Perceptions and viewpoints on proceedings of the Fifteenth Assembly of Heads of State and Government of the African Union Debate on Maternal, Newborn and Child Health and Development, 25-27 July 2010, Kampala, Uganda.
Perceptions and viewpoints on proceedings of the Fifteenth Assembly of Heads of State and Government of the African Union Debate on Maternal, Newborn and Child Health and Development, 25-27 July 2010, Kampala, Uganda.
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DOI：
10.1186/1753-6561-5-s5-s1
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发表时间：
2011-06-13
期刊：
影响因子：
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通讯作者：
Ki-Zerbo G
中科院分区：
文献类型：
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作者：
Sambo LG;Kirigia JM;Ki-Zerbo G
在2008年全球发生的35.8万例孕产妇死亡中，57.8%发生在非洲大陆。非洲的孕产妇死亡率为590，而发达区域为14，拉丁美洲和加勒比为68，亚洲为190。本文回顾了非洲联盟国家元首和政府首脑第十五届大会期间就非洲孕产妇死亡率如此之高的原因以及如何降低孕产妇死亡率进行的讨论，采用的方法包括非洲联盟国家元首和政府首脑之间的小组讨论和公开讨论。本文使用世卫组织卫生系统加强框架，其中包括六大支柱（信息系统，领导和治理，卫生人力，融资，医疗产品，疫苗和技术，卫生服务）来描述讨论的过程。各国孕产妇死亡率高的原因是：国家卫生信息系统薄弱;与贫穷、卫生文盲、交通网络和通信基础设施差、危险的文化习俗、武装冲突和家庭暴力、缺乏妇女赋权有关的领导和治理挑战;熟练助产士人数不足;国内和外部资金不足;消费品缺货;孕产妇和儿童保健干预措施的覆盖面有限。为加快实现千年发展目标4和5的进展，各国国家元首和政府首脑建议，各国应规定孕产妇死亡情况应予以通报，并将孕产妇死亡审计制度化;制定、资助和实施旨在改善孕产妇、新生儿和儿童健康的政策和战略;加快部门间行动，以解决广泛的健康决定因素;增加熟练助产士的人数;履行承诺，将至少15%的国家预算分配给卫生部门，并分配足够的资源，防止基本药品和生殖健康商品缺货;利用健康促进方法提高国民认识;并确保在半径4公里范围内有一个卫生中心，配备提供优质综合孕产妇、新生儿和儿童保健服务的设备。讨论者一致认为，迫切需要加快加强卫生系统的行动，以扩大孕产妇、新生儿和儿童保健服务的覆盖面;并解决妇女、新生儿和儿童健康的广泛决定因素，以实现持续改善健康和其他发展目标。
Out of 358000 maternal deaths that occurred globally in 2008, 57.8% occurred in continental Africa. Africa had a maternal mortality ratio of 590 compared to 14 in developed regions, 68 in Latin America and Caribbean, and 190 in Asia. This article reflects on the discussions held during the Fifteenth Assembly of the Heads of State and Government of the African Union on the reasons why the maternal mortality ratio is so high in Africa and what can be done to reduce it. Methods employed included panel and open public discussions among the Heads of State and Government of the African Union. The article uses the WHO health systems strengthening framework, which consists of six pillars (information systems, leadership and governance, health workforce, financing, and medical products, vaccines and technologies, and health services) to describe the proceedings of the discussions. The high maternal mortality ratios in countries were attributed to weak national health information systems; leadership and governance challenges related to poverty, health illiteracy, poor transport networks and communications infrastructure, risky cultural practices, armed conflicts and domestic violence, dearth of women empowerment; inadequate levels of skilled birth attendants; inadequate domestic and external funding; stock-outs of consumable inputs; and limited coverage of maternal and child health interventions. In order to accelerate progress towards MDGs 4 and 5, the Heads of State and Government recommended that countries should make maternal deaths notifiable and institutionalize maternal death audits; develop, fund and implement policies and strategies geared at improving maternal, newborn and child health; accelerate inter-sectoral action to address the broad health determinants; increase the number of skilled birth attendants; fulfil commitment to allocate at least 15% of the national budget to the health sector and allocate adequate resources to prevent stock-outs of essential medicines and reproductive health commodities; leverage health promotion approaches to raise national awareness; and ensure that there is a health centre within a radius of four kilometres equipped to provide good quality integrated maternal, newborn and child health services. There was consensus among the discussants that there was urgent need to speed up actions for strengthening health systems to improve coverage of maternal, newborn and child health services; and to address broad determinants of women, newborn and children’s health for sustained improvements in health and other development goals.