From safe motherhood, newborn, and child survival partnerships to the continuum of care and accountability: Moving fast forward to 2015

Bustreo, Flavia; Requejo, Jennifer; Merialdi, Mario; Presern, Carole; Songane, Francisco

doi:10.1016/j.ijgo.2012.03.008

Cited by 13 publications

(16 citation statements)

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“…1,2 The priority accorded to reductions in maternal mortality is shown by its choice as one of the eight Millennium Development Goals (MDGs). Despite these efforts and visibility, there was broad concern that little or no progress was being made, which prompted intensified efforts by the UN Secretary General through the launch of Every Woman Every Child in 2010, and the subsequent creation of the Commission on Information and Accountability for Women’s and Children’s Health.…”

Section: Introductionmentioning

confidence: 99%

“…Despite these efforts and visibility, there was broad concern that little or no progress was being made, which prompted intensified efforts by the UN Secretary General through the launch of Every Woman Every Child in 2010, and the subsequent creation of the Commission on Information and Accountability for Women’s and Children’s Health. 2,3 In 2010, a comprehensive assessment of global trends in maternal mortality suggested that the maternal mortality ratio (MMR; number of maternal deaths per 100 000 livebirths) had decreased by 1·3% per year since 1990. 4 Subsequent revisions of the historical estimates have shown even larger worldwide rates of change, from −1·9% to −3·1% per year.…”

Section: Introductionmentioning

confidence: 99%

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Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

et al. 2014

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Summary Background The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100 000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. Methods We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990–2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. Findings 292 982 (95% UI 261 017–327 792) maternal deaths occurred in 2013, compared with 376 034 (343 483–407 574) in 1990. The global annual rate of change in the MMR was −0·3% (−1·1 to 0·6) from 1990 to 2003, and −2·7% (−3·9 to −1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290–2866) maternal deaths were related to HIV in 2013, 0·4% (0·2–0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1–1262·8) in South Sudan to 2·4 (1·6–3·6) in Iceland. Interpretation Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. Funding Bill & Melinda Gates Foundation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

et al. 2014

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“…Flavia Bustreo, the Partnership’s director from 2006 to 2010, has argued that ‘the potential of the PMNCH to unify the previously fragmented maternal, newborn and child health (MNCH) communities created a positive atmosphere and sparked productive collaborations across sectors and constituencies’ (Bustreo et al 2012, p. S7). The increased visibility of the ‘MNCH’ agenda, she argues, helped promote a ‘continuum of care’ approach in maternal, newborn and child health care initiatives, thereby fostering greater appreciation for integrated health systems thinking (Bustreo et al 2012, p. S7).…”

Section: Introductionmentioning

confidence: 99%

“…These relate to the relative emphasis on comprehensive versus selective approaches to health and the role of long-term health system development versus the pursuit of magic bullets. Despite recent claims that the PMNCH is ‘a testament to growing emphasis on collaboration as the most effective way forward to improving the lives of women, newborn and children’ (Bustreo et al 2012, p. 8), we explore how the politics of institutional control and distinct advocacy coalitions’ tendency towards competition for funding and attention have posed a challenge to effective collaboration—or partnership—between expert groups. We end by reflecting on whether the current partnership model that dominates global health governance is equipped to meet the challenges of achieving institutional and programmatic integration.…”

Section: Introductionmentioning

confidence: 99%

“Lives in the balance”: The politics of integration in the Partnership for Maternal, Newborn and Child Health: Table 1.

Storeng

Béhague

2016

Health Policy Plan.

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A decade ago, the Partnership for Maternal, Newborn and Child Health (PMNCH) was established to combat the growing fragmentation of global health action into uncoordinated, issue-specific efforts. Inspired by dominant global public-private partnerships for health, the PMNCH brought together previously competing advocacy coalitions for safe motherhood and child survival and attracted support from major donors, foundations and professional bodies. Today, its founders highlight its achievements in generating priority for ‘MNCH’, encouraging integrated health systems thinking and demonstrating the value of collaboration in global health endeavours. Against this dominant discourse on the success of the PMNCH, this article shows that rhetoric in support of partnership and integration often masks continued structural drivers and political dynamics that bias the global health field towards vertical goals. Drawing on ethnographic research, this article examines the Safe Motherhood Initiative’s evolution into the PMNCH as a response to the competitive forces shaping the current global health field. Despite many successes, the PMNCH has struggled to resolve historically entrenched programmatic and ideological divisions between the maternal and child health advocacy coalitions. For the Safe Motherhood Initiative, the cost of operating within an extremely competitive policy arena has involved a partial renouncement of ambitions to broader social transformations in favour of narrower, but feasible and ‘sellable’ interventions. A widespread perception that maternal health remains subordinated to child health even within the Partnership has elicited self-protective responses from the safe motherhood contingent. Ironically, however, such responses may accentuate the kind of fragmentation to global health governance, financing and policy solutions that the Partnership was intended to challenge. The article contributes to the emerging critical ethnographic literature on global health initiatives by highlighting how integration may only be possible with a more radical conceptualization of global health governance.

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“…1 In general, maternal health have become a priority in MDGs, decanted as the fifth item (MDGs 5), that is to "improve quality of maternal health". 2,3 In the April 2011 report, Hernawati et al 4 from Directorate of Maternal Health Ministry of Health Republic of Indonesia, mentioned that maternal mortality in Indonesia, based on Basic Health Survey called "Riskesdas" latest data on 2007, was 228 per 100.000 live births.…”

Section: Methodsmentioning

confidence: 99%

Current trend of maternal health in Indonesia

Sugiarto¹,

Kumboyo²

2012

Med J Indones

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From safe motherhood, newborn, and child survival partnerships to the continuum of care and accountability: Moving fast forward to 2015

Cited by 13 publications

References 16 publications

Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

“Lives in the balance”: The politics of integration in the Partnership for Maternal, Newborn and Child Health: Table 1.

Current trend of maternal health in Indonesia

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