Monday, April 12, 2010

[EQ] Remarkable declines in Maternal Deaths Globally - IHME study: Maternal mortality for 181 countries, 1980-2008

Maternal mortality for 181 countries, 1980-2008:
a systematic analysis of progress towards Millennium Development Goal 5

Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJL
The Lancet 2010; published online April 12. doi:10.1016/S0140-6736(10)60518-1.

Website: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60518-1/fulltext

Maternal deaths fall worldwide from a half-million annually to less than 350,000

HIV accounts for a large percentage of deaths, with most deaths concentrated in six countries

“…..April 12, 2010–The number of women dying from pregnancy-related causes has dropped by more than 35% in the past 30 years – from more than a half-million deaths annually in 1980 to about 343,000 in 2008, according to a new study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and collaborators at the University of Queensland.

IHME’s research shows that deaths have been declining at an annual rate of about 1.4% since 1990. Contrary to previous reports that have shown very little change in the maternal mortality ratio (MMR), the global MMR – the number of women dying for every 100,000 live births – declined from 422 in 1980 to 320 in 1990. It reached 251 in 2008 and is on pace for further declines.

Developing countries, in particular, have made substantial progress toward the Millennium Development Goal set in 2000 of reducing the MMR. Although only 23 countries are on track to achieve the target of lowering the MMR by 75% between 1990 and 2015, countries such as Egypt, China, Ecuador, and Bolivia have been achieving accelerated progress.

“These findings are very encouraging and quite surprising,” said Dr. Christopher Murray, Institute Director and one of the report’s co-authors. “There are still too many mothers dying worldwide, but now we have a greater reason for optimism than has generally been perceived.”

The study, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, appears online April 12th in The Lancet. Beginning in 2007, researchers analyzed vital registration data, censuses, surveys, and verbal autopsy studies and created new methodological tools to generate the most accurate estimates to date of maternal mortality for nearly every country.

Researchers found that progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. Nearly one out of every five maternal deaths – a total of 61,400 in 2008 – can be linked to HIV, and many of the countries with large populations affected by HIV have had the most difficulty reducing their maternal mortality ratio.

Nearly 80% of all maternal deaths are concentrated in 21 countries, and six countries account for more than half of all maternal deaths.

Eight low-income countries have seen annual increases in the MMR over the period 1990 to 2008, including Afghanistan and Zimbabwe, as have several high-income countries, such as the United States, Canada, and Norway. At least part of the increase in high-income countries appears to be due to changes in the way maternal deaths are reported. Mothers in the US now die at a higher rate than in most other high-income countries, four times the rate of Italy and three times the rate of Australia. ….”

Figures

·                      Figure 1. Global Maternal Mortality Ratio (49k pdf*)

·                      Figure 2. 21 Countries with the Most Maternal Deaths (58k pdf*)

·                      Figure 3. Annualized Rate of Decline in MMR, 1990-2008 (194k pdf*)

Related Content:

·                               See the figures

·                               View the Web appendix

·                               Download countries ranked by their maternal mortality ratio (42k xls)

·                               Download the slides (3M ppt)

·                               Use the datasets and interactive tools



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information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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[EQ] The reference price system and socioeconomic differences in the use of low cost drugs

The reference price system and socioeconomic differences in the use of low cost drugs

 Vrijens France, Van de Voorde Carine, Farfan-Portet Maria-Isabel, le Polain Maïté and Lohest Olivier :
Health Services Research (HSR) - KCE reports vol 126C
The Belgian Health Care Knowledge Centre (KCE)

PDF [88p.] at: http://www.kce.fgov.be/Download.aspx?ID=2156

Website: http://www.kce.fgov.be/index_en.aspx?SGREF=5211&CREF=15353

“…..To control public expenditures on prescription drugs in ambulatory care, almost all European countries have opted for a reference price system (RPS).
This paper focused on the following three research questions:


1. How is the reference price system implemented in Belgium, and how can it be  compared to reference pricing organized in some selected countries (Denmark, France, Germany, Hungary, Italy, the Netherlands, Portugal, Spain, Australia, New Zealand and British Columbia)?

2. Is there evidence of socioeconomic differences associated with the use of low cost drugs in the literature and in Belgian physician prescribing data? If so, what are these differences associated with (e.g. lack of information, attitude, expectations) and what is the impact on patient costs?

3. If such evidence is found in Belgium, what measures can be taken to avoid these differences?..........”



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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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any action in reliance on it. If you received this
transmission in error, please notify us immediately by
email to infosec@paho.org, and please dispose of and
delete this transmission. Thank you.