The Wold Health Report 2005

Book : The Wold Health Report 2005

Author : * --

Language : English

Episode : Child Labor

Publishing Location : France

Published Date : 2005

Publisher : World Health Organization WHO

Language : Turkish

Document Type : Book

Book No : 6660


Message from the Director-General
Patchy progress and widening gaps - what went wrong? Making
the right technical and strategic choices Moving towards universal coverage: access for ali,
with financial protection Chaptersummaries
Chapter 1
İVlothers and ciıildren matter - so tioes their health
The early years of maternal and child health Where we are now: a moral and political imperative Mothers, children and the Millennium Development Goals Uneven gains in child health The nevvborn deaths that went unnoticed Few signs of improvement in maternal health A patchvvork of progress, stagnation and reversal The numbers remain high
Chapter 2
ObsîacSes to progress: conîeıt or poiicy?
Context matters Poverty undermines progress The direct and indirect effects of HIV/AIDS Conflicts and emergencies set systems back The many faces of exclusion from care Sources of exclusion Patterns of exclusion Different exclusion patterns, different challenges Are districts the right strategy for moving tovvards universal coverage? A strategy vvithout resources Have districts failed the test?
Chapter 3
Great expectations: making pregnancy safer
Realizing the potential of antenatal care Meeting expectations in pregnancy Pregnancy - a time with its own dangers Seizing the opportunities Critical directions for the future Not every pregnancy is vvelcome Planning pregnancies before they even happen Unsafe abortion: a majör public health problem Dealing with the compiications of abortion Valuing pregnancy: a matter of legal protection
Chapter 4
Attending to 136 milliorı births, every year
Risking death to give life
Skilled professional care: at birth and aftervvards Successes and reversals: a matter of building health systems Skilled care: rethinking the division of labour Care that is close to vvomen - and safe A back-up in case of compiications Rolling out services simultaneously Postpartum care is just as important
Chapter 5
Newborns: no longer going unnoticed
The greatest risks to life are in its beginning Progress and some reversals No longer falling betvveen the cracks Care during pregnancy Professional care at birth Caring for the baby at home Ensuring continuity of care Planning for universal access Benchmarks for supply-side needs Room for optimism, reasons for caution Closing the human resource and infrastructure gap Scenarios for scaling up Costing the scale up
Chapter 6
Redesigning child care: survival, grovvth and development
Improving the chances of survival The ambitions of the primary health care movement The successes of vertical programmes Time for a change of strategy Combining a vvider range of interventions Dealing with children, not just with diseases Organizing integrated child care
Households and health workers Referring sick children Bringing care closer to children Rolling out child health interventions The cost of scaling up coverage From cost projections to scaling up
Chapter 7
Reconciliog maternal, newS3orn and child heaittı wsth health systern development
Repositioning MNCH
Different constituencies, different languages Sustaining political momentum Rehabilitating the vvorkforce Not just a question of numbers Recovering from the legacy of past neglect Destabilization with the best of intentions Tackling the salary problem Financial protection to ensure universal access Replacing user fees by prepayment, pooling and a refinancing of the sector
Making the most of transitory financial protection mechanisms Generalizing financial protection Channelling funds effectively
StatisîioaS annex
Explanatory notes
AnnexTabie 1
Basic indicators for ali WHO Member States
Annex Table 2a
Under-five mortality rates: estimates for 2003, annual average percent change 1990-2003, and availability of data
Annex Table 2b
Under-five mortality rates (per 1000) directly obtained from surveys and vital registration, by age and latest available period or year
Annex Table 3
Annual number of deaths by cause for children under five years of age in WHO regions, estimates for 2000-2003
Annex Table 4
Annual number of deaths by cause for neonates in WH0 regions, estimates for 2000-2003
Annex Table 5
Selected national health accounts indicators: measured levels of expenditure on health, 1998-2002
Annex Table 6
Selected national health accounts indicators: measured levels of per capita expenditure on health, 1998-2002
Annex Table 7
Selected immunization indicators in ali WH0 Member States
Annex Table 8
Selected indicators related to reproductive, maternal and nevvborn health
Figüre 1.1
Slovving progress in child mortaiity: how Africa is faring worst
Figüre 1.2
Neonatal and maternal mortaiity are related to the absence of a skilled birth attendant
Figüre 1.3
Changes in under-5 mortaiity rates, 1990-2003: countries shovving progress, stagnation or reversal
Figüre 1.4
Patterns of reduction of under-5 mortaiity rates, 1990-2003
Figüre 1.5
Maternal mortaiity ratio per 100 000 live births in 2000
Figüre 1.6
Neonatal mortaiity rate per 1000 live births in 2000
Figüre 2.1
A temporary reversal in maternal mortaiity: Mongolia in the early 1990s
Figüre 2.2
Levelling off after remarkable progress: DTP3 vaccine coverage since 1980
Figüre 2.3
Different patterns of exclusion: massive deprivation at low levels of coverage and marginalization of the poorest at high levels
Figüre 2.4
From massive deprivation to marginal exclusion: moving up the coverage ladder
Figüre 2.5
Survival gap betvveen rich and poor: vvidening in some countries, narrovving in others
Figüre 3.1
Coverage of antenatal care is rising Figüre 3.2
The outcomes of a year's pregnancies
Figüre 3.3
Grounds on which abortion is permitted around the vvorld
Figüre 4.1
Causes of maternal death
Figüre 4.2
Maternal mortaiity since the 1960s in Malaysia, Sri Lanka and Thailand
Figüre 4.3
Number of years to halve maternal mortaiity, selected countries
Figüre 5.1
Deaths before five years of age, 2000
Figüre 5.2
Number of neonatal deaths by cause, 2000-2003
Figüre 5.3
Changes in neonatal mortality rates betvveen 1995 and 2000
Figüre 5.4
Neonatal mortality in African countries shovvs stagnation and some unusual reversals
Figüre 5.5
Neonatal mortality is lower when mothers have received professional care
Figüre 5.6
The proportion of births in health facilities and those attended by medical doctors is increasing
Figüre 5.7
The human resource gap in Benin, Burkina Faso, Mali and
Niger, 2001
Figüre 5.8
Cost of scaling up maternal and nevvborn care, additional to current expenditure
Figüre 6.1
An integrated approach to child health 1
Figüre 6.2
Proportion of districts vvhere training and system strengthening
for İMCİ had been started by 2003 1
Figüre 6.3
Cost of scaling up child health interventions, additional to
current expenditure 1
Box 1.1
Milestones in the establishment of the rights of vvomen and children
Box 1.2
Why invest public money in health care for mothers and children?
Box 1.3
A reversal of maternal mortality in Malawi
Box 1.4
Counting births and deaths
Box 2.1
Economic crisis and health system meltdown: a fatal cascade of events
Box 2.2
How HIV/AIDS affects the health of vvomen and children
Box 2.3
Health districts can make progress, even in adverse circumstances
Box 2.4
Mapping exclusion from life-saving obstetric care
Box 2.5"
Building functional health districts: sustainable results require a long-term commitment
Box 3.1
Reducing the burden of malaria in pregnant vvomen and their children Box 3.2
Anaemia - the silent killer
Box 3.3
Violence against women
Box 4.1
Obstetric fistula: surviving with dignity
Box 4.2
Maternal depression affects both mothers and children
Box 4.3
Screening for high-risk childbirth: a disappointment
Box 4.4
Traditional birth attendants: another disappointment
Box 4.5
Preparing practitioners for safe and effective practice
Box 5.1
Explaining variations in maternal, neonatal and child mortality: care or context?
Box 5.2
Sex selection Box 5.3
Box 5.4
A breakdown of the projected costs of extending the coverage of maternal and nevvborn care
Box 6.1
What do children die of today?
Box 6.2
How households can make a difference
Box 6.3
A breakdovvn of the projected cost of scaling up
Box 7.1
International funds for maternal, nevvborn and child health
Box 7.2
Building pressure: the partnerships for maternal, nevvborn and child health
Box 7.3
MNCH, poverty and the need for strategic information
Box 7.4
Sector-vvide approaches
Box 7.5
Rebuilding health systems in post-crisis situations
Box 7.6
Civil society involvement reguires support
Table 1.1
Neonatal and maternal mortality in countries vvhere the decline in child mortality has stagnated or reversed
Table 2.1
Factors hindering progress
Table 4.1
Incidence of majör complications of childbirth, worldwide
Table 4.2
Key features of first-level and back-up maternal and nevvborn care
Table 5.1
Filling the suppiy gap to scaie up first-level and back-up maternal and nevvborn care in 75 countries (from the current 43% to 73% coverage by 2015 and full coverage in 2030)
Table 6.1
Core interventions to improve child survival


Make every mother and child count