Countdown to world 2015 Report on health care launched

A report, “Countdown to 2015”, has been launched at the ongoing two-day partners forum by the Partnership for Maternal, Newborn and Child health (PMNCH) here in Johannesburg.

The report, lunched by the former First Lady of South Africa, Ms Graca Machel, said many developing countries have taken substantive action to save women’s and children’s lives, but vast areas of “unfinished business” still needed to be addressed. The new report summarized in ‘The Lancet’, said the Countdown to 2015 studied progress in 75 countries and revealed that substantial inequities persist, even in countries that have made solid gains in maternal and child health.

Many countries are still only reaching half or less of women and children with vital health interventions, and the poorest are being left behind. The forum, being attended by over 800 health experts and public health officials, is being organized by PMNCH, a partnership of 625 organizations from across the seven constituencies, governments, multilateral organizations, donors and foundations among others.

The 75 countries covered in Countdown’s 2014 report, “Fulfilling the Health Agenda for Women and Children,” account for more than 95 per cent of all maternal and child deaths each year. “Now is the time to make a final push on the health Millennium Development Goals 4 and 5, and to set the stage for elimination of preventable maternal and child deaths in the years beyond 2015.”

Countdown to 2015 is a global movement to track, stimulate and support country progress towards the health-related Millennium Development Goals, particularly goals 4 (reducing child mortality) and 5 (improve maternal health). Established in 2003, Countdown focuses specifically on tracking coverage of a set of evidence-based interventions proven to reduce maternal, newborn and child mortality in the 75 countries where more than 95per cent of maternal and child deaths occur.

It produces periodic publications, reports and other materials on key aspects of reproductive, maternal, newborn and child health, using data to hold stakeholders to account for global and national action.

The Countdown report shows that in several countries, more than half of the mothers and children in the poorest of the population receive 2 or fewer of 8 interventions, deemed essential for preventing or treating common causes of maternal and child deaths, including vaccinations, skilled birth attendance, pneumonia and diarrhea treatment, and access to family planning.

In nearly one-third of Countdown countries, more than 20 per cent of the poorest women and children receive 2 or fewer of the 8 essential interventions. In nearly every Countdown country, in contrast, a large majority of the richest women and children receives most or all of these 8 key interventions.

Some Countdown countries are targeting the poor with programmes to expand coverage of key interventions, and making real strides in reducing inequities and Countries like Bolivia, Cambodia, and Niger could serve as models for others in reducing inequality in coverage between rich and poor.

According to the report, stunting, a measure of height for age that reflects long-term hunger, illness, or poor child care, is on the average of 2.5 times higher among poor children than among children from wealthier families.

The report noted that in many Countdown countries more than 30 per cent of children are stunted, and that, nearly half of all deaths among children under age 5 or about 3 million deaths a year are attributable to under nutrition. Poor nutrition also harms a woman’s health and increases her risk of stillbirth or delivering a low-birth weight baby.

Consistent with findings from recent reports about the state of newborns and the global health workforce, the new Countdown analysis revealed that improving newborn survival and addressing the human resource crisis required urgent action. The analysis showed that a median of 39p per cent of deaths of children under age five occurred during the first month of life in the Countdown countries, underscoring a need for improved access to quality skilled delivery care for mother and baby around the time of birth, when most stillbirths and maternal and newborn deaths occur.

It also finds that only 7 Countdown countries have enough skilled health professionals to achieve high coverage of essential interventions. Countdown examined countries' progress in adopting policies that enable improvements in women’s and children’s health.

"Many countries are making important and constructive policy changes, but most Countdown countries are lagging behind in endorsing recommended policies, as experience shows that relatively simple policy changes can bring big results, so more action is needed," Bernadette Daelmans of the World Health Organization, co-chair of Countdown's Health Systems and Policies Technical Working Group said.

According to the Countdown analysis, when the Millennium Development Goal (MDG) deadline arrives 18 months from now, the goals related to maternal and child health will not be achieved. Fewer than half of the 75 Countdown countries are likely to have succeeded in reducing child mortality by two-thirds from 1990 levels (MDG target 4.A), only a small fraction will have cut maternal death by three-quarters (MDG target 5.A), and access to reproductive health (MDG target 5.B) will not be nearly universal.

The next 18 months are, therefore, critical for accelerating progress towards the MDG targets and for ensuring that work to achieve the next set of global goals and targets begins right now. This will require intensified support to countries lagging behind and sustained effort in countries where progress is happening.

Action to end preventable maternal and child deaths, by improving nutrition and coverage of effective interventions for all population groups, must not be delayed, according to the report. “Thousands of women and children are suffering and dying every day from causes that are easily preventable and treatable and we cannot and must not wait for the post-2015 agenda to be finalized to address these issues and take concerted, emphatic action to save women, newborns and children.

“We can still make real progress, right now, toward achievement of the health MDGs and we must set a clear path toward a world free of preventable maternal and child death in the years beyond 2015,” Dr. Jennifer Bryce of Johns Hopkins University, a lead author of the report added.