CAMPAIGN ON ACCELERATED REDUCTION OF MATERNAL AND CHILD MORTALITY IN AFRICA (CARMMA) 10th Annual Congress of the Society of Midwives of South Africa St Georges Hotel - Pretoria 04 December 2012 Ms HL Mangate Acting AU/NEPAD Coordinator

PRESENTATION OUTLINE Introduction and Background Overview of Maternal and Child Mortality South African Situation Highlights of the recommended actions to improve maternal health and child survival from the XV AU Summit. CARMMA slogan Objectives of CARMMA Progress at AU level Key Components of CARMMA in South Africa Considerations by AU Member States

INTRODUCTION AND BACKGROUND High maternal and child mortality in Africa WHO estimates 1500 women die each day 10 000 babies die per day within one month of life MMR for Africa ranges between 500 and 1 500 / 100 000 live birth MDG targets - Reduction of maternal deaths by 75% and under-5 child mortality by 67% by 2015 African Union established CARMMA in 2009 In July 2010 the African Union Assembly encouraged all countries to launch CARMMA “in solidarity with women and children of Africa......” AU Summit recommended a list of Actions on Maternal, Newborn and Child Health for countries to implement.

SOUTH AFRICA SITUATION The NDoH Report of Health Data Advisory Committee of November 2011 estimate: MMR at 310/100 000 LB Under 5 mortality at 56/ 1000 LB Infant mortality at 40/1000LB Neonatal mortality at 14/1000 LB The 2015 MDG targets: MMR from 150/100 000 to 38 per 100 000 LB Under 5 from 59/ 1 000 to 20/1000 LB ( DHS, 1998)

HIGHLIGHTS OF THE XV AU SUMMIT RECOMMENDED ACTION TO IMPROVE MATERNAL AND CHILD Extend the Maputo Plan of Action to 2015 to coincide with the MDGs Launch of CARMMA in countries and broaden it as an advocacy strategy for the promotion of maternal, newborn and child health and involve all key stakeholders Institutionalize the Annual CARMMA week in solidarity with the women and children of Africa for the next four years.

ACTIONS CONTINUE Strengthen the health system to provide comprehensive, integrated maternal, newborn and child health care services repositioning of family planning including reproductive health commodity security, infrastructure development in rural areas skilled human resources for health to train Community Health Workers

ACTIONS CONTINUE Provide stewardship - national Governments for policy coherence Provide strong support for sharing and scaling up of identified good practices Provide sustainable financing - domestic resources including 15% Abuja target Call on Global Fund for Fight against HIV/AIDS, Malaria, and TB to create a new window to fund the Maternal, Newborn and Child Health

ACTIONS CONTINUE Institute effective monitoring and evaluation (M&E) for accurate, reliable and timely maternal, newborn and child data including making maternal deaths notifiable and institute maternal deaths reviews Annually reporting on the progress made by member states Promote programs for the total eradication of mother to child transmission so that no child is born with HIV and AIDS Extend the Abuja Call for Accelerated Action Towards Universal access to HIV/AIDS, Tuberculosis and Malaria services in Africa to 2015 to coincide with the MDGs

ACTIONS CONTINUE The AU Commission/AU Organs/RECs/Partners to monitor and conduct an evaluation of the implementation of the Abuja Call and to submit a progress report in 2013 and a final report in June/July 2015 in preparation for the review of the MDGs in 2015. Commemorate an Africa Food and Nutrition Day (AFND) on 30 October every year

THEME OR SLOGAN FOR CARMMA   “Africa Cares: No Woman Should Die While Giving Life!”

OBJECTIVES OF CARMMA To enhance political leadership and commitment at national and continental levels. To identify and work with national champions to mobilize support and participation at national level. To raise and maintain awareness as well as appropriate responses at global, continental, regional and national levels.

OBJECTIVES OF CARMMA CONT. To built linkages with global campaigns, Promote the recognition of maternal mortality as a key indicator of a well-functioning health system. Promote exchange of experiences and practices and adopt and replicate best practices of countries, which have significantly reduced maternal mortality

CARMMA PROGRESS AT AU LEVEL 38 countries launched CARMMA Special meeting on CARMMA held in Namibia in April 2011 made the following recommendations: Ministry of Health to assume leadership Advocacy for increased resources for maternal & child health concentrating of domestic sources Devotion in November of CARMMA week Task shifting to respond to increased needs Promotion of SRHR Maternal, Newborn and Child Mortality audits to be done; operational research for planning

CARMMA PROGRESS AT AU LEVEL cont. Nutrition – promotion of breastfeeding and PMTCT Waiving of user fees for women and children NHI schemes to cover all, especially marginalised groups Community efforts to reach the hard to reach communities Improve transportation for better access to health services

KEY COMPONENTS OF CARMMA IN SA a) Strengthening access to comprehensive SRHR services, with specific focus to family planning services b) Advocacy and promotion of early antenatal care attendance/ booking c) Improve access to Skilled Birth Attendance through: 1. Allocation of obstetric ambulances to every facility where deliveries are conducted 11. Establishment of maternity waiting homes where necessary

KEY COMPONENTS OF CARMMA IN SA CONT. d) Strengthening Human Resources for Maternal and Child Health through: I.    Training on Essential Steps in Management of Obstetric Emergencies (ESMOE) for doctors and midwives. II.   Strengthening midwifery education and training.

KEY COMPONENTS OF CARMMA IN SA CONT. e)  Improve child survival through: I.  Promotion of breast-feeding, II. Provision of facilities for lactating mothers (border mother) in health facilities where children are admitted III.  Promotion of Kangaroo Mother Care (KMC) for low birth weight babies. IV. Advocating for appropriate care and support of pregnant women and lactating mothers in the workplace.

KEY COMPONENTS OF CARMMA IN SA CONT. F) Intensifying management of HIV positive mothers and children through: I. Improved access to treatment for both mothers and children II.   Improved management of co-infections III.  Elimination of Mother to Child Transmission o HIV

CONSIDERATION FOR CARMMA IMPLEMENTATION BY AU MEMBER STATES Identification of Champions and/or Sponsors of CARMMA Establishment of a Campaign Coordinating Mechanism Creating an Intersectoral Committee and establishing Community Network Declaring and Observe a Maternal, Newborn and Child Health Day/Week preferable during November as recommended by Heads of State and Government during AU Summit of July 2010 Preparing Periodic Reports on maternal, newborn and child mortality

I THANK YOU