2. World Health Day 2005 Make Every Mother and Child Count
Dr. Awatif Ali Alam

3. Background: . Pregnancy and childbirth among
Background:  Pregnancy and childbirth among leading causes of death for women in childbearing age.  Many children do not reach their fifth birthday.  Healthy mothers and children are the key to healthy, prosperous societies.

4. Role of Women: -. Women play critical role in promotive and
Role of Women: - Women play critical role in promotive and preventive health fields. - Women are charged with maintaining health of families. Examples:- * Raising children * Food selection and preparation. * Training family in personal hygiene. * Solid waste disposal. * Decides needs for health services.

5. Women should be empowered with:-. -. Education. -
Women should be empowered with:- - Education - Accessibility to resources - Involvement in Decision Making Value of educational attainment: - Reducing child morbidity. - Directing family matters. - Less fatalistic attitudes in responding to child illness. - More awareness of health risks - Practice of behaviors that reinforce health.

6. Burden of Maternal and Child Mortality: -
Burden of Maternal and Child Mortality: - Annually mothers die in childbirth million children < 5 yrs. die from preventable and treatable conditions. - Up to ¾ of deaths during first month of life % - 40% of all infant deaths could be avoided.

7. Ways of improving the situation:. Improved maternal health
Ways of improving the situation: * Improved maternal health. * Adequate nutrition during pregnancy. * Appropriate management of deliveries. * Appropriate care of newborn infants. * Birth spacing.

8. Major factors affecting women well being:. Poverty. Lack of education
Major factors affecting women well being: * Poverty * Lack of education * Lack of power Solutions: * Strengthen political and technical leadership. * Commit financial resources to every mother and child of proven interventions. * Prepardness of skilled health care providers.

9. Global Messages of World Health Day 2005: 1
Global Messages of World Health Day 2005: 1. Too many mothers and children are suffering and dying each year. 2. Healthy mothers and children are the real wealth of societies. 3. Millions of lives could be saved using knowledge we have today. [The challenge is to transform this knowledge into action].

10. Cont’d. Global 4. In order to make a difference, we
Cont’d. Global 4. In order to make a difference, we must all join forces and act. Together we can do it. Each one of us has a role to play.

11. Message (1):. Too many mothers and children are dying: -
Message (1): Too many mothers and children are dying: - Mortality indicators in EMRO alarmingly high - > 1.5 million mothers and children dying annually. - More suffer ill-health and under nutrition. - Newborns are at highest risk and death. - The poorest are the most likely to die.

12. Cont’d. Message (1):- -. Globally, every minute a women dies from
Cont’d. Message (1):- - Globally, every minute a women dies from complications in pregnancy and childbirth; i.e women die everyday - > ½ million women die every year. Many millions more suffer disabilities. - Every minute, 20 children < 5 years of age die. i.e. * 10.6 million children die each year. * Newborn babies are at greatest risk. * Among all child deaths every year, 4 million are among newborns.

13. Cont’d. Message (1):-
Globally, for every two people dying in RTAs, one mother and 20 children die from preventable and treatable causes. - About 99% of maternal and < 5 yrs. child deaths occur in low and middle income countries.

14. Cont’d. Message (1):-
70% of all maternal deaths are essentially caused by: * Haemorrhage (24%) * Infection (15%) * Unsafe abortion (13%) * High blood pressure (12%) * Obstructed labour (8%) - Other causes of Maternal Mort. & Disability: * Poverty * Social exclusion * Low levels of education * Violence against women * Young age at pregnancy * Infectious diseases (Malaria, TB, AIDS) * Malnourishment, anaemia

16. Cont’d. Message (1):- Causes of death among children under 5:
Cont’d. Message (1):- Causes of death among children under 5: * Neonatal causes (37%). * Pneumonia (19%). * Post-neonatal diarrhoea (17%). * Malaria (8%). * Measles (4%). * HIV/AIDS (3%). * Malnutrition (indirectly).

17. Cont’d. Message (1):-
The greatest threat to newborn survival: I. Perinatal conditions: * Low birth weight * Birth trauma * Birth Asphyxia II. Severe infection: * Neonatal sepsis * Pneumonia * Meningitis * Tetanus

19. Proven and effective interventions for reducing maternal and newborn disability and death * Social support should be available for women during labour and birth. * Breastfeeding should start within one hour after birth. * Every newborn should have a safe and clean birth and be immediately dried and kept warm to protect against hypothermia; the umbilical cord should be cut using a safe technique, and should be kept clean and dry.

20. The WHO antenatal care package should be. used for all pregnant women
* The WHO antenatal care package should be used for all pregnant women. * Magnesium sulphate should be used to treat severe pre-eclampsia and eclampsia. * A partogram should be used to identify obstructed labour. * Oxytocin should be used for all women as part of the active management of the third stage of labour. * Antibiotic prophylaxis should be used for women undergoing casearean delivery.

21. Manual vacuum aspiration (MVA) should be
* Manual vacuum aspiration (MVA) should be used for management of incomplete abortion and induced abortion. * Kangaroo-mother-care should be used for all low birth weight babies. * Assisted delivery (including caesarean section) should be performed in cases of obstructed labour. * Iron and folate supplements should be given routinely during pregnancy to prevent maternal anaemia.

22. Critical actions for increasing child survival
Critical actions for increasing child survival. Skilled care during pregnancy and birth * Safe and clean delivery at birth. * Care of the newborn at birth. Appropriate feeding in sickness and health. * Exclusive breastfeeding for the first six months of life. * Starting at six months of age, appropriate complementary feeding with continued breastfeeding up to 2 years of age and beyond. * Micronutrient supplementation (at least vitamin A).

23. Prevention of illness. Vaccination. Insecticide-treated materials
Prevention of illness * Vaccination * Insecticide-treated materials * Water, sanitation and hygiene Prevention of mother-to-child transmission of HIV * Antiretrovirals * Safer infant feeding practices Treatment of illness * Oral rehydration therapy to prevent and treat dehydration resulting from diarrhoea. * Zinc to reduce the duration and severity of diarrhoea. * Antibiotics for sepsis, pneumonia and dysentery * Antimalarials

24. Message (2):- Health mothers and children are the real wealth of societies:- - Ill health is a principal reason for poverty: * Increased family expenditure. * Fees of health care. * Social and economic inbalance.

25. Cont’d. Message (2):-
Mother illness impede productivity contribution to: * Home * Workforce * Economy * Society [Survival and education of children are jeopardized].

26. Cont’d. Message (2):-
Good child health is imperative for economic and social development: * For every dollar invested in child health, seven dollars are returned. * Frequent illness and malnutrition negatively affect cognitive development, body size and strength of children. “reducing educational achievement,” “Productivity,” “Work capacity in later life”.

27. Message (3):- Millions of lives could be saved using knowledge we have today. The challenge is to transform this knowledge into action: * Not enough mothers and children receiving existing and affordable life-saving interventions. e.g.:- 34% - 61% of births only assisted by skilled attendant. - Only 4 out of 10 children with pneumonia worldwide, are treated with antibiotics.

28. Cont’d. Message (3):-
* To reduce maternal mortality, women need:- - Skilled care at birth. - Emergency obstetric care. - Referral system. - Helping women avoid unwanted pregnancies.

29. Cont’d. Message (3):-
Application of preventive and curative interventions for children: - Vaccines - Treatment for common illnesses - Appropriate home care

30. Cont’d. Message (3):-
Special efforts; intensified coordination between: “Safe motherhood initiatives” and “Child survival programmes” [To increase numbers of newborn babies who receive critical life-saving care].

31. Cont’d. Message (3):-
Schooling for girls results in: - Healthier children - Better educated children - Fewer maternal and child deaths - Greater economic opportunities - Enhancing well-being of families [2 out of 3 children not in school are girls; and 2 out of 3 illiterate adults are women].

32. Cont’d. Message (3):-
Supporting International agreements:- 1. UN Millennium Declaration: - > 189 nations committed to targets of MDG. [The MDG acknowledge the importance of healthy mothers and children for social and economic development]

33. Cont’d. Message (3):-
The convention on the Rights of the Child: - Has universal ratification - Promotes holistic approaches to child health through * Non-discrimination * Participation * The best interest of the child * Survival protection * Child development

34. The Millennium Development Goals The Millennium Development Goals identify the actions needed across many different fronts (e.g. education, health, transport, agriculture, housing, energy, water, sanitation, legislation and social welfare) for social and economic development. 1. Eradicate extreme poverty and hunger. 2. Achieve universal primary education. 3. Promote gender equality and empower women.

35. The Millennium Development Goals
4. Reduce child mortality. Target: Reduce by two-thirds, between and 2015, the under-five mortality rate. 5. Improve maternal health. Target: Reduce by three-quarters, between and 2015, the maternal mortality ratio. 6. Combat HIV/AIDS, malaria and other diseases. 7. Ensure environmental sustainability. 8. Develop a global partnership for development

40. Message (4); In order to make a difference, we must all join forces and act. Together we can do it. Each one of us has a role to play: Levels of action: 1. The global community: - Coordinated action across different programs and sectors (support by international aid and global health policy).

41. Cont’d. Message (4):-
Cont’d. Levels of action: - Global partnerships - Allocation and use of available resources - Training health workers - Strengthening the implementation of programs. - Promote sharing of knowledge, skills and experience within and between countries.

42. Cont’d. Message (4):-
Governments: - Developing comprehensive policies - Ensure universal access to health- promoting and life-saving interventions. - Mobilize national partnerships (education, health, legislation, social welfare). - Strengthen home care practices and health seeking behavior. * - Meet needs of skilled health care providers. - Long term commitment and investment. - Monitoring progress.

43. Other concerned parties: NGOs including;. CB groups
Other concerned parties: NGOs including; * CB groups * Health professional bodies * Academic institutions * Commercial enterprises * Mass media

44. The Crucial Role of NGO’s
Health service delivery
Recruitment and training of health professional
Health education
Resource generation
Sensitizing governments and international community to health needs of mothers and children

45. Individuals:. Awareness of rights and responsibilities
Individuals: * Awareness of rights and responsibilities * Participation in community level activities * Practising behaviors that ensure the health and survival of their families. * Practising key health behaviours: - Eating more healthy foods during pregnancy - Breast feeding. - Taking children for vaccinations - Utilization of appropriate health services for sick children and during pregnancy

46. Men, as decision makers, household heads, and, above all, partners, have a key role to play in promoting the health of women and children.

48. Translate your interest into action: “Save lives and improve the health and well being of mothers and children.” Make them count

49. Thank you