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MDG #4: Reduce Under 5 Mortality Rate by 2/3

MDG #4: Reduce Under 5 Mortality Rate by 2/3. 1990 - 2015. Made progress U5M rate has dropped by ~1/3 since 1990 Highest rates remain in Sub-Saharan Africa (1 in 8) > 50% deaths due to malaria, diarrhea, pneumonia Second highest Southern Asia (1 in 14)

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MDG #4: Reduce Under 5 Mortality Rate by 2/3

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  1. MDG #4: Reduce Under 5 Mortality Rate by 2/3 1990 - 2015

  2. Made progress U5M rate has dropped by ~1/3 since 1990 • Highest rates remain in Sub-Saharan Africa (1 in 8) • > 50% deaths due to malaria, diarrhea, pneumonia • Second highest Southern Asia (1 in 14) • Most/many of deaths are in the first 28 days of life • % U5M due to neonatal death rising

  3. Leading causes under 5 mortality globally • Pneumonia (18%) • Diarrheal diseases (15%) • Pre-term birth complications (12%) • Birth asphyxia (9%) • Africa (excluding N. Africa) - malaria major cause child mortality (16%) • Under-nutrition is an underlying cause of ~1/3 U5M

  4. Disparities Within Regions • Within a country/region see increased U5M • Rural • Poor • Less educated mother

  5. “Life-Saving Six” • Iron (mother and child) and folate (mom) • Breastfeeding – 1st 6 months exclusively • Complementary feeding – 6 mos + • Vitamin A ( 2 doses /year, child) • Sight, measles, • Zinc (child) • Diarrhea (give Zn w/ORS as treatment) • Hygiene, water, sanitation

  6. Skilled birth attendant present • Well nourished mom reduces chance pre-term LBW baby • Both increase risk neonatal death • Start breastfeeding within first hour of birth • Hygienic cord care • Keep baby warm at birth – skin to skin • Breast feed exclusively for 1st 6 months • Decreases infant’s risk of dying six-fold

  7. Access to • immunizations • antibiotics for pneumonia • ORS and Zn • Vitamin A supplemenation at 6 mos • Bed nets, anti-malaria treatments

  8. MDG #5: Reduce Maternal Mortality Rate by 75% 1990 - 2015

  9. Not making enough progress in meeting this goal • In spite of proven interventions • Women have a 1 in 150 risk of dying from pregnancy or pregnancy related complications in developing countries • See gains where births are attended by skilled birth attendants

  10. Leading Causes Maternal Death • 80% of all maternal deaths are due to: • severe bleeding (mostly bleeding after childbirth) • infections (usually after childbirth) • high blood pressure during pregnancy (pre-eclampsia and eclampsia) • unsafe abortion • Other causes primarily related to complications due to malaria and AIDS

  11. MM higher in • Rural areas • Poor • Adolescent mothers • highest for adolescent girls under 15 years old • Malnourished, anemic mothers

  12. Country Stats Female Life Expectancy (2010) • Haiti – 64 • Zambia – 50 • Togo – 59 • Somalia – 53 Lifetime risk maternal mortality • Haiti – 1 in 93 • Zambia – 1 in 38 • Togo – 1 in 67 • Somalia – 1 in 14

  13. Country Stats % Births attended by a skilled attendant (2010) • Haiti – 26% • Zambia – 47% • Togo – 60% • Somalia – 33% U5M Rates – per 1000 live births (2010) • Haiti – 165 • Zambia – 111 • Togo – 103 • Somalia - 180

  14. Country Stats % women using modern contraception (2010) • Haiti – 24% • Zambia – 47% • Togo – 11% • Somalia – 33%

  15. Goals • Minimum 4 antenatal visits with health care provider • Nutritional interventions • PMTCT if mother HIV+ • Malaria interventions • Educate about and monitor pre/eclampsia • Skilled birth attendants • Access to meds and knowledge of techniques to stop bleeding at birth

  16. Goals • Access to contraceptives and family planning • Decrease adolescent pregnancies • Decrease transmission STD • Space pregnancies • Decrease abortions (many unsafe)

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