Della R SherrattInternational Skilled

Birth Attendance (SBA) Coordinator

MDG 4 and 5 What News from Lao PDR–?

UNFPA Mission

• UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect.

COUNTDOWN TO 2015 REPORT 2008 DATA, PAINTS POSITIVE PICTURE FOR CHILD HEALTHHTTP://WWW.COUNTDOWN2015MNCH.ORG

But for Lao Newborns, not such a positive trend

Why do we not have data on newborns?

MATERNAL HEALTH = SERIOUSLY “OFF-TRACK” ?

All pregnant women are at risk

• Each year, more than 350,000 women die from pregnancy or delivery-related causes and the vast majority of these deaths occur in developing countries.

• Each pregnancy puts a woman at risk of maternal death, but women who have induced abortions, miscarriages or stillbirths have been found to be at a higher risk of maternal mortality than those who have live births.

Causes of maternal deathsRegional estimates for Asia, 1997-2002

Reducing MMR – 3 Pillars

Community Empowerment and mobilization

Links between Maternal & Child Health

• Mother Newborn dyad: Chances of survival of child to 5, if mother dies is poor

• Newborn Deaths = large proportion of under five child Deaths

• (Many) causes Newborn deaths, illness and disability are same as Maternal

• Nutrition of mother impacts fetal & Child

Same Interventions Needed

Mother• FP = can reduce 20%

MMR• STI Prevention and

Treatment: Postpartum Infection, Sepsis, Death

• Partograph – prevent Prolonged Obstructed labour

Newborn Survival /Child Health

• FP = Increased BF duration,

• STI prevention treatment esp,Congenital Syphilis, and Blindness (Gonn), Pnemonia (Chlamydia)

• Prevent fetal distress, birth asphyxia (brain injury) death = prevent prolgned obstructed labour

Increased Access to Modern Contraceptives and Family Planning for

Maternal and Child Health

• Too many pregnancies, too closely spaced births, are detrimental to women's reproductive health and can result in complicated pregnancies, example fistula (major disability), but also other injuries or death.

• FP can reduce maternal deaths and injuries by at least 20 per cent (more in adolescent girls).

• Increase length of breastfeeding• Under-five Child Development improved• Benefits to Family health and wellbeing

What is Lao PDR doingto improve the health ofmothers and children?

Policies and Plans

2009 Approved NationalStrategy for Integrated Package of MNCH Services

National Plan for Skilled Birth Attendance 2009-2013

2010 National Nutrition Policy 2010 Free Childbirth Care for poorest

Policy

19 May 2011 - Lao PDR announces Commitment to UN Sec General Initiative for Women and Children at WHA

Implement Free Birth Policy

Train and accredit 1,500 Midwives

Reduce unmet need for FP

90 % Children fully immunized

Technical & Financial Support

And ADB and many others NGO

Progress - but still a long way to go

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Getting Family Planning Services to most Rural Communities

Upgraded rural health centres

Old HC / Somboun & Namouang New HC and

delivery room

Lao - Belgium Cooperation Project

Maternity Waiting Home and delivery sites [Silk Home Project and others]

There has been some success in getting women to health care in remote areas –but sustainability can be a problem

Key to successful HR Development• Recruitment - link to where needs

• Train - competency-based; focus on skills required including to save lives (must critical thinking and decision making); train close to where they live and work

• Accredit

• Deploy - where needed• Retain – incentives (financial and none financial).

Career pathways, status; Supportive Supervision

Creating Skilled Attendants(SBA) to keep Mothers & Babies Safe

Creating awareness and identify - A national uniform for midwives - so communities can recognize them

Creating Skills laboratories

Access to EmONC is very Limited currently undertaking National Needs Assessment

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Strategy Vision

Implementing the integrated Maternal, Neonatal and Child mortality reduction strategy will achieve universal coverage of an essential package of interventions for all mothers and children in Lao PDR regardless of gender, geographical, socio-economic and ethnic differences

Thank You

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Sok Dee