Maternal newborn health in the pacific
This presentation is the property of its rightful owner.
Sponsored Links
1 / 47

Maternal & Newborn Health in the Pacific PowerPoint PPT Presentation


  • 100 Views
  • Uploaded on
  • Presentation posted in: General

Maternal & Newborn Health in the Pacific. Pasifika Medical Association, Tonga September 2013. “ Children have a right to special care and assistance”. No mother should die giving life. PICT commonalities. Relative isolation Resource poor Collectivism Service & obligation

Download Presentation

Maternal & Newborn Health in the Pacific

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Maternal newborn health in the pacific

Maternal & Newborn Health in the Pacific

Pasifika Medical Association, Tonga September 2013


Maternal newborn health in the pacific

“ Children have a right to

special care and assistance”


No mother should die giving life

No mother should die giving life


Pict commonalities

PICT commonalities

  • Relative isolation

  • Resource poor

  • Collectivism

  • Service & obligation

  • Traditional social structures

  • Scattered populations

  • Geographical isolation

  • Resource poor

  • Cultural diversity

  • Traditional social structure

  • Gender inequity

  • Globalisation

  • Urbanisation

  • Erosion of traditional social structures


Available medical rx technology

Available Medical Rx & technology


Pregnancy and better outcomes

Pregnancy and better outcomes

Pre-pregnancy health

Antenatal care

Health promoting behaviors

Labour & delivery

Postnatal care

Supportive environment

Mortality & Morbidity for mothers

Mortality & morbidity for babies


Mch policy strategy

MCH Policy & Strategy

  • “Regional Child Survival Strategy” 2005

  • “Pacific Policy Framework for Universal access to Reproductive Health” 2008

  • “Achieving MDG 4 & 5 : Scaling up programmes for Women and Childrens Health”. 9th Meeting Pacific MOH’s, 2011.

  • “Global Strategy for Women and Children’s Health” United Nations, 2010

  • “Monitoring maternal newborn and child health: understanding key progress indicators”. UN Health Metrics, 2011


United nations commission on information and accountability 2011

United Nations Commission on Information and Accountability, 2011


11 global mch indicator pacific data

11 Global MCH indicator Pacific data

Data source: World Bank data Bank 2012, Cook Is Census 2011, World Health Statistics 2012, Division of Statistics FSM 2009, Marshall Is 2007, Nauru DHS 2007, Samoa DHS 2009, Global Aids Progress Reporting 2012


Health information vital statistics

Health information & Vital statistics


Dhs data complementing moh data tuvalu under 5 yr mortality

DHS data complementing MOH dataTUVALU under 5 yr mortality


Maternal newborn health challenges opportunities

Maternal & Newborn healthChallenges & opportunities

  • Access to essential interventions

  • New technologies and medication

  • Lack of Investment in Maternal & infant health

  • Unclear policy and strategic direction

  • Not tracking results

  • ?? Accountability


Maternal newborn health challenges opportunities1

Maternal & Newborn healthChallenges & opportunities

  • Maternal obesity

  • Maternal smoking

  • Non-communicable diseases

  • Maternal mental health

  • Family Planning access

  • Adolescent Mothers


Maternal newborn health in the pacific

Adapted from Black et al.2008.Cook I, FSM ,Fiji, Marshal Is, Nauru, Nuie, Palau, PNG, Samoa, Solomon Is, Tonga, Tuvalu, Vanuatu


Children s lives saved if mdg target trajectory increased

Children’s lives saved if MDG target trajectory increased

Adapted from : Asia Pacific MDG Report 2011/12 UNFPA, UNICEF, WHO


Maternal newborn health in the pacific

Oceania

31%

30%

23%


Country neonatal mortality 2010 per 1000 livebirths

Country Neonatal Mortality, 2010per 1000 livebirths


Newborn survival

Newborn survival

  • Maternal health & perinatal care

  • Neonatal resuscitation

  • Neonatal care – warmth, antibiotics, breastfed

  • Postnatal review <3 days


Best bets saving newborn lives

“Best Bets” Saving Newborn lives


Maternal newborn health in the pacific

“Neonatal Resuscitation in Low resource settings. What , who and How to overcome challenges to scale up” Wall et al. 2009


Change in maternal mortality ratio by region 1990 2010 not all on track to achieve mdg 5

Change in Maternal Mortality Ratio by region 1990 – 2010Not all on track to Achieve MDG 5

WHO 2012 “MM Trends”


Mdg 5 reduce maternal mortality by 75 mmr maternal deaths 100 000 births

MDG 5 – Reduce Maternal mortality by 75%MMR (maternal deaths/100,000 births)

MMR

Source: ESCAP database


Maternal deaths saved if off track countries achieved mdg target

Maternal Deaths saved if “Off track” countries achieved MDG target

Adapted from : Asia Pacific MDG Report 2011/12 UNFPA, UNICEF, WHO


Preventing maternal mortality

Preventing Maternal Mortality

  • Maternal / women’s health

  • Prevent unintended pregnancies

  • Antenatal care

  • Skilled birth attendant

  • Access to emergency obstetric care

  • Postnatal care


Why women die

Why women die

Ronsmans et al. Maternal Survival. The Lancet, 2006


Giving birth in the pacific

Giving Birth in the Pacific

  • Ideal = Delivery in a health facility with skilled birth attendant

  • Most continue to deliver at home with Skilled birth attendant access improving

  • Intervention needs to be “at the right time”

    >50% maternal & newborn deaths during the birth period (labour/delivery/postpartum)


Obstetric complications

Obstetric complications


Maternal newborn survival strategies for limited health facility setting

Maternal & Newborn survivalStrategies for limited health facility setting

Community based care

  • Education, access to Family Planning

  • Community Antenatal visits (nutrition, malaria, STI, birth preparedness)

  • Traditional Birth attendants / Village health workers

  • Delivery kits/hygiene/neonatal resuscitation/oral misoprostol

  • Postnatal care – temperature/hygiene/exclusive breast


Giving birth in the pacific the three delays

Giving Birth in the Pacific - The “three delays”

  • Delay in decision to seek care

  • Delay in reaching care

  • Delay in receiving adequate care


The 1 st delay barriers strategies

The 1st delay – barriers & strategies

  • Female Education

  • Antenatal education

  • Antenatal care

  • Community promotion of Maternal & newborn care

  • Low status of women

  • Lack of understanding of pregnancy /labour complications

  • Lack of knowledge of interventions

  • Acceptance of maternal death


The 2 nd delay

The “2nd delay”

  • Geography

  • Isolation & distance

  • Transport, roads

  • Seasonal barriers

  • Climate disasters

  • Cost

  • Transport infrastructure

  • Emergency transport

  • Anticipatory transfer

  • “waiting houses”

  • Patient subsidies


Third delay strategies

“third delay” - strategies

  • Infrastructure

  • Workforce

  • Skilled birth attendants

  • Emergency Obstetric care

  • Technology

  • Equipment & meds

  • Communication


Mdg 5 of births with skilled birth attendant

MDG 5 - % of Births with Skilled birth attendant

%


Maternal newborn health in the pacific

HIV +ve antenatal women receiving antiretroviral treatmentSource: Global Aids Progress Reporting 2012 for individual countries

Pacific MCH Indicators


Essential equipment

Essential equipment


Stillbirth weights ttm hospital samoa 2006 2009

“Stillbirth” weights TTM Hospital, Samoa, 2006-2009

Source: Pacific CHIP project PATIS & Delivery unit record data, Percival & Stowers 2012


Family planning in the pacific

Family Planning in the Pacific

  • 1 in 5 Adolescent girls (15-19yrs) already mothers

  • Increased health risk to mother & baby


Contraception prevalence by region

Contraception Prevalence by region


Improving maternal newborn health

Improving Maternal & newborn Health

  • Leadership (Country & Region)

  • Prioritize mothers and children

  • Prioritize Health

  • Infrastructure & workforce

  • Health Information, Vital statistics

  • Evidence based policy

  • Upscale “best bets”


Levels of maternal newborn care

Levels of Maternal & Newborn care

Essential tools & skills

  • Village level (non-clinical workforce)

  • Core intervention/Rx

  • Expanded care & Rx

  • Comprehensive care & Rx


Maternal newborn health in the pacific

Maternal and newborn health included in other Policy


  • Login