Reduction of MMR Roadmap.ppt

7/29/2019 Reduction of MMR Roadmap.ppt

1/23

Road Map for Accelerating the

Reduction of Maternal andNeonatal Mortality and

Morbidity in Uganda

Dr. Olive Sentumbwe-MugisaFamily Health and Population, WHO


2/23

Demographic Characteristics

Total Population - 33 million

Population growth rate - 3.2%

Doubling time - 21 years

Life expectancy at birth - 48 yrs

HIV Seroprevalence - 6.2%

Infant mortality rate - 76/1000 L.B.

Under 5 mortality rate - 145/1000 L.B.

Maternal mortality ratio - 435/100,000 L.B.


3/23

Low Status of Women

Low completion of secondary education

Limited Access to Economic Opportunities

Land ownership - 7%

Engaged in formal sector employment - 20%

Limited Control over Economic Proceeds

Limited Participation in Governance

Women Ministers - -------%

Women Perm. Secretaries - 19.4% Female parliamentarians - 33?%


4/23

TRENDS OF THE REPRODUCTIVE

HEALTH INDICATORS IN UGANDA

1987 1995 2000 2005

TF R

UNMET FPCPR

DELIVERIES(skilled)

ADOL PREG.

MMRIMR

Neonatal

7.3

33%5%

37%

44%

527122

-

6.9

29%15%

38%

43%

50681

-

6.9

35%23%

38%

32%

50588

33/1000

6.7

40.623.7

41

32

43577

29


5/23

Persistently High Maternal Mortality Ratios

Inadequate national commitment and financial support

Poor co-ordination amongst partners

Weak health systems characterised by poor functioning

health systems, with weak referrals systems and poorlogistics for management

Inadequate access to, and availability of quality skilled care

Weak national human resource development andmanagement and unclear policies concerning practice

regulation Inadequate community involvement and harmful socio-

cultural beliefs and practices


6/23

Every Pregnancy carries a risk

Need for a skilled attendant

At all levels of the health care delivery

system:

Community

Primary Health Care Levels

Referral levels


7/23

Global Response

1987 - Launch of the Safe MotherhoodInitiative

1997 - Review of the Safe MotherhoodInitiative

10 Main Messages

2000 - MDGs

2004 - The African Road Map

2006 - Presidents letter to the MoH

2006 - Uganda Road Map


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The Road Map Vision

To have women in Uganda go

through pregnancy, childbirth and

postpartum period safely, andtheir babies born alive and

healthy.


9/23

The Goal of the Road Map

The overall goal is to accelerate

the reduction of maternal and

neonatal morbidity and mortalityin Uganda and help the country

achieve the MDGs.


10/23

Specific Objectives

To increase the availability, accessibility andutilization of quality skilled care during pregnancy,childbirth and postnatal period at all levels of thehealth care delivery system.

To promote and support appropriate healthseeking behaviour among pregnant women, theirfamilies and the community.

To strengthen family planning information andservice provision for women/men/couples whowant to space or limit their childbearing thuspreventing unwanted and/or untimely pregnanciesthat increase the risk of a maternal death


11/23

Strategy 1

Improving legal and policy environmentfor effective formulation and

implementation of maternal andnewborn health programmes: (i) Developing, reviewing and updating

policies, guidelines and protocols thatenable health professionals use theirskills

(ii) Ensuring adequate and appropriate

staffingat the health facility to provide the


12/23

Strategy 2

Improving the availability of, access to, and utilization ofquality Maternal and Newborn Care Services, particularly atsub-counties:

Provide Skilled Attendance at Births

Scaling up Emergency Obstetric Care, Goal oriented ANC,Neonatal and Postnatal care and PMTCT services, particularlyat sub county levels

Increasing access to accurate and quality Family Planninginformation and services

Establishing an appropriate and effective referral system

Strengthening of youth friendly sexual and reproductive healthservices


13/23

Strategy 3

Strengthening human resources and

building capacity to provide quality

maternal and newborn skilled health

care:

Build the capacity of training institutions

and service providers for key maternal andnewborn health interventions


14/23

Strategy 4

Advocating for increased resource

allocation for maternal and newborn

health care

Review resource allocations and

mechanism to improve accountability at all

levels

Strengthen the capacity of districts to

prioritise maternal and newborn health in

their Development and Annual

Implementation Plans


15/23

Strategy 5

Strengthening Coordination and

Management of Maternal and Newborn

Health Care Services:

Improve multi sectoral partnership,

collaboration and coordination between

and among all stakeholders

Promote effective public/private

partnership


16/23

Strategy 6

Empowering communities to ensure acontinuum of care between thehousehold and the health care facility

Empower communities to create demandfor maternal and newborn health services

Strengthen the capacity of health planning

teams and health facilities to manageMaternal and Newborn Health Services


17/23

Strategy 7

Strengthening monitoring and evaluation mechanisms forbetter decision making and service delivery of Maternal andNewborn Health Services

Improve accessibility and utilization of quality dataand information for planning and management ofmaternal and newborn health programmes

Review the Health Management Information System(HMIS) to capture all essential information onMaternal and Newborn Health

Strengthen MOH and Local Government capacity formonitoring and evaluation


18/23

Strategy 7 cont..

Providing technical/ facilitativesupport supervision to enhancequality of care

Institutionalizing maternal andnewborn death audits and reviews

Establishing a Monitoring andEvaluation System for the Road Map


19/23

Guiding Principles

Evidence-based

Health systems support

Complementarities

Partnership

Division of labour


20/23

Guiding principles cont.

Appropriateness and relevance

Transparency and accountability

Equity and accessibility

Phased planning and implementation

Human rights based and gender responsive


21/23

Institutional Framework

To be executed through the various line

ministries

National institutions-academic

Civil society

Professional bodies

Cultural and faith based institutionsNGOs and CBOs


22/23

Multi sectoral Response

Multi sectoral Technical working Group

Monitor policy development and

implementation

Ministry of Health

Coordinate implementation

Together with Ministry of local government

The Road Map is in line with the Goalsand objectives of the PEAP-MoF


23/23

Thank you for listening

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Reduction of MMR Roadmap.ppt

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