A Focus on the Journey to Self-Reliance for Preventing Child and Maternal Deaths . June 2018
The 2018 Acting on the Call report focuses on 25 countries’ journeys to self-reliance for preventing child and maternal deaths. Self-reliance is a country’s ability to finance and implement solution...s to its own development challenges. Understanding where countries lie on this effort - known as the journey to self-reliance - helps USAID to best partner with countries and support their efforts.
The report looks at the health status of 25 priority countries as well as the current capacity of the health system to meet the needs of women and children. In the report, we recount progress since the 2012 Call to Action as well as identify gaps in order to inform future programming and areas that need strengthening during the journey to self-reliance. For the first time ever, we’ve calculated the return on our investment to eliminate bottlenecks to improving health services.
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This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction... of community-based provision of Family Planning through community health workers. In addition, the expansion of adolescent sexual and reproductive health programs is a pillar of this policy that will help attract and retain the next generation of Family Planning users. These efforts are anticipated to trigger a paradigm change in the way Family Planning services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all.
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The National Institute for Transforming India (NITI) Aayog has developed the Composite Water Management Index (CWMI) to enable effective water management in Indian states in the face of extreme water stress. The Index and this associated report are expected to: (1) establish a clear baseline and ben...chmark for state-level performance on key water indicators; (2) uncover and explain how states have progressed on water issues over time, including identifying high-performers and under-performers, thereby inculcating a culture of constructive competition among states; and, (3) identify areas for deeper engagement and investment on the part of the states. Eventually, NITI Aayog plans to develop the index into a composite, national-level data management platform for all water resources in India.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv...ices closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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In where under-five mortality is high and vitamin A deficiency is a public health problem, two high-dose supplements of vitamin A per year, spaced four to six months apart, can strengthen children’s immune systems and improve their chances of survival.
During much of early childhood – from... 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurr...ing in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.
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Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine | The aim of this study was to explore the risk factors for stillbirth and neonatal death and change in perinatal outcomes after the introduction of helping Babies Breathe Quality Improvement Cycle in Nepal.
The Newborn Situational Analysis reports of 2009 and 2011, as well as the “Bottleneck analysis on neonatal health” of 2013, culminated in the Nigeria launch of “Call to action on Newborn health” at the first National Newborn Health Conference in 2014. This call to action provided the framewo...rk for the development of the Nigeria Every Newborn Action
Plan (NiENAP). The NiENAP lays out a vision to end preventable stillbirths and newborn deaths by accelerating progress and scaling up evidence- based high-impact and cost effective interventions. The plan is guided by the principles of country-leadership, integration, accountability, equity, human rights, innovation and research. This blue print outlines our commitment as government and stakeholders to repositioning newborn health as we implement approaches that impact on the lives of newborns for improved health outcome.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicat...ed, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting.
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Contraception and Family Planning, Preventing Unsafe Abortion and Accessing Postabortion Care, and Maternal Health
The Report describes the evaluation of WHO's contribution to the Maternal Health Program in South-East Asia Region. This was an independent evaluation conducted in 2015 by Amaltas, a Delhi based organization. The evaluation highlights the progress in five countries, namely Bangladesh, Indonesia, Mya...nmar, Nepal and Sri Lanka and provides specific recommendations for Organizational Learning and Development. This report will be useful for all those interested in WHO's work on Maternal Health Program in the Region.
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The plan contains the latest available evidence on the extent of insecticide resistance around the world, and puts forward a strategy for global and country levels, identifying clear roles and timelines for all stakeholders. The GPIRM also summarizes information about innovative new products being d...eveloped and sets out the immediate research and development priorities.
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Findings on maternal and child health in Nepal, Mozambique and
Rwanda, and neglected tropical diseases in Cambodia and Sierra Leone | This report synthesises findings from five country case studies from the health dimension of this project, which focus on maternal and child health (MCH) (Mozambique...,Nepal, Rwanda) and neglected tropical diseases (NTDs)(Cambodia, Sierra Leone). MCH was selected given its centrality in two of the Millennium Development Goals (MDGs) and its ability to act as a proxy for strengthened health systems. NTDs, while until recently relatively neglected in global policy debates, are now attracting more interest, not least because they are viewed as diseases of the poor whose treatment could positively impact on most of the other MDGs.
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Zero Draft for Consultation, 3rd Version, November 2015
Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec...t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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