Maternal, neonatal, child health and nutrition

1. Maternal, neonatal, child health and nutrition Gunta Lazdane WHO Regional Office for Europe

2. A big challenge … Globally every year… 7,6 million children die before their 5th birthday 3,2 million newborn babies in the first month of life 2,4 million infants between 1 – 12 months 356 000 women die due to complications of pregnancy and childbirth 15 million women develop long-term consequences due to pregnancy and childbirth

3. Child nutrition and MDGs • In 2010, globally, an estimated 27% of children younger than 5 years were stunted • Undernutrition continues to be high and delays progress toward reaching Millennium Development Goals • Extremely poor breastfeeding and complementary feeding practices • Micronutrient deficiencies (iodine, iron deficiency ) still a serious problem and obesity on the rise….

4. The way forward… By 2015: Saving 16 million lives of women and children Preventing 33 million unwanted pregnancies Protecting 88 million children from stunting Protecting 120 million children from pneumonia

5. Targets and indicators for monitoring MDG 4 and 5 • Under-five mortality rate • Infant mortality rate • Proportion of 1 year-old children immunised against measles Goal 4: Reduce child mortality Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate • Maternal mortality ratio • Proportion of births attended by skilled health personnel Goal 5: Improve maternal health Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio Target 5B: Achieve, by 2015, universal access to reproductive health • Contraceptive prevalence rate • Adolescent birth rate • Antenatal care coverage • Unmet need for family planning

6. Mongolian Welfare Association … and other partners

7. WORLD HEALTH ORGANIZATION WHO Constitution Executive Board, DG Resolutions and decisions http://apps.who.int/gb/or/ World Health Assembly Executive Board Regional Committees 10-13 September 2012 Malta Standing Committee of RC - only in WHO/Europe

8. Monitoring progress

10. Good progress in achieving MDG 4 in the WHO European Region In 2009 11 countries achieved MDG 4 target Source: WHO European Region estimates; WHO, 2011

11. Probability of dying before age 5 years per 1 000 live births However big discrepancies between countries 70 60 50 40 30 20 10 0 Central Asian Republics 1980 1990 2000 2010 Source: WHO/Europe Health for all Database Commonwealth of Independent States European Region European Union

12. Major causes of deaths are known Deaths among children under-five Neonatal deaths Source: Major causes of under five and neonatal deaths, European Region, 2008; WHO The World Health Statistics 2011

13. Good progress in maternal health – MDG5 WHO European Region average annual decline of 3.8% 5.5% required to achieve MDG5 Source: Trends in Maternal Mortality: 1990 to 2008; WHO, 2010

14. Maternal deaths per 100000 live births 70 60 50 40 30 Central Asian Republics 20 Commonwealth of Independent States European Region European Union 10 0 1980 1990 2000 2010

15. Every two years WHO secretariat develops a progress report based on the filled in questionnaires received from the WHO Member States and presents it to the World Health Assembly (2006,2008, 2010, 2012, 2014!) Questionnaires will be sent to countries in 2013

16. Guidelines and tools available European strategy for child and adolescent health and development (2005) Tools for implementation

17. Effective Interventions exist… expected % of reduction in U5M Intervention Source: Lancet Child Survival Series 2003

18. Monitor Review Action

19. From recommendations to actions COMMISSION RECOMMENDATIONS 1 Monitoring results & CRVS 2 11 core indicators & equity 3 Digital health & innovation 4 Financial indicators tracked 5 Comprehensive reporting 6 Capacity for NHA 7 National Accountability mechanisms 8 Transparency 9 MNCH specific reporting 10 Expert Review Mechanism NHA & MNCH tracking Monitoring of results Birth and death registration Maternal death surveillance & response Country assessment & Roadmap ehealth & innovation Country review processes Advocacy and action Monitoring results Global actions Tracking resources Global review (iERG)

20. To accelerate progress … Tackle inequities by addressing the determinants of maternal and child health through cross-sector and gender-right based approach Strengthen health Strengthen health information Implement new vaccines and develop immunization service delivery strategies Address the links between noncommunicable diseases and MDGs

21. Sharing experiences and success stories…

22. Sharing experiences and success stories…

23. Health 2020: a European policy framework supporting action across government and society for health and well-being

24. Proportion (%) of children exclusively breastfed at 3 and 6 months, 2005-2010

25. Continuum of care

26. Developing clear policies and action plans from a life-course and multi-sectorial perspective Improved data collection, analysis and evidence-based decision making Supported and monitored implementation of evidence based health interventions Improving access and quality of care; trained health professionals with right skill mix Involvement of communities and civil society Accelerated actions to achieve MDG 4 and 5

27. THANK YOU!