Thursday, September 16, 2010

[EQ] Trends in maternal mortality: 1990 to 2008 - Estimates developed by WHO, UNICEF, UNFPA and The World Bank

Trends in maternal mortality: 1990 to 2008

Estimates developed by WHO, UNICEF, UNFPA and The World Bank
World Health Organization, UNICEF, UNFPA and The World Bank – September 2010
ISBN: 978 92 4 150026 5

Available online PDF [55p.] at: http://bit.ly/9BOg95

“…..Millennium development goal (MDG) 5 Target 5A calls for the reduction of maternal mortality ratio (MMR) by three quarters between 1990 and 2015. It has been a challenge to assess the extent of progress due to the lack of reliable and accurate maternal mortality data – particularly in developing-country settings where maternal mortality is high. As part on going efforts, the WHO, UNICEF, UNFPA and the World Bank revised and improved earlier methods to estimate maternal mortality in 1990, 1995, 2000, 2005, and 2008; and developed methodology to present trends in maternal mortality from 1990 to 2008 at country, regional, and global levels.

This report highlights the following.

· Ten out of 87 countries with maternal mortality ratios over 100 in 1990, are on track with an annual decline of 5.5% between 1990 and 2008. At the other extreme, 30 made insufficient or no progress since 1990.

· The study shows progress in sub-Saharan Africa where maternal mortality decreased by 26%.

· In Asia, the number of maternal deaths is estimated to have dropped from 315 000 to 139 000 between 1990 and 2008, a 52% decrease.

Methods

Technical report [pdf 2.31Mb]

Files and programmes [zip 2.19Mb] Data and programmes (R and STATA) used for computing the maternal mortality estimates

Content:
1. INTRODUCTION

2. MEASURING MATERNAL MORTALITY

2.1 Concepts and definitions

2.2 Measures of maternal mortality

2.3 Approaches for measuring maternal mortality

3. THE DEVELOPMENT OF 2008 ESTIMATES OF MATERNAL MORTALITY

3.1 Sources of country data used for the 2008 estimates

3.2 Methods used to estimate MMR in 2008 according to data source

3.3 Calculation of adult lifetime risk of maternal mortality

3.4 Global and regional estimates

3.5 Differences in the 2008 methodology compared with

3.6 Differences from other recent estimates 1

4. ANALYSIS AND INTERPRETATION OF 2008 ESTIMATES

5. IS THE FIFTH MDG ACHIEVABLE?

ANNEXES

Annex 1. Estimates of maternal mortality ratio (MMR, deaths per 100 000 live births), number of maternal deaths and lifetime risk (2008) 23

Annex 2. Map with countries by category according to their maternal mortality ratio (MMR, deaths per 100 000 live births), 2008 27

Annex 3. Comparison of 1990, 1995, 2000, 2005, and 2008 estimates of maternal mortality ratio (MMR, deaths per 100 000 live births) by country 28
Annex 4. Countries with 40% or more decrease in maternal mortality ratio (MMR, deaths per 100 000 live births) between 1990 and 2008 33

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information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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“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
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[EQ] The MDGs in Europe and Central Asia: Achievements, Challenges and the Way Forward

The MDGs in Europe and Central Asia:
Achievements, Challenges and the Way Forward

Report coordinated by the United Nations Economic Commission for Europe – 2010

Available online PDF [142p.] at: http://bit.ly/b4vZ8f

This report, prepared jointly by the United Nations Economic Commission for Europe (UNECE) and the Regional Offices for Europe and Central Asia of the United Nations Funds, Programmes and Specialized Agencies, takes stock of progress made in reaching the MDG goals and offers decision-makers policy-oriented, operationally feasible suggestions for bolstering progress towards fully achieving these goals by 2015. It also identifies and contextualizes the greatest challenges facing human development, taking into account the specific characteristics of the UNECE region.

“……In addition to the governance issue, the report points to other priority policy areas which can have a multiplier effect in reaching the MDGs.
The following six should be highlighted.
First, the design of sustainable social-protection schemes is critical to ensure a universal access to social services in a human rights perspective.
Second, extra emphasis should be placed on promoting gender equality since it has cross-cutting effects on all the other MDGs.
Third, budget allocation and choice in public investment must strike the right balance between social infrastructure and support to the productive capacity,

including in the agricultural sector.
Fourth, reviewing fiscal policies is decisive for reducing inequalities and for providing more fiscal space to finance social protection.
Fifth, regional cooperation must be enhanced to address major MDG transboundary issues such as international migration, cross-border water management, trade and transport facilitation and climate change adaptation and mitigation. And
sixth, donor countries of the region should at least maintain the existing ODA level for the lower income countries of the region and intervene for relaxing the conditionality of the international financial institutions on loans to emerging economies hardly hit by the economic downturn…..” from Ján Kubiš

U.N. Under-Secretary-General

[….] The following are some cross-cutting considerations for scaling up action towards the three health MDGs:

• There is a need to reinforce all health system functions, with attention to service delivery, financing, workforce, health information systems, procurement and distribution of medicines, vaccines and technologies, sexual and reproductive health care and political will in leadership and governance. Actions should be grounded in a primary health care approach, involving communities and civil society. Measures to include the MDGs in national health plans, scale up key targeted and equity-proofed interventions, and provide appropriate integrated services are opportune.

• It is important to account for health equity in all national policies that address social determinants of health and gender inequities, and to consider developing and strengthening universal comprehensive social-protection policies that include health promotion, infectious and non-communicable disease prevention and health care, and to promote the availability of and access to goods and services essential to health and well-being.

• Accelerating progress towards the health MDGs will require increasing/maximizing the benefits of investment in financial and human resources and strengthening national health information systems to generate accurate, reliable, disaggregated and timely evidence on achievement of the health MDGs.

• All efforts should be made to fulfill commitments regarding official development assistance and improve donor and aid coordination so that it strengthens national health systems and brings greater coherence and alignment to the donor response at country level.

Jointly prepared by:

United Nations Economic Commission for Europe - United Nations Development Programme - International Labour Organization - Food and Agriculture Organization of the United Nations

World Food Programme - United Nations Educational, Scientific and Cultural Organization - United Nations Development Fund for Women - World Health Organization

United Nations Children’s Fund - United Nations Population Fund - Joint United Nations Programme on HIV/AIDS - United Nations Environment Programme - United Nations Industrial Development Organization - United Nations Conference on Trade and Development -International Trade Centre

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[EQ] How health systems can address inequities in priority public health conditions: the example of tuberculosis

How health systems can address inequities in priority public health conditions:
the example of tuberculosis

Copenhagen, WHO Regional Office for Europe, 2010

Available online as PDF [32p.] at: http://bit.ly/cHgRnT

“….The Priority Public Health Conditions Knowledge Network of the WHO Commission on Social Determinants of Health identified TB as a priority public health condition because it represents a large aggregate burden of disease, exhibits significant disparities across and within populations and affects certain groups disproportionately.Current patterns of inequity also favour the continued prevalence of TB.

This briefing merges two fields of analysis:

1. research on the social determinants of priority public health conditions, using TB as an example, for improved health equity; and

2. analysis on how a health-systems-strengthening approach can contribute to more effective programme delivery and health outcomes.…”

Content
Executive summary

Introduction

TB in the European Region

National TB programmes, social determinants, and health systems

The social determinants of TB

Socioeconomic position

Differential exposure to upstream risk factors

Differential exposure to mid- and downstream risk factors

Differential vulnerability

Differential health outcomes

Differential consequences

Policy implications

Universal social protection systems, including social health protection

Enhanced PHC approach and health care financing and organization

Intersectoral action for health

Social empowerment and respectful treatment

Priorities for future research

Bibliography and references

Bibliography

References

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[EQ] Assessing equity in systematic reviews: realising the recommendations of the Commission on Social Determinants of Health

Assessing equity in systematic reviews:
realising the recommendations of the Commission on Social Determinants of Health

Peter Tugwell, professor 1, Mark Petticrew, chair in public health evaluation 2, Elizabeth Kristjansson, associate professor 3, Vivian Welch, research coordinator4, Erin Ueffing, coordinator5, Elizabeth Waters, Jack Brockhoff chair of child public health6, Josiane Bonnefoy, assistant professor7, Antony Morgan, associate director8, Emma Doohan, project manager8, Michael P Kelly, director8

1Department of Medicine and Institute of Population Health, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

2Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK

3School of Psychology, Institute of Population Health, University of Ottawa

4Ottawa Hospital Research Institute, Institute of Population Health, University of Ottawa

5Campbell and Cochrane Equity Methods Group, Institute of Population Health, University of Ottawa

6The McCaughey Centre, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia

7School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile

8Centre for Public Health Excellence, National Institute for Health and Clinical Excellence, London, UK

A group from the Cochrane Collaboration, Campbell Collaboration, and the World Health Organization Measurement and Evidence Knowledge Network has developed guidance on assessing health equity effects in systematic reviews of healthcare interventions. This guidance is also relevant to primary research

BMJ 2010; 341:c4739 doi: 10.1136/bmj.c4739 (Published 13 September 2010)

BMJ 2010; 341:c4739 at: http://bit.ly/9lUV7k

“….Summary points

The Commission on Social Determinants for Health has recommended assessment of health equity effects of public policy decisions

This article provides guidance on assessing equity for users and authors of systematic reviews of interventions

Particular challenges occur in seven components of such reviews:
(1) developing a logic model,
(2) defining disadvantage and for whom interventions are intended,
(3) deciding on appropriate study design(s),
(4) identifying outcomes of interest,
(5) process evaluation and understanding context,
(6) analysing and presenting data, and
(7) judging applicability of results

Greater focus on health equity in systematic reviews may improve their relevance for both clinical practice and public policy making …”

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any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission. 

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Thursday, September 16, 2010

[EQ] Trends in maternal mortality: 1990 to 2008 - Estimates developed by WHO, UNICEF, UNFPA and The World Bank

Trends in maternal mortality: 1990 to 2008

Estimates developed by WHO, UNICEF, UNFPA and The World Bank World Health Organization, UNICEF, UNFPA and The World Bank – September 2010 ISBN: 978 92 4 150026 5

Available online PDF [55p.] at: http://bit.ly/9BOg95

Methods

[EQ] The MDGs in Europe and Central Asia: Achievements, Challenges and the Way Forward

[EQ] How health systems can address inequities in priority public health conditions: the example of tuberculosis

[EQ] Assessing equity in systematic reviews: realising the recommendations of the Commission on Social Determinants of Health

Estimates developed by WHO, UNICEF, UNFPA and The World Bank
World Health Organization, UNICEF, UNFPA and The World Bank – September 2010
ISBN: 978 92 4 150026 5