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Aid Effectiveness and MDG 5 in Jamaica

Aid Effectiveness and MDG 5 in Jamaica. Rudolph Stevens LIHP Programme 2011. Definition. Aid effectiveness is the impact that aid has in reducing poverty and inequality, increasing growth, building capacity and accelerating achievement of the MDGs. (World Bank, 2011).

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Aid Effectiveness and MDG 5 in Jamaica

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  1. Aid Effectiveness and MDG 5 in Jamaica Rudolph Stevens LIHP Programme 2011

  2. Definition • Aid effectiveness is the impact that aid has in reducing poverty and inequality, increasing growth, building capacity and accelerating achievement of the MDGs. (World Bank, 2011)

  3. MDG 5: Maternal Health • 5A: Reduction of Maternal mortality ratio by ¾ by 2015 • 5B: • Adolescent health • Proportion of births attended by skilled practitioners • Contraceptive prevalence

  4. Situational Analysis - Jamaica • Population: 2,699,617 (2009) • Land mass: 11m2 • Literacy Rate: 86% (2009); 80% (1999) • Unemployment rate: 14.4% (2009); • School enrolment • Poverty: 9.9% (2009);19.1% (2003)

  5. Background: Health Infrastructure

  6. Reproductive Health Situational Analysis 1 • Births: 44,000 per year (Avg: 2.3 per woman) Statistical Institute of Jamaica http://statinja.gov.jm/population.aspx • 93% in government hospitals. • Health Seeking Behaviour • 99% attend ANC, 61% in the first trimester • 87% made 4 or more visits • 91% screened for HIV • 97% delivered in hospital by skilled attendant • Cesarean section rate: 15%

  7. RH Situational Analysis 2Reproductive Health Survey, Jamaica 2008, NFPB/STATIN/USAID/CDC • High Risk pregnancies • Inadequate care 41% • Partially adequate care 18% • Women with 5 or more births were less likely to receive adequate care • Educational attainment & socioeconomic status were positively correlated with receiving adequate care • Contraception • Knowledge of Emergency Contraceptives increase 65% from 39% (2002) to 89% (2008) • 73% of women currently in union use contraceptives • Availability of contraceptives increase from 31% to 51%

  8. RH Situational Analysis 3Health Related Behaviour(15-49years) • Gynae Exam: 43% reported ever having • Pap smear: 62% • Breast Cancer: 62% clinical exam & 64.6% BSE • Smoking: current: 3.5%, Ever: 6% unchanged • Recreational drugs: 3.3% • Commonest health condition: hypertension

  9. Maternal Mortality • 120/100,000 (1990) • 30/100,000 (2015) • 88.3/100,000 (2006) • McCawpBinns, A: Safe Motherhood in Jamaica, Paedi and PerinatalEpidemiol, (2005) 19, 254-261 • McCaw-Binns, A et al: Epidemiologic transition in maternal mortality & morbidity: New Challenges for Jamaica, Int J Gynecol & Obstet (2007) 96, 226-232 • Current 2007 – 2009: 105/100,000 (MOH, Director Family Health), June 2011 • Trajectory to 2015

  10. Maternal Mortality 2Table 1 : Illustrating categories of MMRMcCaw-Binns et al Alternative strategies to achieve MDG 5&6 Alliance for Health Policy & Systems Research Project proposal WHO 2010

  11. Table 2: Indicators of MDG 5Adopted & modified from Maung Aung, LIHP 2010 Country Project

  12. Overseas Development Assistancehttp://data.worldbank.org/topic/aideffectiveness • Net ODA received per capita (current US$) • $18.8 (2009) Jamaica • LAC: $15.9 • Europe & Central Asia: $20.0 • East Asia & pacific: $5.3 • Sub- Saharan Africa: $53.0 • Economics • External Debt Stock (% GNI): 77.8%2009 • GNI per capita: U$4,590 (2009)

  13. The Actors • International • PAHO • UNICEF • UNFPA • Local • Ministry of Health

  14. Ownership • Role of national vs international agencies • Stewardship • National Maternal Mortality committee has not met since 2007 • Regional and facility discussion • Functional desk in MOH • Absorptive Capacity issues

  15. Alignment • Partners meeting 2007 • Traditional project to horizontal approach • DFp policy framework: found 90% was disbursed as project funding

  16. Harmonization • Who is talking to who? • Needs an enabling platform for coordination by international partners • World Bank is currently examining with respect to HIV/AIDS

  17. Conclusion • HIV

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