S31 1 integrating tobacco control and maternal and child health to achieve the united nations...
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MDGs, Tobacco and MCH | April 26, 2012 1 |
Integrating tobacco control and
maternal and child health to
achieve the UN Millennium
Development Goals
MDGs, Tobacco and MCH | April 26, 2012 2 |
Presentation Outline
Connection of tobacco and MDGs
Impact of tobacco use on maternal health – Fecundity and fertility, impact of co-morbidities related to tobacco
Impact of tobacco use on child health – Preterm, LBW, IUGR, congenital malformations, SIDS, URI, Asthma
Tobacco use among adults and youth (prevalence) – Smoking and smokeless
– SHS exposure and gender disparities
Interventions based around Life cycle approach
WHO guidelines for management of tobacco use and SHS during pregnancy
MDGs, Tobacco and MCH | April 26, 2012 3 |
UN Millennium Development Goals
Eradicate extreme poverty
and hunger
Achieve universal primary
education
Promote gender equality
and empower women
Reduce child
mortality
Improve maternal
health
Combat HIV/AIDS,
malaria and other diseases
Ensure environ- mental
sustain-ability
MDGs, Tobacco and MCH | April 26, 2012 4 |
Reduce child mortality
Improve maternal
health
MDGs, Tobacco and MCH | April 26, 2012 5 |
Maternal health: To reduce by three quarters the
maternal mortality ratio between 1990 and 2015
Child mortality: To reduce by two thirds the infant
and under-five mortality between 1990 and 2015
NCD HLM proposed global tobacco target: 40%
relative reduction in current tobacco smoking by
2025
MCH and Tobacco targets
MDGs, Tobacco and MCH | April 26, 2012 6 |
Impact of Tobacco on Maternal and Child
health
Neonatal & Infant outcomes Maternal Outcomes
Preterm birth
Low birth weight
Congenital malformations
Sudden Infant Death
Syndrome
Infertility
Spontaneous abortion
Ectopic pregnancy
Placenta previa
Placental abruption
Premature rupture of
membranes
Smoking in the
preconception period and
during pregnancy
Stillbirth
Preterm birth
Low birth weight
Pre-eclampsia Using smokeless tobacco in
the preconception and
during pregnancy
Stillbirth
Lower birth weight
Respiratory problems Exposure to second hand
smoke during the
preconception period and
pregnancy
MDGs, Tobacco and MCH | April 26, 2012 7 |
Advertising and Promoting targeting
women and girls
Tobacco industry spends billions of dollars worldwide
each year on advertising, promotion and sponsorship.
In the last 2 years, the industry has launched its most
aggressive marketing campaigns aimed at women and
girls in over a decade
October 2008: Purse packs -- small, rectangular cigarette
packs that come in mauve or teal and contain superslim
cigarettes.
Designed to look like popular clutch-style purses with pop-up
purse packs inside and coupons for over $5 off.
Targeting women of different cultures
Targeting young women
MDGs, Tobacco and MCH | April 26, 2012 12 |
Prevalence of current cigarette smoking
among 13-15 year olds
Source: Global Youth Tobacco Survey, 2000- 2007
MDGs, Tobacco and MCH | April 26, 2012 13 |
Prevalence of current use of smokeless and
other tobacco products among 13-15 year olds
Source: Global Youth Tobacco Survey, 2000- 2007
MDGs, Tobacco and MCH | April 26, 2012 14 |
Prevalence of adult tobacco smoking
Source: Global Adult Tobacco Survey, 2008–2010
MDGs, Tobacco and MCH | April 26, 2012 15 |
Proportion of non-smoking adults exposed to
secondhand smoke, by WHO region - 2010
MDGs, Tobacco and MCH | April 26, 2012 16 |
Prevalence of SHS exposure at home and
public places - 13-15 year olds
Source: Global Youth Tobacco Survey, 2000- 2007
WHO Framework Convention
on Tobacco Control
Proposed action by WHO:
Development of guidelines for management
of tobacco use and second hand smoke
during pregnancy
MDGs, Tobacco and MCH | April 26, 2012 19 |
Effective interventions and their delivery mechanisms
Existing delivery
mechanisms
Health interventions Tobacco use
Primary Health Care (PHC) facilities
and existing health care systems
Screening of women and girls for tobacco
use (smoking and smokeless tobacco) at all
clinical visits
Brief tobacco cessation advice
Referral to intensive behavioural counseling
services
Pharmacotherapy including Nicotine
Replacement Therapy (NRT) if available
Tobacco use (smoking
and smokeless) by
women
MDGs, Tobacco and MCH | April 26, 2012 20 |
Effective interventions and their delivery mechanisms
Existing delivery
mechanisms
Health interventions Exposure to SHS
Primary Health Care (PHC) facilities
and existing health care systems
Screening for tobacco use (smoking tobacco)
at all clinical visits, both men and women
Provide information of dangers of second
hand smoking and its harmful effects on the
pregnant woman, unborn child and other
family members
Brief tobacco cessation advice for the
partners/husbands and others who smoke
Referral to intensive behavioral counseling
services
Pharmacotherapy including Nicotine
Replacement Therapy (NRT) if available for
the partners/husbands who smoke
Exposure to second hand
smoke
MDGs, Tobacco and MCH | April 26, 2012 21 |
Antenatal Care Coverage – WHO regions
MDGs, Tobacco and MCH | April 26, 2012 22 |
Antenatal Care Coverage
Antenatal care coverage - at least four visits (%). Source: WHOSIS, 29 Sep 2009
0
20
40
60
80
100
Cap
e V
erd
e
Bo
tsw
ana
Cze
ch R
ep
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lic
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ic P
eo
ple
's
Do
min
ican
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pu
bli
c
Jord
anM
ald
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s
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pu
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c o
f M
old
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ru
Lib
eri
aC
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me
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Ho
nd
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Kyr
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Ind
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eki
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Ro
man
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Co
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arag
ua
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alva
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ibia
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nm
ar
Gab
on
Tun
isia
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ite
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Bah
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ero
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t
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ite
d A
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mo
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Ke
nya
Ind
ia
Gu
ine
aN
ige
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Uga
nd
a
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te d
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ire
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rab
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lge
ria
Erit
rea
Ce
ntr
al A
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an R
ep
ub
lic
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agas
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Sen
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rial
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ine
a
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rocc
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Mal
iA
zerb
aija
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Tim
or-
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Ne
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Vie
t N
amC
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rkin
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ad
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rita
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Ban
glad
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and
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uti
Antenatal care coverage - at least four visits (%). Data extracted from WHOSIS, 29 Sep 2009
MDGs, Tobacco and MCH | April 26, 2012 23 |
SHS Exposure among Pregnant Women by Country
0
25
50
75
100
Dom
inican
Rep
ublic
Gha
na
Niger
ia
Eth
iopia
Libe
ria
Swaz
iland
Malaw
i
Uga
nda
Zim
babw
e
Tan
zania
Moz
ambiqu
e
Zam
bia
Ken
ya
Nam
ibia
Leso
tho
Maldive
s
Ukr
aine
Moldo
va
Alban
ia
Sierra Le
one
Mad
agas
car
Aze
rbaijan
Nep
al
Philip
ines
Ban
glad
esh
India
Arm
enia
Tim
or-L
este
Country
Percent
Women whose husband/partner attended at least one antenatal care visit
MDGs, Tobacco and MCH | April 26, 2012 24 |
WHO Guidelines
TARGET: health care providers and health systems
stakeholders
AIM: Make evidence-based recommendations for:
– management of tobacco use during pregnancy
– prevention of second hand smoke exposure during pregnancy
TIMEFRAME:
Planned to be completed by end of 2012
MDGs, Tobacco and MCH | April 26, 2012 25 |
WHO Guidelines
Invitation to a side meeting:
Date: 24 March 2012
Time: 14:00 – 16:00 hours (followed by coffee/tea)
Venue: Pan-Pacific Hotel, Singapore
2nd Floor, Meeting room Ocean 6.
7 Raffles Boulevard, Marina Square, Singapore
MDGs, Tobacco and MCH | April 26, 2012 26 |
Thank you