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Aid Effectiveness and MDG 5 in Jamaica

Aid Effectiveness and MDG 5 in Jamaica

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Aid Effectiveness and MDG 5 in Jamaica

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  1. Aid Effectiveness and MDG 5 in Jamaica Rudolph Stevens LIHP Programme 2011

  2. Definition • Aid effectiveness is the impact that aid has in reducing poverty and inequality, increasing growth, building capacity and accelerating achievement of the MDGs. (World Bank, 2011)

  3. MDG 5: Maternal Health • 5A: Reduction of Maternal mortality ratio by ¾ by 2015 • 5B: • Adolescent health • Proportion of births attended by skilled practitioners • Contraceptive prevalence

  4. Situational Analysis - Jamaica • Population: 2,699,617 (2009) • Land mass: 11m2 • Literacy Rate: 86% (2009); 80% (1999) • Unemployment rate: 14.4% (2009); • School enrolment • Poverty: 9.9% (2009);19.1% (2003)

  5. Background: Health Infrastructure

  6. Reproductive Health Situational Analysis 1 • Births: 44,000 per year (Avg: 2.3 per woman) Statistical Institute of Jamaica http://statinja.gov.jm/population.aspx • 93% in government hospitals. • Health Seeking Behaviour • 99% attend ANC, 61% in the first trimester • 87% made 4 or more visits • 91% screened for HIV • 97% delivered in hospital by skilled attendant • Cesarean section rate: 15%

  7. RH Situational Analysis 2Reproductive Health Survey, Jamaica 2008, NFPB/STATIN/USAID/CDC • High Risk pregnancies • Inadequate care 41% • Partially adequate care 18% • Women with 5 or more births were less likely to receive adequate care • Educational attainment & socioeconomic status were positively correlated with receiving adequate care • Contraception • Knowledge of Emergency Contraceptives increase 65% from 39% (2002) to 89% (2008) • 73% of women currently in union use contraceptives • Availability of contraceptives increase from 31% to 51%

  8. RH Situational Analysis 3Health Related Behaviour(15-49years) • Gynae Exam: 43% reported ever having • Pap smear: 62% • Breast Cancer: 62% clinical exam & 64.6% BSE • Smoking: current: 3.5%, Ever: 6% unchanged • Recreational drugs: 3.3% • Commonest health condition: hypertension

  9. Maternal Mortality • 120/100,000 (1990) • 30/100,000 (2015) • 88.3/100,000 (2006) • McCawpBinns, A: Safe Motherhood in Jamaica, Paedi and PerinatalEpidemiol, (2005) 19, 254-261 • McCaw-Binns, A et al: Epidemiologic transition in maternal mortality & morbidity: New Challenges for Jamaica, Int J Gynecol & Obstet (2007) 96, 226-232 • Current 2007 – 2009: 105/100,000 (MOH, Director Family Health), June 2011 • Trajectory to 2015

  10. Maternal Mortality 2Table 1 : Illustrating categories of MMRMcCaw-Binns et al Alternative strategies to achieve MDG 5&6 Alliance for Health Policy & Systems Research Project proposal WHO 2010

  11. Table 2: Indicators of MDG 5Adopted & modified from Maung Aung, LIHP 2010 Country Project

  12. Overseas Development Assistancehttp://data.worldbank.org/topic/aideffectiveness • Net ODA received per capita (current US$) • $18.8 (2009) Jamaica • LAC: $15.9 • Europe & Central Asia: $20.0 • East Asia & pacific: $5.3 • Sub- Saharan Africa: $53.0 • Economics • External Debt Stock (% GNI): 77.8%2009 • GNI per capita: U$4,590 (2009)

  13. The Actors • International • PAHO • UNICEF • UNFPA • Local • Ministry of Health

  14. Ownership • Role of national vs international agencies • Stewardship • National Maternal Mortality committee has not met since 2007 • Regional and facility discussion • Functional desk in MOH • Absorptive Capacity issues

  15. Alignment • Partners meeting 2007 • Traditional project to horizontal approach • DFp policy framework: found 90% was disbursed as project funding

  16. Harmonization • Who is talking to who? • Needs an enabling platform for coordination by international partners • World Bank is currently examining with respect to HIV/AIDS

  17. Conclusion • HIV