1. Programming for MNCH and nutrition Jerker Liljestrand Copenhagen, 18 January, 2013

2. Under 5 mortality, global UNICEF 2009

3. Under 5 mortality, global In 2010, newborn mortality was 23/1000......................UNICEF

4. The rule of two thirds Of infant mortality, 2/3 is in first month Of those, 2/3 are in first week Of those, 2/3 are in first 24 hours

5. Maternal mortality ratio, global, 1990-2010 (WHO et al)

6. Life expectancy at birth, global Source State of the World´s Children 2009, UNICEF

7. Total fertility rate, TFR, global (”average number of children”)

8. Source: National Health Statistics MoH 2002-2011. Mainly public sector Interventions for Maternal Health In Cambodia Peace, growth, education Roads, phones Health centers, midwives Peace, growth, education Roads, phones Health centers, midwives

9. Source: National Health Statistics MoH 2002-2011. Mainly public sector Interventions for Maternal Health In Cambodia Peace, growth, education Roads, phones Health centers, midwives Peace, growth, education Roads, phones Health centers, midwives Removing financial barriers: - Health equity funds, vouchers - Live birth incentive ($15) Removing financial barriers: - Health equity funds, vouchers - Live birth incentive ($15)

12. Now, 4 perspectives… Programmatic Health system Development (society) Partnership (what can we do?)

14. Conclusions (1) Programs: work in technical areas Try to integrate Multipronged approach Spend time on partnerships

15. Conclusions (2) Health system: work in “horisontal area”, cross-cutting Broader approach to address commonalities => MNCH can be health system strengthening

16. Conclusions (3) Development context: Need to link programs to community approaches = demand side Mobilize community, more in maternal and newborn health

17. Huge improvements in MNCH/FP in low income countries It can be done!

18. Achievements, Cambodia Met MDG 4 (child health) May meet MDG 5 (maternal health) Met MDG 6 (HIV)

19. Improve newborn survival – stagnant since >5 yrs Improve nutrition - 35% of 2-5 year olds are stunted or wasted. Stagnant >5 yrs Challenges, Cambodia

20. MNH Challenges, Cambodia Improve links HCs hospitals Improve quality of care Regulate private sector Increase FP availability