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{Photo credit: Warren Zelman, Ethiopia}Photo credit: Warren Zelman, Ethiopia

My home region of Tigray in northern Ethiopia has made great strides in ending preventable maternal mortality. Best estimates suggest that the maternal mortality ratio in our region dropped from approximately 653 maternal deaths per 100,000 live births in 1990, to 267 in 2014. However, while most pregnant women in Tigray attend at least one antenatal care visit, only 41 percent attend the recommended four visits, and less than 63 percent deliver with a skilled birth attendant.

We at Management Sciences for Health (MSH) are always looking for new approaches to support the Government of Ethiopia’s efforts to improve maternal health. We discovered one such approach through communities of practice (COP) -- or what we call technical exchange networks.

 {Photo credit: Michele Alexander/MSH}MSH staff link arms in support of healthy moms and babies.Photo credit: Michele Alexander/MSH

Since 1990, nearly 100 million children around the world have been saved due to global efforts to reduce child mortality, and maternal deaths have been cut nearly in half. The US government has played a large role in this great success story.

Yet still, each day, more than 17,000 children’s lives and nearly 800 mothers’ lives are lost due mostly to preventable causes. If you’re like us, you think this is unacceptable. The good news is, history has shown us what we can do when we work together -- and research has backed it up.

We can end preventable maternal, newborn, and child deaths within a generation. But we must all play our role to make it happen!

The opportunity: A more coordinated US strategy

This week, the Reach Every Mother and Child Act (PDF) will be introduced in Congress, calling for the scaling up of simple solutions and requiring a coordinated, streamlined strategy to end preventable maternal, newborn, and child deaths by 2035.

Learn more about the bill (PDF)

 {Photo credit: MSH staff.}MSH staff at IAS2015 included: Dr. Ndulue Nwokedi, Deputy Project Director, Pro-ACT; Dr. Ginika Egesimba, Senior Clinical Advisor, TB/HIV, Pro-ACT; Emmanuel Nfor, Principal Technical Advisor, SIAPS; Dr. Andrew Etsetowaghan, Clinical Advisor, PMTCT, Pro-ACT.Photo credit: MSH staff.

Management Sciences for Health (MSH) presented seven abstracts at the 8th International Aids Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015) in Vancouver, Canada, July 19-22, 2015.

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

[UN's final MDG Report 2015]UN's final MDG Report 20152015 — the finish line of the United Nations' grand experiment, the Millennium Development Goals (MDGs). Framed in 2000, the MDGs represent a leap of faith by the global community to transform, through unified action, the lives of millions living under the threat of extreme poverty, malnourishment, inadequate health care, poor hygiene, and without dignity. 

As “The Millennium Development Goals Report 2015” — released in early July — shows, significant progress has been made over the last 15 years, but the work is not complete. Among the MDGs’ eight goal framework, steady progress in the areas of child mortality, maternal health, and infectious diseases (goals 4, 5, and 6) have saved and impacted millions of lives around the world.

{Photo credit: Jawad Jalali-Afghan Eyes}Photo credit: Jawad Jalali-Afghan Eyes

For almost three years, the USAID-funded Leadership, Management, and Governance (LMG)-Afghanistan Project, led by Management Sciences for Health (MSH), has been offering technical assistance to support inspired leadership, sound management, and transparent governance within Afghanistan’s health system.

As the $37 million project came to a close in June 2015, the achievements and results of the project have been celebrated and recognized at two end-of-project events, one in Washington, D.C. and one in Kabul, and in an end-of-project report, Profiles of Courage: Stories of Impact from the LMG-Afghanistan Project (2012-2015).

{Photo by: Mark Tuschman}Photo by: Mark Tuschman

In the poorest, most remote areas of the world, health services are often hard to come by. Communities are marginalized economically and geographically; people often do not seek preventative care and are not reached by primary and secondary health services.  

Reproductive health and family planning messages and services often do not reach these groups. According to demographic and health survey reports, in nearly every country, the poorest quintile also have the highest fertility rates, lowest contraceptive prevalence rates (CPR), and least amount of knowledge of contraception methods. And when crisis strikes, access to basic health services declines even more as resources are diverted to deal with the emergency.  That’s why the theme of this year’s World Population Day, “vulnerable populations in emergencies,” observed July 11, is so important.

During humanitarian crises, women and children are especially vulnerable. More than a year after the start of the largest Ebola outbreak since the disease was discovered, assessments show that the gains that had been made in reproductive, maternal, and child health in Guinea, Liberia, and Sierra Leone are in danger of regressing.  Even those not affected by Ebola itself have been greatly affected by the diversion of health resources.

 #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.

{Photo credit: Glenn Ruga}Photo credit: Glenn Ruga

Management Sciences for Health (MSH) is pleased to announce the availability of the 2014 edition of the International Drug Price Indicator Guide. The Guide provides a spectrum of prices from 25 sources, including pharmaceutical suppliers, international development organizations, and government agencies.

Use the Guide to determine the probable cost of pharmaceutical products for programs, compare current prices paid to prices available on the international market, assess the potential financial impact of changes to a medicines list, and to support rational medicine use education.

 {Photo credit: Todd Shapera}Antibiotics on the shelves of a pharmacy in Rwanda.Photo credit: Todd Shapera

In May 2015, the World Health Assembly discussed and endorsed a global action plan on antimicrobial resistance. The action plan sets five strategic objectives to promote better understanding of the threat of antimicrobial resistance, and to ensure the proper use and conservation of existing antimicrobials.

{Photo credit: Katy Doyle/MSH, West Africa}Photo credit: Katy Doyle/MSH, West Africa

The following blog post is a web-formatted version of MSH's Global Health Impact newsletter (June 2015 edition), Good Governance Strengthens Health Systems. We welcome your questions and feedback in the comments. Get Global Health Impact in your inbox

Notes

by James A. Rice, PhD

What do we mean by governance? Governance is a structured process used by a group of people—often referred to as a governing body, board, or council—to make decisions about policy, plans, and rules of collective action for an organization or system. For health organizations, the focus of this collective action is strengthening health systems to expand access to quality health services and achieve sustainable gains in health outcomes.

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