The time has come for universal health coverage

By Patrick L. Osewe

Investments in universal health coverage are investments in economic growth. They play a critical role in leveraging opportunities, anticipating challenges, and delivering the knowledge, expertise, and financing countries need to achieve universal health coverage. 

For millions of people around the world, basic health care still remains out of reach. As global leaders gather this week in Osaka, Japan for the G20 Summit—and ahead of the United Nations’ high-level meeting on universal health coverage in New York this September—it is as important as ever to consider how countries can deliver on the global goal of reaching universal health coverage by 2030.

WHO recommendation on task shifting components of antenatal care delivery

 

28 March 2018

Recommendations
1. Task shifting the promotion of health-related behaviours for maternal and newborn health ad to a broad range of cadres, including lay health workers, auxiliary nurses, nurses, midwives and doctors is recommended.
(Recommended)

2. Task shifting the distribution of recommended nutritional supplements and intermittent preventive treatment in pregnancy (IPTp) for malaria prevention to a broad range of cadres, including auxiliary nurses, nurses, midwives and doctors is recommended.
(Recommended)

Cambodian Red Cross president champions mother and child health

Source: International Federation of Red Cross And Red Crescent Societies (IFRC)
Date: 04 Mar 2011



By Andy Mcelroy, IFRC Bangkok

The president of Cambodian Red Cross has been recognised as a national champion for mother and child health at a major ceremony in Phnom Penh. More than 800 people witnessed Dr Bun Rany Hun Sen receive the award from the UN population fund's Asia Pacific regional director Nobuko Horibe. Letters of recognition were also received from UNICEF and UNAIDS.

The Cambodian Red Cross president said that there were several challenges in Cambodia around mother and child health including a lack of midwives, limited health budgets, lack of medical equipment as well as basic key health messages reaching those who were most vulnerable and isolated in the country.

'While this is an honour for me, there are clearly many more duties that I have to carry out especially at a time of so many challenges around maternal and child health here in Cambodia and around the world,' Dr Hun Sen said.

The Cambodian Red Cross president speaks from experience, some of it tragic. She lost her first child after giving birth in November 1976 during some of the most difficult times in Cambodia. She trained and became an experienced midwife and has assisted in the delivery of hundreds of babies.

Dr Hun Sen called for broader and more intensive focus on health and hygiene. 'In particular, pregnant women should be advised to change their habit of having babies delivered at home by traditional midwives with no professional training.'

In a strong declaration of humanitarian diplomacy, the Red Cross president stated: 'At the same time, the Ministry of Health and other agencies should continue to strengthen and be more active in providing services to people without discrimination based on either political affiliation or wealth status, particularly vulnerable people from remote areas.'

At the ceremony the Cambodian government announced the adoption of 21 February as the national day for maternal, newborn and child health.


Cambodian Red Cross' health strategy 2012 stresses the need to reduce deaths, illness and impact from disease by addressing the leading causes of child and maternal morbidity and mortality. This area is a central pillar of the national society's approach in health.

It is part of the national society's contribution to the International Federation's global initiative of "making every mother and child count" towards the Millennium Development Goals. This drive sees the national society contribute significantly to the national health agenda driven by government but with the auxiliary role of the Red Cross playing a defined and supportive role.


The Cambodian government is seeking to reduce the under five mortality rate by two-thirds; and the maternal mortality by three-quarters ration, both by 2015. It also wants to move towards universal access to reproductive health.

Maternal deaths down: report

The Phnom Penh Post
Friday, 17 September 2010 15:00 Brooke Lewis and Chrann Chamroeun

Photo by: Heng Chivoan

Nurse Heal Channy prepares a syringe for a pregnant woman at a referral hospital in Pursat province last year.

A NEW international report provides an estimate of the Cambodian maternal mortality rate that falls far below the government’s, but still places the Kingdom off track to meet the Millennium Development Goal of reducing maternal deaths by three-quarters.

The report, which was released globally yesterday, estimates that there were 290 deaths per 100,000 live births in the Kingdom in 2008.

That figure, which draws from data produced by the World Health Organisation, the United Nations Children’s Fund, the United Nations Population Fund and the World Bank, falls far below the Kingdom’s official figure of 461 deaths per 100,000 live births, which is based on 2008 census data.

Despite the relatively positive findings, the report concludes that, with a 58 percent reduction in the maternal mortality rate between 1990 and 2008, Cambodia is “making progress” but is still not on track to meet the MDG by 2015.

Using a 1990 baseline figure of 690 deaths per 100,000 live births, the report concludes that the number of maternal deaths in the Kingdom had dropped by an annual average of 4.8 percent.

Countries such as Cambodia that had a baseline of more than 100 deaths per 100,000 live births needed to have an annual decline in the maternal mortality rate of 5.5 percent or more to be classified as “on track” to meet the MDG.

Cambodia was listed as one of seven countries with high maternal mortality rates outside of Sub-Saharan Africa, which as a region accounted for nearly three-fifths of maternal deaths globally. Also listed were Afghanistan, Laos, Nepal, East Timor, Bangladesh and Haiti.

Sarah Knibbs, UNFPA Representative in Cambodia, said via email yesterday that the figures used in the report had referred to government data, but that they had been “adjusted to a level that makes them comparable globally”.

She added that the maternal mortality rate was one of the most difficult MDG indicators to measure reliably.

The new figures were met with some scepticism from other local experts.

Paou Linar, the head of Child and Maternal Health Care for the municipal Health Department, said yesterday that the rate cited in the report sounded far too low.

“Their statistic is unrealistic and unofficial,” he said, and cautioned that overly generous estimates of Cambodia’s success in reducing maternal deaths might harm future efforts to reduce the figure.

He said that although the Kingdom’s “present situation related to maternal mortality is not going smooth yet”, he remained optimistic that Cambodia could reach the maternal mortality MDG.

The government has “strategic plans” and is making a concerted effort, he said.

Knibbs noted that Cambodia last year set a national target to reduce the maternal mortality rate to 250 deaths per 100,000 live births by 2015. This target was revised upward from an original target of 140.

Chan Theary, executive director of the Reproductive and Child Health Alliance, said via email yesterday that Cambodia faces special challenges, including a “shortage of qualified care providers, lack of skills among birth attendants, lack of drugs and equipment at facilities, and poor health-seeking behaviours of clients owing to sociocultural and economic factors”.

However, she said that she, too, remained optimistic that Cambodia could meet its revised MDG target.

“It is possible if collective efforts from all sectors (donors, civil societies and other sectors) are focused into it with the strong commitment and political will of the government,” she said.

Mums encouraged to breast-feed

Source: Viet Nam News,
August, 04 2010

by Thanh Hai

A recent survey conducted by the Ministry of Health revealed that just 10 per cent of mothers in Viet Nam breast-feed their babies for the first six months of their lives, compared to a global rate of 32 per cent.

Meanwhile, in Cambodia, where health and economic standards are lower than in Viet Nam, about 65 per cent of mothers exclusively breast feed their babies for the first six months of their lives.

Hoang Dieu Hang, 25, who works for Ha Noi Securities Exchange, said she found it difficult to hold down a job and be a full-time mother at the same time.

"How am I meant to breast feed my baby for the first six months of her life when legally I'm only allowed four months maternity leave," Hang said.

The ministry calculates that 20-30 per cent of all new mothers have to return to work within four months of giving birth.

Dinh Thi Phuong Hoa, deputy director of the Reproductive Health Department, said insufficient maternity leave was a major deterrent to new mothers who wanted to properly breast-feed their babies.

Hoa said maternity leave should be extended to six months to allow mothers to properly breast-feed their children.

Hang said she often gave her baby fruit juice or water when not breast feeding her child – despite the fact that doctors recommend that new born babies be given nothing but human milk for the first six months of their lives.

"Doctors and health staff at the obstetrics hospital did not tell me that it was important to exclusively breast feed my child for the first six months," Hang said.

"I've leant all I know about nursing my baby from my mother, friends and the mass media – not health staff," she said.

Hoa said that the vast majority of medical workers in Viet Nam were unaware of the importance of breast feeding a new-born baby.

"Health staff rarely advise mothers that they should breast feed their babies one hour after giving birth, and that they should continue to do so for the first six months of the baby's life. Ideally, they should continue to breast feed their babies for the next two years," Hoa said.

Despite official guidelines, it is reported that medical staff at one in three health care units encourage the use of bottles for feeding infants. It is also reported that powdered milk is routinely advertised at health care centres and paediatric departments where formula milk is prohibited.

Medical experts say that feeding a new-born infant breast milk yields enormous benefits. It is claimed that 13 per cent of deaths of under-five-year-olds could be prevented if infants were fed breast milk. Allergies, hypertension, diabetes, obesity, cardiovascular diseases and cancer are also linked to non-breast milk alternatives, said Jean Dupraz, from the United Nations Fund for Children (UNICEF)'s Acting Representative in Viet Nam.

A programme called Baby Friendly Hospital Initiative was launched in 1992 to encourage mothers in Viet Nam to breast feed their youngsters.

Last week, the Ministry of Health, UNICEF and Alive and Thrive, which is funded by the Bill&Melinda Gates Foundation, launched a campaign to promote breast feeding on the occasion of World Breast Feeding Week.

Despite the campaign, just 59 out of 12,146 hospitals and health centres in the country offering maternal services are certified as "Baby Friendly Hospitals."

Viet Nam has set itself the goal of having 50 per cent of all new-borns breast fed for the first six months of their lives by 2015. If that target is not achieved, among other things, it is claimed that Viet Nam would at the very least fail to achieve its Millennium Development Goals. — VNS

In Brief: Cambodia needs more midwives to reduce maternal deaths

Source: IRIN, Sunday 15 August 2010

Photo: David Swanson/IRIN

Maternal mortality is a key challenge for Cambodia

PHNOM PENH, 9 August 2010 (IRIN) - Cambodia must increase the number of trained health professionals to reduce its high maternal mortality rate, experts say.

There is one doctor or midwife for every 1,000 people in Cambodia, compared with two per 1,000 in Thailand, and 12 per 1,000 in Japan, according to the World Health Organization (WHO).

"We need more experts, like midwives and medical doctors, and more equipment," said Keth Ly Sotha, deputy director of the National Maternal Child Health Centre.

While 56 percent of births are attended by a health professional - up from 32 percent in 2000 - Cambodia is unlikely to meet its Millennium Development Goal (MDG) of reducing maternal mortality to 140 deaths per 100,000 live births by 2015, said Sherif Rushdy, a UN Development Programme consultant.

With 540 maternal deaths per 100,000 live births, Cambodia has the second highest maternal mortality rate in the region, after 660 per 100,000 births in Laos, according to WHO.