Successes&in& Improving&Health& Outcomes:& · 2 1. Individuals: scientists/ academics,...
Transcript of Successes&in& Improving&Health& Outcomes:& · 2 1. Individuals: scientists/ academics,...
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Successes&in&
Improving&Health&
Outcomes:&
Countdown(Country(Case(Studies
Professor&Zulfiqar&A.&Bhu?a&
Co#chair,*Countdown(to(2015(26*September*2015*
Accountability(in(the(Post(2015(Era&
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1. Individuals: scientists/academics, policymakers, public health workers, communications experts, teachers…
2. Governments: RMNCH policymakers, members of Parliament…
3. Organizations: NGOs, UN agencies, HCPAs, donors, medical journals…
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Who&is&Countdown?&
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75*countries*that*together*account*for*>*95%*of*maternal*and*child*deaths*worldwide*
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! To*disseminate*the*best*and*most*recent*informaCon*on*country#level*progress**
! To*take*stock*of*progress*and*propose*new*acCons*
! To*hold*governments,*partners*and*donors*accountable*wherever*progress*is*lacking*
Countdown&aims&
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! MulC#sectoral,*supra#insCtuConal,*consensus#building*
! Use*of*recent,*replicable,*relevant*data*on*coverage*and*its*determinants*
! DisaggregaCon*of*data*to*reveal*inequiCes*
! Explaining*the*data*to*promote*uptake*and*acCon*
! Strengthening*analyCcal*capacity*in*high#priority*countries*
Countdown’s&strengths&
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Countdown*Country*Case*Studies*
Use*evidence*to*explain*HOW*a*
country*progressed*in*MDG&4&&&5&
Translate&
research*to*policy*through*country*disseminaNon&
CapacityObuilding&
of*country*leaders*for*RMNCH&
monitoring*and*research*
Objec2ves:(
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PHASE&1&(n=2&)
PHASE&2&(n=6)&
PHASE&3&(n=2)
Bangladesh R M N C
75&Countdown&Countries
Niger R M N C
Ethiopia R M N C
Kenya R M N C
Malawi R M N C
Afghanistan R M N CChina R M N C
Tanzania R M N C
Peru R M N C
Pakistan R M N C
Countdown&&Country&Case&Studies
10*Case*Study*countries*
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! Led*by*in#country*insCtuCon*independent*of*program*implementaCon**
! Assessment*of*coverage*and*impact*measures*across*conCnuum*of*care;*equity*analyses,*including*subnaConal*analysis;*complementary*data*on*policy,*health*systems,*financing*
! Strong*capacity#building*component,*with*technical*assistance*via*Countdown*Technical*Working*Groups*
! Plans*and*results*presented*and*discussed*with*Government*and*relevant*stakeholders*in*country*
! PublicaCon*and*in#country*disseminaCon*
How&it&works&
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2012& 2015&
Today*
Sep* 2013* May* Sep* 2014* May* Sep* 2015* May* Sep*
Niger&publicaNon&&
9/12*
SelecNon&of&first&6&full&county&case&studies&&
2/13*
First&country&case&study&meeNng&at&Women&
Deliver&Conference&in&Kuala&Lumpur&
5/13*
First&countryO
capacity&building&
workshop&in&
Pelotas&
6/13*
Health&systems&&&policy&and&financing&
workshop&in&Nairobi&
2/14*
Tanzania&disseminaNon&&
5/14*
Bangladesh&publicaNon&
6/14*
Country&case&study&meeNng&in&South&Africa&
at&Partner's&Forum&&&
7/14*
Peru&disseminaNon&&
11/14*
Capacity&bulding&workshop&in&London&
2/15*
Afghanistan&&&Pakistan&
disseminaNon&&
5/15*
Tanzania&publicaNon&&
6/15*
Ethiopia&disseminaNon&&
6/15*
Malawi&disseminaNon&&
7/15*
2/15/2013*#*11/15/2015*Phase&2&Country&Case&Studies&
4/1/2014*#*12/31/2015*Phase&3&Country&case&studies&&
Case*Study*Timeline*
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Case&study&milestones&
…*with*more*to*come*
5*capacity#building*workshops*and*
meeCngs*
6*disseminaCon*events*
5*scienCfic*publicaCons*
5&Case*Study*Briefs*
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10
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%
Interventions varies across the continuum of care in Afghanistan
Pregnancy Birth Postnatal Infancy Childhood Water and sanitation
Pre- Pregnancy
Median national coverage of selected interventions **MICS 2010,*NNS 2013 & ǂEPIC 2013
• Provincial Coverage (%)
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Change in Skilled Birth Attendance (Afghanistan 2003-2011)
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2682
10973
14330
18939 19648
21227
23363 25478
28837
2005 2006 2007 2008 2009 2010 2011 2012 2013 0
5000
10000
15000
20000
25000
30000
35000
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
CH
W (F
requ
ency
)
Oth
er H
W C
adre
s (F
requ
ency
)
Community Health Workers MD Specialists MD Generalists Nurses Midwives
Investing in health workers makes sense (Afghanistan)
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Children (%) with ARI for whom advice or treatment was sought from a health facility or provider
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Proportion of children never immunized (12-23 months children)
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Some&common&findings&
! VerCcal*intervenCons*were*implemented*widely,*reached*high*coverage**
! Persistently*lower*coverage*for*more*complex*intervenCons,*like*curaCve*and*maternal*care*services*
! Childhood*malnutriCon,*requiring*mulC#sectoral*approach,*has*been*slow*to*improve*
! Significant*equity*gaps,*along*socioeconomic*and*geographic*dimensions,*gender**persist*in*most*case*study*countries*
! Importance*of*contextual*factors,*including*socioeconomic*development,*poliCcal*stability,*conflict*and*decentralizaCon*
But(many(mixed(findings(reinforce(the(need((for(more(countryAspecific(inAdepth(case(studies((
*
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Looking Forward
• Countdown will continue to advance its technical inputs to monitoring & evaluating progress in delivering interventions for RMNCH & Nutrition of relevance to EWEC 2.0 and the Sustainable Development Goals.
• Continue to develop its country-level work, strategic in-country partnerships & capacity development with regional networks
• Build on the foundations of the last decade & strengthen
its contribution to the unified accountability process