Global Health and the Future Role of the United States (2017) / Chapter Skim
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5 Investing in Women's and Children's Health
5 Investing in Women's and Children's Health
Pages 135-168
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From page 135... ...
Because healthy women and children are the linchpin for healthy and thriving societies (see Figure 5-1) , investing in the health of women and children is indispensable to achieving the new Sustainable Development Goals (SDGs)
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From page 136... ...
136 GLOBAL HEALTH AND THE FUTURE ROLE OF THE UNITED STATES INVEST IN GIRLS AND WOMEN: THE RIPPLE EFFECT FIGURE 5-1 Invest in girls and women: The ripple effect. NOTE: GDP = gross domestic product.
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From page 137... ...
GLOBAL DEVELOPMENT AGENDA SHIFT: WOMEN AND CHILDREN The MDGs adopted by world leaders in 2000 set forth the first global goals for women's and children's health, calling for a two-thirds reduction in the mortality rate for children under age 5, a three-quarter reduction in the maternal mortality ratio, and universal access to reproductive health by 2015 (UN, 2015c,d)
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Reduce the global maternal mortality ratio from the current rate, which is 216 maternal deaths for every 100,000 live births (UN, 2015a) , to <70 maternal deaths per 100,000 live births.
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. These maternal mortality rates put the United States squarely in line with middleincome countries such as Chile, Mexico, and Turkey -- clearly highlighting pregnancy- and childbirth-related maternal deaths as an area that would benefit from shared investment with other countries to achieve common solutions for improvement.
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From page 140... ...
Strategies should focus on ensuring the highest impact through scaling innovative approaches, with rigorous monitoring and evaluation, with a focus on immunization; integrated management of child illness, nutrition, and prenatal care; and increasing access to contraceptives, including family planning. World Health Organization A new global agenda, WHO's Global Strategy for Women's, Children's, and Adolescents' Health (2016–2030)
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From page 141... ...
. Establishing GFF platforms in all high-burden countries by 2030 has the potential to prevent up to 3.8 million maternal deaths, 101 million child deaths, and 21 million stillbirths (GFF, 2016)
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From page 142... ...
. Examining preterm birth as one of the top causes of death and disability in children highlights a need for an improvement in health care services for babies and their mothers, especially in LMICs, and also explains the important interplay between women's health and children's health.
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From page 143... ...
Although the world has not yet reached the MDG 5 -- A goal of reducing maternal mortality by 75 percent (achieving fewer than 70 deaths per 100,000 live births) , the gains that have been made allowed for women to have greater access to trained health care workers during pregnancy.
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From page 144... ...
The committee has selected five key areas (described in the sections below) in which it suggests investment and attention in order to maximize rates of survival for pregnant women and children: immunizations; integrated management of childhood illness; nutrition for pregnant women, newborns, infants, and children; keeping pregnant women safe; and access to contraceptives.
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was developed in 1995 by WHO and the United Nations Children's Fund to promote health and provide preventive and curative services for children under 5 in countries with high child mortality rates (WHO, 2016f)
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Ensuring babies are born at adequate birth weight starts with the m other's nutrition, even before she gets pregnant. Making certain that pregnant women have access to adequate food will ensure that the baby has nutrients to grow and develop in utero (USAID, 2014)
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. In addition to breastfeeding, micronutrient supplementation is a key intervention to improve maternal, infant, and child health.
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Keeping Pregnant Women Safe: Prenatal Care, Safe Delivery, and Access to Emergency Obstetrical Care Although the number of women who die each year from pregnancy and childbirth complications has fallen by nearly half in the past 20 years, 303,000 women still die every year from these causes (WHO, 2016d)
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. An analysis of 172 countries showed that family planning prevents approximately 272,000 maternal deaths worldwide each year (Ahmed et al., 2012)
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. Maternal mortality stands at 216 per 100,000 births, while child deaths are at 41 per 1,000 live births (Kassebaum et al., 2016; UN, 2015c)
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Recommendation 7: Improve Survival in Women and Children Congress should increase funding for the U.S. Agency for Interna tional Development to augment the agency's investments in ending preventable maternal and child mortality, defined as global mater nal mortality rates of fewer than 70 deaths per 100,000 live births by 2020 and fewer than 25 child deaths per 1,000 live births by 2030.
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. Such early child development practices translate into significant lifelong benefits in terms of labor market participation and earnings (Richter et al., 2017)
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. The recent Lancet series Early Child Development proposed a set of packages that consider these factors while also incorporating nurturing care and protection and tailoring the packages to unique sets of risks and adversities that characterize complex environments (Britto et al., 2017)
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. Additionally, members of the Lancet Commission on Early Childhood Development found that programs providing parental support for child development within the context of larger social protection efforts in Latin America have shown substantial benefits for child development (Fernald et al., 2017)
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Pakistan: Using the Lady Health Worker program, the study investigated the feasibility and effectiveness of integrating interventions directed at children under 2 years of age to enhance child development and growth outcomes. All interventions were integrated within existing services through home visits and group meetings.
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The United Nations International Children's Emergency Fund (UNICEF) recommends that efforts along six dimensions are needed as part of a global violence prevention strategy (UNICEF, 2014)
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. High-quality early child development programs and opportunities for early learning, such as day care, child care, and preschool, improve child outcomes during later schooling (Britto et al., 2017)
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. With the decline of nutrition- and infection-related child mortality and the push for universal primary school, the support and promotion of child development is crucially important.
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• Support and promote early education and cognitive stimula tion in young children. TRANSFORM: DEVELOPING WHOLE SYSTEMS OF CARE Many of the strategies and opportunities for investments related to reducing maternal and child mortality described above do not necessarily require new and separate funding streams or a novel and dedicated workforce.
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From page 160... ...
Training community health workers to share the tasks of physicians and nurses serves as an effective means to increase awareness in low-resource settings about NCDs (e.g., high blood pressure) , and they can help to disseminate information about particular diseases with the community's needs and culture in mind (Abrahams-Gessel et al., 2015)
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Within the category of workforce development, it is important to ensure that skilled birth attendants, community health workers, nurses, and primary care physicians have appropriate training in exclusive breastfeeding promotion and can ensure proper nutrition for newborns (WHO, 2017a)
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. Saving Mothers, Giving Life's latest report showed a 55 percent reduction in maternal mortality in target facilities in Zambia as a result of its interventions, and target districts in Uganda saw a 44 percent reduction in maternal mortality (SMGL, 2016)
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2015. The training and fieldwork experiences of community health workers conducting population-based, noninvasive screening for CVD in LMIC.
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2017. Promoting child development through group-based parent support within a cash transfer program: Experimental effects on children's outcomes.
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2016. Global, regional, and national levels of maternal mortality, 1990– 2015: A systematic analysis for the Global Burden of Disease Study 2015.
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2016. 2016 annual report: Reducing maternal mortality in sub-Saharan Africa.
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2016. Acting on the call: Ending preventable child and maternal deaths: A focus on equity.
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2014. Effect of integrated responsive stimulation and nutrition interventions in the lady health worker programme in Pakistan on child development, growth, and health outcomes: A cluster randomised factorial effectiveness trial.
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