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How Attainable are the Millennium Development Goals for a Developing Country like South Africa. Minister Theuns Botha Western Cape Government: Health UCT South African Medical Students Association 6 March 201 3. What are MDG’s. 8 international development goals

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how attainable are the millennium development goals for a developing country like south africa

How Attainable are the Millennium Development Goals for a Developing Country like South Africa

Minister Theuns Botha

Western Cape Government: Health

UCT South African Medical Students Association

6 March 2013

what are mdg s
What are MDG’s
  • 8 international development goals
  • Set after UN Millennium Summit in 2000
  • Signed by all 193 member states and 23 international organisations
  • They set very specific targets o be attained by 2015
mdg s recognise the importance of social determinants
MDG’s recognise the importance of social determinants

PRE-DETERMINANTS

Material: food, water, air, income, housing

Policies: childcare, minimum wage, benefits, occ. Health

Society: cohesion, values, tolerance, diversity

  • Differential exposure
  • Differential vulnerability
  • Differential outcomes
  • Differential consequences

Dalgren and Whitehead framework 1991

the mdg s
The MDG’s
  • Eradicating extreme poverty and hunger
  • Achieving universal primary education
  • Promoting gender equality and empowering women
  • Reducing child mortality rates
  • Improving maternal health
  • Combating HIV/AIDS, malaria and other diseases,
  • Ensuring environmental sustainability
  • Developing a global partnership for development.
mdg 1 eradicate extreme poverty
MDG 1Eradicate extreme poverty
  • Poverty generally results in poor levels of nutrition, increased levels of food insecurity and incidence of malnutrition.
  • Multiple deprivation is key risk factor for the Burden of disease
one health related mdg goal
One health-related MDG goal

From Millenium Development Goals Republic of South Africa Country report UNDP 2010

severe malnutrition
Severe Malnutrition

Western Cape has achieved this target

slide9

Systematic review of nutrition studies in the Western Cape

  • Dual epidemic
  • Under nutrition
  • Over nutrition
what are we doing about this
What are we doing about this?
  • Promotion of breast feeding:
    • Mother and Baby friendly health facilities
  • Vitamin A supplementation in children under 5years at health facilities
  • Nutrition programme at primary schools
  • Mandatory fortification of maize & bread
mdg 4 reduce child mortality
MDG 4Reduce child mortality
  • The overall health of children is reflected in infant and child mortality and coverage of immunisation for preventable diseases such as polio and measles.
even though not likely to achieve target child mortality rates are reducing in sa
Even though not likely to achieve targetchild mortality rates are reducing in SA

56

53

Target

20

18

40

42

37

30

infant mortality in the western cape
Infant mortality in the Western Cape

Target

20

18

26

21

Achievable in Western Cape

what are we doing about it
What are we doing about it?
  • Improve key socio-economic factors that impact on health status of children e.g. water, sanitation, food security
  • Enhance access to and quality of child health services, particular PHC services
  • Expand PMTCT and nutrition programmes
  • Prioritiseintegrated management of childhood illnesses (IMCI)
  • Promotion of breast feeding
  • Improve immunisation coverage
life expectancy at birth is increasing but target of 70 years will not be achieved
Life expectancy at birth is increasing but target of 70 years will not be achieved

WC: In 2001-2006 males was 57.yyears and 63.9 years for females,

in 2006-2011 has increased to 59.9 years for males and 65.8years for females.

(SOURCE: StatsSA, mid term population estmates 2011)

mdg 5 improve maternal health
MDG 5Improve maternal health
  • Good maternal health reflects on the quality of and access to maternal (reproductive and sexual) health care and the status of women in society
  • Related to MDG goal 3 “Promote gender equality and empower women”.
mdg goals
MDG goals

From Millenium Development Goals Republic of South Africa Country report UNDP 2010

maternal mortality western cape per 100 000 live births
Maternal Mortality Western Cape(per 100 000 live births)

Target 36

Confidential Inquiry MMR

Unlikely to be achieved in Western Cape

use of modern contraceptive method
Use of modern contraceptive method

Target 70%

Achievable in Western Cape

what are we doing about it1
What are we doing about it?
  • Standardised protocols to manage causes of maternal mortality
  • Improve obstetric skills
  • Improve management of pregnant women
  • Improve referral systems
  • Strengthen post natal care
  • Improve quality of family planning services
  • Eliminate deaths from unsafe abortions
mdg 6 combat hiv aids malaria other diseases
MDG 6Combat HIV/AIDS malaria other diseases
  • Dealing with the challenges of HIV and TB and malaria where this is endemic.
hiv goals
HIV goals

From Millenium Development Goals Republic of South Africa Country report UNDP 2010

slide28

Prevention

Tap = incidence

Bucket = population

ART

HIV prevalence

Treatment

Plug hole = mortality

hiv in western cape
HIV in Western Cape

Target <9.3%

Western Cape 11.6%

condom use at last sex not necessarily high risk sex
Condom use at last sex(not necessarily high risk sex)

Target for condom use at last high risk sex 100%

access to antiretorvirals in sa
Access to antiretorvirals in SA

Target 100%

Western Cape close to 100%

tuberculosis
Tuberculosis

From Millenium Development Goals Republic of South Africa Country report UNDP 2010

siamese twins hiv and tb in areas of deprivation
Siamese twins: HIV and TB in areas of deprivation

~300,000 HIV infected individuals

~50,000 diagnosed TB cases per annum

Of HIV-infected people, 86% are in 14 sub-districts

Of TB diagnoses, 76% are in the same 14 sub-districts

in a nut shell
In a nut shell
  • Signifant progress has been made but unlikely to meet all targets
  • SA has met the target for getting orphaned children in school & antenatal coverage
  • SA is likely to meet targets for:
    • Increasing immunisation coverage
    • Having all births attended to by a professional
  • SA will possibly meet targets for
    • Reducing severe malnutrition
    • Reducing HIV in young people
we are not alone e g child mortality
We are not alone e.g. child mortality

SOURCE: Global MDG report 2012

where to from here
Where to from here?
  • Likely that MDG’s will continue beyond 2015
  • Likely other issues will be included such as:
    • eradicating poverty and hunger by 100% and not just 50%
    • Include other diseases such as chronic diseases (?injuries)
    • Empowering both men and women
    • Global agenda on defeating corruption, as well as for good governance
provincial strategic plan
Provincial Strategic Plan

Strategic Objective 1: Creating opportunities for growth and jobs

Strategic Objective 2: Improving education outcomes

Strategic Objective 3: Increasing access to safe and efficient transport

Strategic Objective 4: Increasing wellness

Strategic Objective 5: Increasing safety

Strategic Objective 6: Developing integrated and sustainable human settlements

Strategic Objective 7: Mainstreaming sustainability and optimising resource use efficiency

Strategic Objective 8 &9: Promoting social inclusion and reducing poverty

Strategic Objective 10: Integrating service delivery for maximum impact

Strategic Objective 11: Increasing opportunities for growth and development in rural areas

Strategic Objective 12: Building the best-run provincial government in the world.

the six priorities for wellness
The six priorities for wellness
  • Decreasing the incidence Infectious Diseases (HIV and TB)
  • Preventing violence and road injuries prevention
  • Healthy lifestyles to address non communicable diseases
  • Women’s health
  • Maternal and child health
  • Mental Health
what can you do as a health professional
What can you do as a health professional?
  • Understand that health is more than just the absence of disease
  • Provide effective and efficient health services
    • but these are not the only essential ingredient required for increasing wellness
    • recognise the importance of other disciplines e.g. CHW
    • balanced health services (CBS, PHC, Hospital services)
    • Patient centred care not a nice to have: improved outcomes
  • Become an upstream advocate and become an health activists
    • Do your job to the best of your ability
    • Challenge other sectors to also do their bit!
thank you
Thank you

Worcester Hospital