Maternal Survival in Afghanistan: Progress and Challenges - PowerPoint PPT Presentation

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Maternal Survival in Afghanistan: Progress and Challenges

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Maternal Survival in Afghanistan: Progress and Challenges Mary Ellen Stanton Senior Maternal Health Advisor Bureau for Global Health, USAID Health in Afghanistan: – PowerPoint PPT presentation

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Title: Maternal Survival in Afghanistan: Progress and Challenges


1
Maternal Survival in AfghanistanProgress and
Challenges
  • Mary Ellen Stanton
  • Senior Maternal Health Advisor
  • Bureau for Global Health, USAID
  • Health in Afghanistan
  • How Can We Save Womens Lives?
  • Womens Policy, Inc
  • Canon House Office Building
  • July 20, 2010

2
Health Situation (2001-2002)
  • Fertility 6.8 children/women
  • No access to health care services for 1/3
    population
  • Crumbling health infrastructure
  • Vast human resource needs

Photo Linda Bartlett
3
Lifetime Risk of Maternal Death
14,800 USA
18 Afghanistan
The chance of a woman dying as a result of
pregnancy is 600 x greater in Afghanistan than it
is in the United States.
Source WHO/ UNICEF/UNFPA, The World Bank.
Maternal Mortality Estimates 2005, App 8, pub
2007
4
Maternal causes of death in Afghanistan 4
regions (n154), 1999-2002
Cause of death Cause of death Life Saving Interventions
- Family planning
Hemorrhage 33 - Active management of the third stage of labor - Misoprostol
Obstructed labor 22 - Partograph - Cesarean section
Pregnancy induced hypertension 8 - Calcium supplementation - Magnesium sulfate
Sepsis 5 - Tetanus toxoid - Infection prevention - Antibiotics
Source L Bartlett, 2002 Source L Bartlett, 2002 Source L Bartlett, 2002
5
Maternal Mortality and the Cycle of Poverty in
Afghanistan
6
Much has been achieved much remains to be done
Indicator Post-Taliban (2002) Current Situation (2009)
Under-five mortality rate (deaths per 1,000 live births per year) 257/1,000 191/1,000 (26 reduction)
Access to basic services ( of population within 2 hours walk of a health facility) 9 64
Coverage of female health workers ( of facilities with a female health worker) 26 85
Use of antenatal services ( of pregnant women who use antenatal services) 5 32
7
Ingredients of success formaternal and child
health
  • Government leadership
  • Focus on rural health, equity
  • BPHS Basic Package of Health Services
  • EPHS Essential Package of Hospital Services
  • Large-scale contracting capacity with NGOs
  • Human resource policies
  • Pharmaceutical policies
  • Clinic construction
  • Social marketing of health products
  • Recruitment, training support of female
    community midwives community health workers

8
Looking ahead
  • Security
  • Expanded attention to midwifery education
  • Family planning more services to meet unmet
    need
  • Focus on quality improvement, especially at
    referral level prevention treatment of
    obstetric complications
  • Accountability to communities working with
    religious and community leaders on availability
    and quality of interpersonal care
  • Seizing the opportunities and developing strategy
    for innovation such as mobile health/telemedicine
  • Measuring impact
  • RAMOS II a possibility
  • National survey all cause mortality underway
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