London—A new report tracking global progress in improving the health of mothers and newborns revealed today that most high-risk countries still do not provide them the basic health services needed to lower unacceptably high death and injury rates. However, the Countdown to 2015 study found that some countries have made significant progress and others have put many factors in place to allow future movement.
A joint effort by United Nations agencies, universities, non-governmental organizations and individual researchers, the report evaluated action since 1990 in 68 developing countries that account for 97 percent of maternal and child deaths worldwide. Fewer than one-quarter of those countries are on track to reach the Millennium Development Goals on improving maternal health and reducing child death rates, the report said. Many more have made little or no progress or even reversed earlier gains, especially in sub-Saharan Africa. Dr. Richard Horton, editor of the British medical journal The Lancet, said in an editorial introducing a special issue on the report that the findings showed "strikingly inadequate" progress toward the MDGs. "Children and mothers are dying because those who have the power to prevent their deaths choose not to act," he said. "This indifference – by politicians, policy-makers, donors, research funders and civil society – is a betrayal of our collective hope for a stronger and more just society."
Of the 16 high-risk countries that the study found to be on track for achieving MDG 4, which calls for halving the number of newborn deaths by 2015, seven were already on track when Countdown to 2015 was launched in 2005, including Brazil, Bangladesh, Mexico, and Indonesia. Only three made the shift from lagging behind to being on course: Haiti, Turkmenistan and China. In 12 African countries, armed conflict and high rates of HIV prevalence together have erased any gains in child survival, the report said. In 56 of the 68 countries, maternal mortality rates remained high or very high, the study said, suggesting that they are not on track to reach MDG 5, which calls for improving women’s health by cutting maternal deaths by three-quarters. The study found that health interventions that could be routinely scheduled, such as immunization and antenatal care, had much higher coverage than those needing functional health systems and 24-hour service availability, such as skilled or emergency care at birth and care of sick children.
"Priority attention in health-system strengthening should be given to establishment of a functional continuum of care that encompasses women before pregnancy, pregnancy, childbirth, the postnatal period, and the first 24 months of a child's life," the report said. It noted that overseas development aid had risen significantly since 1990 but was still inadequate: an investment of US $10 billion per year is needed to achieve the two MDGs by 2015. Rising aid was among the factors that the report said offer encouragement for great progress in future years, along with a general consensus on the priority interventions needed, a strong verbal commitment from countries and donors, and the existence of many programmes already in place. The report said, however, that aid should be directed more to strengthening target countries’ health systems in general and to goals such as lowering malnutrition and broadening access to family planning, and restricted less to specific projects. It said much better data collection is critical to gauging progress in all areas, and that new ways to reach vulnerable populations should be tested and used.
"We will not achieve the Millennium Development Goals unless the health and rights of women and children are made a priority," said Thoraya Ahmed Obaid, executive director of UNFPA, the United Nations Population Fund. "No woman should die giving life." The Countdown to 2015 findings will be debated during an April 17-19 conference in Cape Town, South Africa, including special sessions with parliamentarians from the 68 countries and donor nations attending the 118th Assembly of the Inter-Parliamentary Union.
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international conference being held in Cape Town, South Africa 17 – 19 April 2008.