Progress towards Millennium Development Goals 4 & 5: strengthening human resources for maternal, newborn and child health.

Abstract

Since the 1990s developing countries as a whole have made remarkable efforts to reduce under-five mortality rate from 90 to 48 deaths per thousand live births in 2012. As a result the number of annual under-five deaths dropped by nearly 6 million during that period. Unfortunately the pace of reduction was slowest in sub-Saharan Africa making it impossible that the region will reach the target for the Millennium Development Goals (MDGs) 4 but a few countries including some of the poorest such as Ethiopia Liberia Malawi and Niger have already met the MDG 4 target or are making progress that are consistent with the target. At the same time global maternal deaths have been nearly halved since the 1990s from 380 deaths per 100000 live births to 210 in 2013. In sub-Saharan Africa and South Asia the two regions where more than 85% of all maternal deaths occur the maternal mortality ratio (MMR) dropped from 990 to 510 and from 530 to 190 respectively. Skilled birth attendance (SBA) one of the proximate determinants of maternal mortality increased only modestly during the period 1990-2012 from 40% to 53% in sub-Saharan Africa and from 33% to 51% in South Asia. As with most health indicators there are wide variations in the coverage of SBA from 20% or less in Ethiopia and Niger to more than 80% in countries including Benin Namibia and Botswana. Most maternal newborn and child deaths result from causes that can be adequately treated by a package of well-known interventions. One of the main challenges in delivering essential and life-saving interventions to avert these deaths is the shortage of a well-trained supervised and motivated health workforce. With the vast amount of evidence showing that increased availability of skilled health workers is directly linked to improved maternal newborn and child health (MNCH) outcomes health workforce development is increasingly seen as a critical component of MNCH care delivery. (Excerpt)