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Programming for MNCH and nutrition Jerker Liljestrand Copenhagen, 18 January, 2013
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Under 5 mortality, global UNICEF 2009
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Under 5 mortality, global In 2010, newborn mortality was 23/1000......................UNICEF
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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
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Maternal mortality ratio, global, 1990-2010 (WHO et al)
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Life expectancy at birth, global Source State of the World´s Children 2009, UNICEF
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Total fertility rate, TFR, global (”average number of children”)
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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
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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)
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Now, 4 perspectives… Programmatic Health system Development (society) Partnership (what can we do?)
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Conclusions (1) Programs: work in technical areas Try to integrate Multipronged approach Spend time on partnerships
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Conclusions (2) Health system: work in “horisontal area”, cross-cutting Broader approach to address commonalities => MNCH can be health system strengthening
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Conclusions (3) Development context: Need to link programs to community approaches = demand side Mobilize community, more in maternal and newborn health
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Huge improvements in MNCH/FP in low income countries It can be done!
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Achievements, Cambodia Met MDG 4 (child health) May meet MDG 5 (maternal health) Met MDG 6 (HIV)
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Improve newborn survival – stagnant since >5 yrs Improve nutrition - 35% of 2-5 year olds are stunted or wasted. Stagnant >5 yrs Challenges, Cambodia
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MNH Challenges, Cambodia Improve links HCs hospitals Improve quality of care Regulate private sector Increase FP availability
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