MDGs

 #Action2015.

More mothers and children under five are surviving, but progress is "uneven across regions and countries, leaving significant gaps", the United Nations Secretary-General Ban Ki-moon confirmed today, July 6, launching the final Millennium Development Goals Report (2015). Child under-five mortality has been cut in half since 1990 (reduced from 90 to 43 deaths per 1,000 live births) and maternal mortality has been reduced 45 percent -- with much of the reduction occuring since 2000.

According to the UN press release:

Targeted investments in fighting diseases, such as HIV/AIDs and malaria, have brought unprecedented results. Over 6.2 million malaria deaths were averted between 2000 and 2015, while tuberculosis prevention, diagnosis and treatment interventions saved an estimated 37 million lives between 2000 and 2013.

Worldwide, 2.1 billion have gained access to improved sanitation and the proportion of people practicing open defecation has fallen almost by half since 1990.

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A girl in the Democratic Republic of Congo {Photo credit: Warren Zelman}Photo credit: Warren Zelman

All involved with women’s health and gender wish that access to quality health care for women and girls was easy to achieve at scale. But the attitudes and expectations of many societies limit women’s and girls’ access to resources and skills associated with better health. And health-related vulnerabilities and poor outcomes for women and girls have social and financial costs that hamper the consistency and quality of available health services. 

To advocate for universal health coverage (UHC), and help countries achieve this worthy goal, health leaders, managers, and those who govern must work to end social biases and gender-based discrimination--whether deliberate or unintended. 

Among other things, health leaders must support the hiring and promotion of women; advocate for gender-sensitive employment and working conditions; help to reduce women’s out-of-pocket healthcare payments (that are generally higher than men’s due in part to the high costs of newborn deliveries and reproductive health services); adjust clinic hours to accommodate women and girls’ mobility constraints; and consider how even unexpected health provider bias can make female clients hesitate to seek the services they need in a timely fashion. 

Dr. Jonathan Quick, President and CEO of MSH, tours with Dr. Christian Nzitimira, director of Kibagabaga Hospital in Rwanda. {Photo credit: Jon Jay/MSH.}Photo credit: Jon Jay/MSH.

In a postoperative ward of Kibagabaga Hospital, the district hospital serving Rwanda’s capital city of Kigali, Eric Bizimana sits up in bed. Bizimana, 25, had sought care after severe pain in his right leg forced him to stop work as a barber. He was diagnosed with a bone infection called osteomyelitis. Antibiotics alone couldn’t clear the infection. Without an operation to remove the diseased bone, Eric faced the possibility of losing his leg.

Eric was one of the 40 patients who enter Kibagabaga for surgery every day. In Rwanda’s tiered healthcare delivery system, patients are referred from local health centers up to the district hospital when their conditions require more complex care. Most babies are delivered at health centers, for example, but a woman suffering complications or who was expected to need a C-section would be referred to the district level.

A Rwandese woman shows her child's community-based health insurance card. {Photo credit: C. T. Ngoc/MSH.}Photo credit: C. T. Ngoc/MSH.

Last week, the 67th United Nations General Assembly adopted a historic resolution that emphasizes universal health coverage (UHC) in the global health and foreign policy work of the UN and Member States in the coming year.

Dr. Sima Samar speaking on 'How to advance women's rights in developing countries.' {Photo from World Bank webcast, March 5, 2012.}Photo from World Bank webcast, March 5, 2012.

On Monday, March 5, 2012, everyone from policymakers to students gathered at the World Bank for a Special Event on the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and Women’s Rights.

CEDAW is a treaty that has been ratified worldwide by all but six countries --- the United States, Iran, Sudan, Somalia, and two small Pacific Island nations (Palau and Tonga).

The event was hosted by Caroline Anstey, Managing Director of the World Bank, in conjunction with the Nordic Trust Fund, The Leadership Conference Education Fund, and the United Nations Foundation.

The future is indeed bright for public health in Nigeria, judging from what Dr. Muhammad Ali Pate, the Honorable Minister of State for Health of the Federal Republic of Nigeria, said at the Africare House in Washington, D.C. on September 21. The event, Innovative Approaches to Expanding Health Care Services, was co-sponsored by Management Sciences for Health (MSH), fhi360, the Anadach Group, and hosted by Africare.

It was an exciting and insightful week of discussions at this month’s Global Health Council meeting on how to address the drastically growing burden of non-communicable diseases (NCDs), such as cancers, diabetes, and heart and lung disease, in advance of the UN High Level Summit on NCDs in September. Speakers made a strong case for including NCDs as a priority on the global health agenda. The intertwining of these diseases with communicable diseases such as HIV, TB and malaria are striking. Julio Frenk, MD, MPH, Dean of the Harvard School of Public Health described the commonalities:

(This blog post was originally posted on Global Health Council's Global Health Magazine blog.)

How do we set a gold standard for monitoring and evaluating capacity building?

Last week I attended the inaugural HIV Capacity Building Partners Summit in Nairobi from March 16-18, 2011. The Summit provided a timely opportunity to reflect on capacity building achievements in the region thus far, and use the lessons learned to rethink, gather momentum and repackage HIV capacity building in ways that ensure achievement of universal access and the targets set in the Millennium Development Goals 4, 5 and 6.

Issakha Diallo, MD, MPH, DrPH

Part six of the blog series: Spotlight on Global Health Initiative Plus Countries Amid grave health statistics, the Global Health Initiative (GHI) brings hope of a healthier future in Mali.

Mali is one of the ten poorest countries in the world, ranking 173 out of 175 countries on the 2007 Human Development index of the United Nations Development Program (UNDP). Mali has highest percentage of people living on less than a dollar a day.  And, Mali has some of the worst demographic indicators in the sub-Saharan region: a population growth rate of 2.6%, a 6.6 fertility rate (the highest in the sub-Saharan Africa after Niger, at 6.8), and a birth rate of 49.8 per 1,000. The population is very young, with more than 50% of Malians under 15 years old and 17% under 5 years old.

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