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Reducing child mortality and improving maternal health (MDGs 4 and 5)

Reducing child mortality and improving maternal health (MDGs 4 and 5)

France is deeply committed to promoting access to healthcare for women and children and to the promotion of "sexual and reproductive rights". Millennium Development Goals (MDGs) 4 and 5, along with MDG 6 (combating HIV/AIDS, malaria and other diseases), are at the very heart of the health component of France’s development policy and inseparable from active promotion of gender equality and the empowerment of women (MDG 3).

In 2000, United Nations Member States adopted eight Millennium Development Goals (MDGs), including:

-  reducing the under-5 mortality rate by two thirds (MDG 4);
-  reducing maternal mortality by two thirds (MDG 5).

MDG 5 remains one of the least successful of the goals, despite progress made through priority actions recognised for their effectiveness: skilled attendance at delivery, availability of and access to emergency obstetric care, access to family planning and, more widely, improvements in women’s rights and the education of girls. While progress has certainly made on a global scale between 1990 and 2010, the continuing high level of maternal mortality is unacceptable.

The current situation

Some 287,000 women and girls die from pregnancy-related causes every year, 99% of them in developing countries. The risk women face of dying from a complication arising from pregnancy or childbirth is one of the greatest injustices at the international level: ranging from 1 in 3,800 in the developed countries to 1 in 39 in sub-Saharan Africa (WHO, 2010).

Between 1990 and 2010, the global maternal mortality ratio (number of maternal deaths per 100,000 live births) fell by no more than 3.1% annually, and it is clear that MDG 5 will not now be achieved.

Maternal mortality may occur at any stage in pregnancy, but actual delivery is by fatr the most dangerous phase for both mother and child.

The main causes, accounting for 80% of maternal deaths, are:

severe haemorrhaging (mainly post-delivery);
infections (again, usually post-delivery);
high blood pressure during pregnancy (pre-eclampsia, eclampsia);
unsafe abortions.

Most of these deaths could be avoided if access to quality obstetric services were available.

The health of the mother and the newborn are closely linked. Over 3 million newborns die each year and another 2.6 million babies are stillborn. Almost 9 million children under the age of five die every year. Despite these alarming figures, the situation is gradually improving: infant mortality fell by 35% between 2000 and 2010. Six diseases account for 90% of deaths among children under five:

neonatal conditions (from birth to the 28th day of life): pre-term birth, birth asphyxia, infections, tetanus): 37%
acute respiratory infections (pneumonia): 19%
diarrhoea: 18%
malaria: 8%
measles: 4%
HIV/AIDS: 3%

Solutions existTo combat maternal mortality:

Prevention of unwanted pregnancies and spacing of births: acess to family planning methods.
-  Skilled attendance at delivery (midwives, obstetricians).
-  Availability of and access to emergency obstetric care (including Caesarean section and blood transfusions).
-  Greater empowerment of women and reinforced women’s rights, active promotion of gender equality.

To combat under-five child mortality:

-  Vaccination.
-  Prevention and appropriate treatment of pneumonia, diarrhoea, malaria and HIV/AIDS.
-  Prevention and appropriate treatment of neonatal conditions: spacing of births and family planning, antenatal care, skilled attendance at delivery, care of the newborn.
-  Prevention and treatment of malnutrition.

France’s commitmentsThe Muskoka initiative

France is deeply committed to promoting access to healthcare for women and children and to the promotion of "sexual and reproductive rights". Millennium Development Goals (MDGs) 4 and 5, along with MDG 6 (combating HIV/AIDS, malaria and other diseases), are at the very heart of the health component of France’s development policy and inseparable from active promotion of gender equality and the empowerment of women (MDG 3).

At the G8 summit in Muskoka in June 2010, France undertook to increase its annual contribution by €500 million over the 2011 – 2015 period, over and above its existing annual contribution, evaluated at some €300 million, to achieving MDGs 4 and 5.

These undertakings will take different concrete forms:

Support for multilateral organisations

A joint project in concertation with four United Nations agencies, financed through the Priority Solidarity Fund (FSP): €19 million annually. France provides direct support to the WHO (World Health Organization), the UNFPA (the United Nations Population Fund), UNICEF (the United Nations Children’s Fund) and UN Women (the United Nations Entity for Gender Equality and the Empowerment of Women). These four programmes develop their programmes via a common framework of coordinated and harmonised activities: spacing of births and prevention of unwanted pregnancies, antenatal/perinatal/postnatal care, holistic treatment of childhood diseases, vaccination and mother and child nutrition.

A specific project, launched in 2012, is funded by the FSP in association with the Aga Khan Development Network (AKDN), running campaigns to promote women’s and children’s health in crossborder regions of Afghanistan, Pakistan and Tadjikistan, at a cost of €0.5 million annually over four years.

Estimated cost of additional contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunisation (GAVI): €32.5 million annually. France estimates its additional contribution to the Global Fund at €27 million annually.

Thanks to a project funded by the FSP, GAVI is able to step up its action in the priority countries and in the Horn of Africa, which is prey to a severe food crisis from which children are the first to suffer: €6 million in 2011, followed by €5.5 annually from 2012 to 2015.

France provided the Global Alliance for Vaccines and Immunisation (GAVI) with funding og €15 million between 2002 and 2006 and contributed €1.3 billion to the International Finance Facility for Immunisation (IFFIm) for the 2006-2026 period (25% of IFFIm’s total funding, making France the world’s second largest contributor). At the 2011 pledging conference, France pledged an additional budget contribution of €100 million for the 2011-2015 period (making it the 6th largest donor in the GAVI alliance).

Bilateral channels: €48 million annually

With the agreement of the partner countries, the French development agency AFD provides support for mother and child health schemes, and for sexual and reproductive health schemes. This funding is dedicated exclusively to measures designed to improve the health of mothers and children. Sixteen African countries considered as being among the least developed on the planet are priority targets for this support: Benin, Burkina Faso, Cameroon, the Comoros, Congo, Ivory Coast, Guinea, Madagascar, Mali, Mauritania, Niger, Central African Republic, DRC, Senegal, Chad and Togo. Two countries in crisis, Haiti and Afghanistan, are also considered priorities.

Further information

The Millennium Development Goals (MDG)

MDG 4
-  www.un.org/fr/millenniumgoals/childhealth.shtml

MDG 5
-  www.un.org/fr/millenniumgoals/maternal.shtml

Updated 15.03.13

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