DEPARTMENT
OF COMMUNITY MEDICINE (MPH)
CURRENT ISSUES IN
WOMEN AND CHILD HEALTH IN DEVELOPING COUNTRIES
The current issues in women and child health in developing
countries is as outlined in the following Millennium Development Goals, in MDG4
MDG5.
MDG4
§ Reduce Child Mortality
Target-reduce by two-thirds the mortality rate among
children under five
MDG 5
§ Improve Maternal Health
Target-reduce by three-quarters the Maternal mortality
Ratio. The approaches to achieving these targets may differ from one country to
another in the developing world (even in advanced countries). The current
issues in women and child health in developing countries will be centered on Nigeria.
In a paper titled, “Maternal, New Born and Child Health in
Nigeria-where
are we now”? and presented by the Honourable Minister of Health, Prof C.O.
Onyebuchi Chukwu talking the health of these age groups began with;
1. Implementation
of disease specific programs
2. Vertical
in-service training of health workers.
3. Government
programmes/projects dependent on donors
4. Non professionalism
of the civil service
5. Too much
out-of-pocket expenses for health
6. Less
emphasis on community involvement and participation
Situation analysis:
§ Population 150 million (1 in 5 Africans
is a Nigerian)
* 23% women of child bearing age
* 20%
children under five years.
§ Crude birth rate 4006 per 100
§ Total fertility rate of 5.7(NDHS 2008)
§ 1,000,000 < 5years die every year (10%
of global deaths)
§ 33,000 women die annually
from pregnancy related
complications (of the global 529,000)
As a result of the analysis, the Federal Ministry of
Health adopted the Integrated Maternal, Newborn and Child Health Strategy
(IMNCH)
Priority Areas for
Action
Ø Focused antennal care
Ø Intrapartum care
Ø Emergency obstetrix and New born care
Ø Routine postnatal care
Ø Newborn care
Ø Infant and young child feeding (IYCF)
Ø Prevention of malaria using LLINs and IPT
Ø Immunization plus
Ø PMTCT
Ø Management of common child hood illnesses and care of HIV
exposed or infected children
Ø Water, sanitation and hygiene
Achievements/where
are we
§ Reduction in maternal
mortality ratio: 545 deaths per 100,000
live births (NDHS 2008) from 800 deaths per 100,000 live births.
§ Reeducation in Under Five Mortality Rate: 157 deaths per 100 LBS (NDHS 2008) from 201 deaths per
1000 LBS
§ Reduction in Infant
Mortality Rate: 75 deaths per 100LBS from 100 per 1000LBS.
The current issues in women and child health in
developing countries are actually the current strides to meet MDG targets,
which are;
Adoption and implementation of the integrated maternal,
newborn and child health strategy.
- Institutionalization
of bi-annual MNCH week
- Strengthening
institutional capacity and infrastructure.
- Refurbishing and procurement of equipments to tertiary health
facilities for emergency obstetrix and Newborn Care,
- Building of
more PHCs
- Capacity building of health workers in life saving skills,
IMCL, Essential newborn care etc.
- Improved human resources at PHC level through the midwives
service scheme
- Deployment of 4000 midwives (and-Chews) to primary Health
care facilities
- Capacity building of all the midwives in life saving skills
(LSS) and integrated management of child hood illness (IMCI) to enhance their
performance in providing quality care.
- Upward review of number of admissions into schools of midwifery
- Strengthening supply of RMNCH commodities
- Procurement of Anti shock garments (pilot in 6 states)
- Procurement of and training of health workers in the use of
magnesium sulphate and misoprotol.
- Midwifery kits along with consumables.
- Free distribution of contraceptives commodities. Procurement
and distribution of ARVs, LLITNs, and ACTS
§ Review of RMNCH Policy Guidelines;
- National RH policy was revised in 2010.
- Training manual on the use of magnesium
sulphate
- National family planning/reproductive Health service
protocols and policy guidelines and standards of practice.
- IMCI Health Facility and community guidelines and protocols
in 2011
- Kangaroo training guidelines for
low-birth weight babies
§ Establishment of Vesico-Vaginal Fistula Centres
- Upgrade the Ebonyi VVF centre to a National
One
- Establish other 12 centres Nation Wide
- On going training so far trained 47 Doctors and 49 Nurses
§ Management of Childhood Illness
- Capacity building (IMCL trainers) across the six geo-political
zones.
- Implementation of Community Case Management of childhood illnesses
(malaria, diarrhea and pneumonia): strategy being fine tuned.
§ Health Financing
- National Health Insurance and Community based Health
Insurance Scheme in selected states.
- MDGs Conditional Grant Scheme
- Improved budgetary allocation to health (from 5% in 2006 to
7% in 2011).
§ Tapping into support of Bilateral Agencies/NGOS
- Submitted proposal to EU – UNH4 for MDG 5: Expected to be implemented in 16 states with high burden
of maternal mortality. Priority area of focus includes Emergency obstetrix and Newborn
Care.
- CIDA
project for MDG4 & 5 support.
§ Research Priorities
- Implementation research projects on PMTCT, MNCH etc are
currently on-going.