KARACHI: WHO health report 2005 Many women, children without health care
KARACHI, April 15: Almost 90 per cent of all deaths among children under the age of five in developing countries including Pakistan are attributable to acute neonatal conditions, lower respiratory infections, mostly pneumonia, diarrhoea, measles, and HIV/ AIDS. According to the WHO health report for 2005 titled ‘Make every mother and child count’, most of these deaths are avoidable through existing interventions that are simple, affordable and effective. They include oral re-hydration therapy, antibiotics, anti-malarial drugs and insecticide-treated bed nets, vitamin-A and other micronutrients, promotion of breastfeeding, immunisation, and skilled care during pregnancy and childbirth.
Hundreds of millions of women and children have no access to potentially life-saving care with often fatal results, the WHO 2005 report said.
To reduce the death toll, the report calls for much greater use of these interventions, and advocates a ‘continuum of care approach’ for mother and child that begins before pregnancy and extends through childbirth and into the baby’s childhood.
This in turn would require a massive investment in health systems, particularly the deployment of many more health professionals, including doctors, midwives and nurses.
“For optimum safety, every woman without exception needs professional skilled care when giving birth,” the report says, adding that continuity of care for the newborn in the following weeks is vital.
The report focuses on developing countries where progress in maternal and child health is slow, stagnating or has even gone into reverse in recent years. Within such countries, less than half of mothers and newborns receive care.
‘Make every mother and child count’ is a wide-ranging study of the health obstacles facing women before and during pregnancy, in childbirth, and in the weeks, months and years that follow for them and their children.
It pays particular attention to the plight of newborns, whose specific needs have “fallen between the cracks” separating maternal and child care programmes.
It is being published in the “report card year” of the United Nations’ Millennium Development Goals, two of which are to improve maternal and child health drastically by 2015.
The latest available data shows that the total annual public health expenditure for 75 countries with the biggest problems amounts to $97 billion.
The report calculates that this amount needs to be increased by an average of $9 billion a year for each of the next 10 years in order to increase access to care in those countries to a level that would permit them to move towards and even beyond the MDGs. This extra amount includes $3.5 billion in additional costs for human resources.
Exclusion from maternal, newborn and child health care is a key feature of inequity as well as a crucial obstacle to progress towards the MDGs, the report says, adding that the health of mothers and children “is at the core of the struggle against poverty and inequality, as a matter of human right”.
Lack of access to skilled care and to major obstetric interventions is the prime reason why a large number of mothers in rural areas are excluded from life-saving care at childbirth. For example, in a study of 2.7 million deliveries in seven developing countries, only 32 per cent of women, who needed a major life-saving intervention, received it.
More than 18 million induced abortions each year are performed by people lacking the necessary skills or in an environment lacking the minimal medical standards, or both, and are, therefore, unsafe. As a consequence, 68,000 women die annually.
WHO is developing a series of policy actions for each of the areas covered in the report and is encouraging governments and other stakeholders to introduce the recommended interventions and scale up maternal, newborn and child health programmer. The progress of these programmes will be monitored and evaluated by WHO.—APP
