Motsoaledi, South African Health Minister. The Government of South Africa is a Forum co-host, together with PMNCH, Countdown to 2015, A Promise Renewed and the independent Expert Review Group.

Despite improvements, 289,000 women still die every year from complications at birth and 6.6 million children do not live to see their fifth birthday, including nearly 3 million newborns. At least 200 million women and girls are unable to access family planning services that would allow them to control when they have children.

The world has been especially slow in improving health outcomes for newborns. Globally, each year, 2.9 million newborns (first 28 days of life) die and 2.6 million are stillborn (die in the last three months of pregnancy or during childbirth). Recent data published in The Lancet Every Newborn Series indicate that 15,000 babies are born and die every day without ever receiving a birth or death certificate. The accompanying analysis found that 3 million maternal and newborn deaths and stillbirths in 75 high burden countries could be prevented each year with proven interventions that can be implemented for an annual cost of only US$1.15 per person.

Responding to this crisis, partners at the Forum launched the ENAP, endorsed by the World Health Assembly in May 2014. The action plan is based on concrete evidence to further reduce preventable newborn deaths and stillbirths. Signalling their support for the full and prompt implementation of the plan, Forum attendees announced 40 new commitments. These commitments are in support of the UN Secretary-General's Every Woman Every Child movement and come from a diverse group of stakeholders, including governments, civil society organizations and the private sector.

"There is absolutely no reason for so many newborns to die every year when their lives can be saved with simple, cost-effective solutions," said Dr. Flavia Bustreo, Assistant Director-General for Family, Women's and Community Health at the World Health Organization. "The WHO remains committed to support countries and work with partners as the plan gets implemented, and to the accountability agenda, which includes reporting on progress achieved every year until 2030."

New data is critical to inform discussions about changing this reality. Today, partners at the Forum released the Countdown to 2015 Report for 2014, which presents the latest assessment of progress in the 75 countries that account for 95 percent of all maternal and child deaths each year. The report finds that in several countries, more than half of the mothers and children in the poorest 20 percent of the population still receive two or fewer of the eight interventions deemed essential for preventing or treating common causes of maternal and child death, including vaccinations, skilled birth attendance, pneumonia and diarrhea treatment, and access to family planning. The analysis shows that, in these 75 countries, a median of 39 percent of deaths of children under age five occur during the first month of life, underscoring a need for improved access to quality skilled delivery care for mother and baby around the time of birth, when most stillbirths and maternal and newborn deaths occur.

"We have affordable interventions that we know work. There's no excuse for not bringing them to the women and children who need them," said Dr. Mickey Chopra, Chief of Health at UNICEF and co-Chair of Countdown to 2015. "The health and well-being of our next generation, and the right of millions of children to live happy, productive lives, is at stake."

One other report was also launched at the 2014 PMNCH Partners' Forum: Success Factors for Women's and Children's Health Report spotlights 10 "fast track" countries making considerable progress in reducing maternal and child deaths, showing that rapid progress is possible despite significant social and economic challenges. The report showed the benefits of investing in high-impact interventions such as skilled care at birth, immunization, and family planning.

Delegates at the Forum emphasized the importance of ensuring that future efforts focus on countries that are making slow progress, and on poor and marginalized populations, including newborns and adolescents. Delegates also urged political leaders to work across different sectors—including education, skills and employment, water supply and sanitation, nutrition, energy, roads, and women's empowerment—to ensure an integrated approach to improving the health of women and children.

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PMNCH

The Partnership for Maternal, Newborn & Child Health (PMNCH) is a partnership of 625 organizations from across seven constituencies: governments, multilateral organizations, donors and foundations, nongovernmental organizations, healthcare professional associations, academic, research and training institutions, and the private sector. Hosted by the World Health Organization and launched in 2005, the vision of the Partnership is the achievement of the Millennium Development Goals, with women and children enabled to realize their right to the highest attainable standard of health in the years to 2015 and beyond.

Government of South Africa

The Government of South Africa recognizes that success in achieving better health outcomes as a country depends on partners' collective ability to build relationships and work across sectors. We are highly committed to improving the lives of women and children, and the reduction of maternal and child mortality remains a critical area of focus in South Africa. In 2012, South Africa launched the Campaign on the Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA) strategy, setting goals of reducing maternal and neonatal mortality by more than half between 2013/2014 and 2018/19.

Countdown to 2015

Countdown to 2015 is a global movement to track, stimulate and support country progress towards the health-related Millennium Development Goals, particularly goals 4 (reduce child mortality) and 5 (improve maternal health). Established in 2003, Countdown is supra-institutional and includes academics, governments, international agencies, professional associations, donors, nongovernmental organizations and other members of civil society, with The Lancet as a key partner. The Countdown Secretariat is hosted by the Partnership for Maternal, Newborn & Child Health. Countdown focuses specifically on tracking coverage of a set of evidence-based interventions proven to reduce maternal, newborn and child mortality in the 75 countries where more than 95% of maternal and child deaths occur. Countdown produces periodic publications, reports and other materials on key aspects of reproductive, maternal, newborn and child health, using data to hold stakeholders to account for global and national action. At the core of Countdown reporting are country profiles that present current evidence to assess country progress in improving reproductive, maternal, newborn and child health.

A Promise Renewed

Committing to Child Survival: A Promise Renewed is a global movement to end preventable child deaths. Under the leadership of participating governments and in support of the United Nations Secretary-General's Every Woman Every Child strategy, A Promise Renewed brings together public, private and civil society actors committed to advocacy and action for maternal, newborn and child survival. A Promise Renewed emerged from the Child Survival Call to Action, convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF. The more than 700 government, civil society and private sector participants who gathered for the Call to Action reaffirmed their shared commitment to scale up progress on child survival, building on the success of the many partnerships, initiatives and interventions that currently exist within and beyond the field of health. A Promise Renewed is represented on the Forum steering committee by USAID and UNICEF.

Independent Expert Review Group (iERG)

The UN Commission on Information and Accountability for Women's and Children's Health was established by WHO at the request of the United Nations Secretary-General to accelerate progress on the Global Strategy for Women's and Children's Health. Starting in 2012 and ending in 2015, the iERG is reporting regularly to the United Nations Secretary-General on the results and resources related to the Global Strategy and on progress in implementing this Commission's recommendations.

30 June 2014

By All Africa

Source: http://allafrica.com/stories/201406300590.html?viewall=1

Invest in Adolescents and Young People for a Better Future

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The Partnership for Maternal, Newborn and Child Health (PMNCH) Partners’ Forum begins on June 30th in South Africa. The annual conference brings together global partners in the maternal, newborn, and child health communities to discuss trends, challenges, and opportunities in ensuring the wellbeing and empowerment of the world's children and women. With the Millennium Development Goals set to expire in 2015, this year’s conference will have a particular focus on envisioning the post-2015 development framework. Ahead of the event, Women Deliver launched a new infographic and co-hosted a Google+ Hangout with Girls’ Globe and young leaders to reignite a conversation about the importance of investing in the health and rights of adolescents and young people.

The new infographic brings attention to the current global status of today’s youth. It highlights the barriers that young people, particularly young women, face in fully realizing their rights and makes the case for meaningful youth participation in the development processes. The infographic joins six others in a series, all devoted to a variety of girls’ and women’s health and rights issues.

The Google+ Hangout was moderated by Julia Wiklander from Girls’ Globe and Women Deliver Young Leader Yemurai Nyoni from Zimbabwe and Kelly Thompson from the International Federation of Medical Students’ Associations, among others, joined the discussion. Participants shared their perspectives on why governments must recognize the human rights, including the sexual and reproductive rights, of young people, as well as include youth voices in the design and implementation of programs that affect their lives.

View the infographic here.

Source: http://www.womendeliver.org/updates/entry/invest-in-adolescents-and-young-people-for-a-better-future

 

SA making progress in reducing maternal mortality

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05-6-2014

 

Pretoria – The Department of Health has welcomed findings that South Africa is one of the 16 sub-Saharan countries that stand a chance of meeting the Millennium Development Goal (MDG) on maternal mortality by 2015.

According to the findings of the study undertaken by the University of Cape Town’s Hatter Institute for Cardiovascular Research in Africa, in conjunction with the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, the number of maternal deaths has dropped from about 376 000 in 1990 to about 293 000 in 2013.

Maternal mortality in the country has dropped by almost 7% a year over the past decade – at 171.4 maternal deaths per 100 000 live births.

The study showed that 30 countries had annual reductions in the Maternal Mortality Rate (MMR) of MDG 5 pace or better from 2003 to 2013.

“Eight of which were in sub-Saharan Africa (Botswana, Burundi, Kenya, Malawi, Namibia, Rwanda, South Africa, and Swaziland) and 10 in central and eastern Europe (Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Estonia, Latvia, Lithuania, Poland, Romania, and Russia,” according to the findings.

However, the study noted that despite reductions in the number of maternal deaths, only 16 countries, seven of which are developing countries, are expected to achieve the MDG 5 target of a 75% reduction in the MMR by 2015.

Speaking to the GCIS Radio Bulletin, health spokesperson Joe Maila stressed the need to work very hard to make sure that the numbers decline even further.

“The numbers that are there right now are not as good and we want them to be less than what it is. We need to make sure that we work very hard to make sure that it indeed declines further.

“If we work together with all the people involved, one of the things we can do is to make sure that mothers – as soon as they are pregnant – come to our facilities within 14 weeks. That (way), we would be able to know what is it that we can do to make sure that we restore their health,” said Maila.

The findings were part of a study into maternal mortality across the globe over the past two decades. The study aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.

MDG 5 established the goal of a 75% reduction in the number of maternal deaths per 100 000 live births between 1990 and 2015.

According to the 20 Year Review released by The Presidency in February, life expectancy in the country has increased from 52.7 years in 2002 to 59.6 years in 2013. The Infant Mortality Rate has decreased from 63.5 deaths per 1 000 live births in 2002, to 41.7 deaths per live births in 2013.

The under-five mortality rate has also decreased from 92.9 deaths per 1 000 live births in 2002 to 56.6 deaths per 1 000 live births in 2013. Severe malnutrition among children has decreased from 88 971 in 2001 to 23 521 in 2011. –SAnews.gov.za

Source: http://www.sanews.gov.za/south-africa/sa-making-progress-reducing-maternal-mortality

 

Maternal and Child Health in Kenya

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Why Are Women Dying to Give Life and Children Not Surviving to Experience Childhood?

A recent article Changing Lives, One Woman at a Time: Maternal Heath in Kenya by Siddharth Chatterjee, the United Nations Population Fund (UNFPA) Representative to Kenya and Dr. Abbas Gullet the SG of the Kenyan Red Cross (KRCS) concluded with the words: "no woman should die giving life."

Kenya is a country of incredible contradictions. As the richest country in East Africa,with $840 income per capita, Kenya is the closest to meeting the international middle -income threshold of $1,000. This is a significant rite of passage, but that annual income is still less than $3 per day. The peaceful elections in 2013 and reforms enhancing security and governance have renewed investor confidence-economic growth, estimated at 4.9 percent in 2013 and expected to increase to 5.7 percent in 2014.

Much progress has been made in approaching some of the Millennium Development Goals — examples include Kenya's poverty rate, which has declined from 56 percent in 2000 to 42 percent in 2009 (still a grotesque number). Primary school enrollment reached 84 percent in 2008-2011 (although we must remember this statistic does not account for quality of education, gender inequities in enrollments and secondary school outcomes). Certain health indicators have shown improvement — immunization coverage rates in 201 ranged from 73 percent (newborn tetanus) to 93 percent (MCV) and use of improved drinking water sources reached almost 61 percent (82.7 percent in urban areas).

Yet this nation, which is hurtling towards "development," boasts some of the worst outcomes for maternal and child health in Africa and the world. In 2010, 360 women died out of every 100,000 live births, ranking Kenya 51st on the list of the 75 countries where more than 95 percent of all maternal and child deaths occur. This represents a negligible improvement from 1990 during which 400 women died out of 100,000 live births (and a far cry from the MDG goal of a 75 percent reduction between 1990 and 2015). According to Save the Children's 15th Annual State of the World's Mother Report, Kenya moved 13 places up in world rankings last year but still holds the shameful 143rd place out of 178 countries that report maternal deaths.

For children under five, mortality in Kenya is a much happier story, but not quite happy enough. Mortality decreased from 98.2 children per 1,000 live births in 1990 to 72.9 in 2012. On an absolute basis, Kenya is significantly off track of the MDG goal of a 75 percent reduction by 2015 but recently has seen a fall of more than 8 percent a year, almost twice the MDG rate and enough to halve child mortality in a decade. Still, "each day 15 women and 290 children die as a result of pregnancy complications — including giving birth, HIV and several curable and preventable childhood diseases." Kenya ranked 33rd globally in under-5 deaths (with approximately 35 percent of all neonatal deaths due to severe infections, followed by asphyxia, preterm births and congenital anomalies). Two-thirds of under-5 deaths are post-natal and leading causes include pneumonia and diarrhea. Over 34,000 stillbirths occur a year and 1/3 of children under-5 are stunted, a sign of chronic malnutrition.

Gabriel Demombynes (World Bank Nairobi office) attributes Kenya's success in cutting the rate of infant mortality (deaths of children under one year old) more than any other country to the relatively healthy economy, a functioning democracy and the increased use of treated bed nets from 8 percent of all households in 2003 to 60 percent in 2008. Using figures on the geographical variation of malaria, he calculated that half the overall drop in Kenya's infant mortality can by explained by the huge rise in the use of ITNs in areas where malaria is endemic.

So what is behind this painstakingly slow progress on maternal health in Kenya, especially in light of the enlightened approach to many development issues, including infant mortality? Clearly abject poverty as alluded to above is an overwhelming issue especially in rural areas. With 42 percent of the country still living below the poverty line, access to adequate health care is more than a challenge. Maternal morbidity and mortality in Kenya results from the interplay of social, cultural, economic and logistical barriers, coupled with a high fertility rate (3.76 children born per woman as per World Bank) and inadequate and under-funded health services ($17 US per capita in 2012 according to WHO data). Inadequate water supply, sanitation and hygiene resulting in WASH related illness is the reason for over 50 percent of the hospital visits in Kenya. According to the Kenya AIDS Indicator Survey released by the government in 2009, approximately 1.33 million adults were infected with HIV and many more unaware of the illness. A disproportionate number of those infected by HIV were women (8.7 percent vs 5.6 percent for men), contributing to negative health outcomes.

Tens of thousands of Kenyan women and girls in Kenya suffer from obstetric fistula, a childbirth injury causing leakage of urine and feces, a direct result of inadequate health services. While approximately 92 percent of women giving birth received some antenatal care in 2010 only 47 percent had the recommended 4 or more visits and 56 percent of Kenyan women deliver their babies at home (more in rural areas). Only 44 percent of births were assisted by health care professionals, well below the target of 90 percent of deliveries by 2015, and these rates of antenatal care and skilled birth attendance have declined over the past 10 years, particularly among the poor. Traditional birth attendants assist with 28 percent of births, relatives and friends with 21 percent and in 7 percent of births, mothers receive no assistance at all.

Together with income, education also plays a major role in determining maternal health outcomes, including fertility rates, access to family planning and antenatal coverage. Women with higher education are much more likely to receive antenatal care from a medical doctor than are those with no education (36 vs 21 percent) and clearly the higher the wealth quintile, the more likely a woman is to get antenatal care from a doctor. Although the Constitution of 2010 permits abortions to protect the life or health of a mother, women in Kenya continue to turn to unsafe procedures by unskilled practitioners en masse, due to lack of awareness of the law, stigmas against abortion, resistance from health workers and fear of prosecution by police.

Kenya would do well by drawing lessons and inspiration from success stories in other countries. Today, more than ever, actors at all levels, from large government bodies to small local non-governmental organizations (NGOs) are innovating programs that can directly impact maternal and reproductive health, thereby bringing the MDGs into the reach of many poor and underserved communities. Successful programs in countries like Ethiopia, India and Bangladesh have focused on two key facts; one, often the poorest women who are in dire need of health care live in hard-to-reach rural areas and two, mobile phone technology has expanded at a rapid pace in developing countries.

Since 2000, Ethiopia has reduced the risk of maternal death by nearly two-thirds (from 1 in 24 to 1 in 67). The country's Health Extension Programme created access to preventive services as well as high impact curative interventions at the community level. The deployment of more than 38,000 health extension workers bridged the gap between the community and hospitals, In addition, the Ethiopian government built 3,525 health centers and 16,048 posts to increase access to essential services to communities across the country.

Saadhan in India is a helpline that poor customers can call to access information regarding reproductive health. The service is supplemented by Community Health Workers who can then make house calls, provide information on contraception and refer patients to doctors.

The Indian government's 'Boat Clinics' are aimed at reaching geographically isolated communities in the north-eastern state of Assam. Boats carrying doctors, nurses, lab technicians and pharmacists make regular visits by boat and work with local community health workers to provide mothers and children with necessary services like routine immunization of children 0-5 years and pregnant mothers, vitamin A supplementation, general health check-ups and provision of family planning information and education.

In Bangladesh, the Demand Side Financing Pilot Program provides subsidies and vouchers to pregnant women so they can cover travel costs for regular antenatal health check-ups, deliver their children in hospitals or community health centres and to pay for medication. A similar program also exists in Cambodia.

In Kerala, a study from the International Center for Research on Women revealed that strengthening women's land rights reduces women's risks of HIV, protects women from poverty and sexual violence, and promotes child nutrition and schooling

Lessons from these parts of the world also show cash subsidies, conditional cash transfers and vouchers are all effective tools to aid poor mothers in accessing much-needed maternal health services.

Social workers and policy analysts from developing countries are now extolling the virtues of public-private partnerships (PPP) with regard to maternal and reproductive health care. PPPs combine the reach and muscle of large governmental bodies with the flexibility and ground-level reality understanding of smaller, private institutions.

For example, in Zambia, Merck for Mothers took the step of asking mothers in poor communities about their experiences and what was lacking. This type of 'market research' enabled them to tailor their services to fit the community in question.

Kenya's challenge is now two-fold. It must expand access and information regarding health care and it must make maternal health care affordable. The commitment to the cause already exists in Kenya. What is needed now is smart and decisive action.

The First Lady of Kenya, Margaret Kenyatta launched launched the Beyond Zero campaign on January 24, 2013 to accelerate the implementation of the national plan towards the elimination of new HIV infections among children. This is an appropriate starting point to address the deep and complex factors that have resulted in Kenya's dismal maternal mortality rates.

UNFPA and Kenyan Red Cross in concert with the Kenyan government have an opportunity here to transplant and adapt these lessons from other developing countries in order to implement them in a Kenyan context. From there, successful examples could also be exported to other sub-Saharan African countries, making Kenya a true leader in the continent and an incubator for innovative social policy.

Indeed, "no woman should die giving life," anywhere in the world.

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Dr. Annie Sparrow, a paediatrician and public health expert, is an Assistant Professor of Global Health and Deputy Director of the Human Rights Program at Icahn School of Medicine at Mount Sinai in New York City.

 

Source: http://www.huffingtonpost.com/anniesparrow/maternal-and-child-health_1_b_5454692.html

Standing together: Reproductive Rights and LGBTQ Rights

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By Jimmy Radosta, Special to PQ Monthly

In the 45 years since the Stonewall riots — where the modern LGBTQ movement was born —we’ve seen extraordinary progress on LGBTQ rights in this country, including last year’s historic ruling against the Defense of Marriage Act and 2011’s repeal of “Don’t Ask, Don’t Tell.” Here in Oregon we finally achieved marriage equality in May, and we’re one of only five states that have affirmed that transition care for transgender individuals should be considered an essential part of medical coverage.

This progress is rooted in the same principles that underlie reproductive rights: that politicians should not get to decide what you do with your body or what your family looks like, and that rights in this country should not depend on the state you live in.

We at Planned Parenthood Advocates of Oregon believe that reproductive rights are deeply connected to civil rights for all Americans. We have long stood with LGBTQ people in the struggle for full equality — many of whom turn to Planned Parenthood for health care, information and education.

Members of the LGBTQ community face greater obstacles to obtaining and benefiting from sexual and reproductive health services than non-LGBTQ people. In addition to high rates of stress due to systematic harassment and discrimination — which has been shown to affect physical and mental health — LGBTQ people face low rates of health insurance coverage, high rates of HIV/AIDS and cancer, and high rates of discrimination from medical providers. LGBTQ people of color are at an even higher risk for these disparities.

This is why Planned Parenthood health centers throughout Oregon welcome LGBTQ patients for STD testing and treatment, lifesaving cancer screenings, and other preventive services. Planned Parenthood Columbia Willamette’s “Equal Access Fund” helps provide gynecological exams for women and trans men who aren’t covered by state pregnancy-prevention funding but meet the same economic requirements.

Planned Parenthood also delivers sex education that covers the full range of topics affecting sexual health, and we provide sensitive and accurate information on sexual orientation and gender identity to Oregonians of all ages every day. Oregon is one of only 12 states to require its sexual health curriculum to be medically accurate. This means that, in the rest of the country, young people are receiving false information about birth control’s effectiveness and the right way to prevent STDs.

While this country has seen significant strides in the LGBTQ movement in recent years, there is still work to be done. This year Oregonians faced the possibility of a ballot measure that could have allowed corporations to deny services to same-sex couples. Meanwhile, the U.S. Supreme Court is expected to rule this month on a lawsuit that could allow corporations like Hobby Lobby to deny their employees insurance coverage for birth control because of their personal beliefs. This could create a slippery slope and let bosses deny a whole host of other medical procedures based on their own personal beliefs – such as vaccines, surgeries, blood transfusions and mental health care. The bottom line is this: When secular, for-profit corporations hire and serve the general public, they shouldn’t get to pick and choose which laws to follow. Planned Parenthood Advocates of Oregon vows continued support for any future legislative efforts that will allow for greater access to health care and information for the LGBTQ community in our state.

At Planned Parenthood, we realize that our incredible patients and supporters don’t comprise any one identity, and we’re grateful for the many volunteers, staff and supporters of all genders and identities who work every day to ensure that Oregonians get the health care and information they need.

This year, 45 years after the birth of the modern LGBTQ movement at Stonewall, we are committed now more than ever to fighting for LGBTQ rights. We know the only way we can move forward — all of us together — is by standing side by side.

Jimmy Radosta is the Communications Director for Planned Parenthood Advocates of Oregon. For more information visit PPAOregon.org.

 

Source: http://www.pqmonthly.com/standing-together-reproductive-rights-lgbtq-rights/19898