According to this report, substantial progress has been made towards achieving Millennium Development Goal (MDG) 4, namely to reduce global child mortality by two-thirds by 2015. The number of under-five deaths worldwide has declined from nearly 12 million in 1990 to 6.9 million in 2011. Since 1990 the global under-five mortality rate has dropped 41% and the annual rate of reduction in under-five mortality has accelerated from 1.8% a year over 1990–2000 to 3.2% over 2000–2011, but it remains insufficient to reach MDG 4. Globally, more than a third of under-five deaths are attributable to undernutrition. The highest rates of child mortality are still in sub-Saharan Africa, where 1 in 9 children dies before age five and Southern Asia (1 in 16). As under-five mortality rates have fallen more sharply elsewhere, the disparity between these two regions and the rest of the world has grown. By 2050, 1 in 3 children will be born in sub-Saharan Africa, and almost 1 in 3 will live there, so the global number of under-five deaths may stagnate or even increase without more progress in the region.
Equity in Health
South Africa is one of the countries in which neonatal mortality has remained the same or increased over the last 20 years. The major causes of neonatal deaths are related to prematurity and intrapartum hypoxia. In this paper, the authors discuss a number of interventions that have been shown to reduce neonatal deaths and, if implemented on a wider scale, could reduce neonatal deaths significantly. These interventions include providing basic and comprehensive emergency obstetric care, use of antenatal steroids for women in preterm labour, training in immediate care of the newborn and neonatal resuscitation, and post-resuscitation management and ongoing neonatal care (e.g. CPAP), especially to babies who are born preterm.
The objective of this paper was to determine how social and economic factors contribute to disability differences between older men and women. Researchers analysed World Health Survey data from 57 countries drawn from all income groups, including in their final sample a total of 63,638 respondents aged 50 and older, of whom 28,568 were males and 35,070 females. The researchers computed disability prevalence for males and females by socio-demographic factors, and estimated the adjusted effects of each social determinant on disability for males and females. Results indicated that prevalence of disability among women compared with men aged 50+ years was 40.1% vs. 23.8%. Lower levels of education and economic status were associated with disability in women and men. Approximately 45% of the sex inequality in disability could be be attributed to differences in the distribution of socio-demographic factors, while approximately 55% of the inequality resulted from differences in the effects of the determinants. The authors call for data and methodologies that can identify how social, biological and other factors separately contribute to the health decrements facing men and women as they age. This study highlights the need for action to address social structures and institutional practices that impact unfairly on the health of older men and women.
The main goal of South Africa’s new strategic healthcare and nutrition plan for women and children is to reduce by 10% by 2016: the maternal mortality ratio (MMR); the neonatal mortality rate (NMR); the infant mortality rate (IMR); and the child mortality rate. What are the key strategies for the implementation of the priority interventions? These include addressing inequity and social determinants of health; developing a framework for MNCWH and nutrition services; strengthening community-based MNCWH and nutrition interventions; increasing provision of key MNCWH and nutrition interventions at primary health care and district levels; strengthening the capacity of the health system, as well as human resource capacity, to support the provision of these services; and strengthening systems for monitoring and evaluation of outcomes. The plan indentifies a number of factors that can be considered critical for success. Government will have to address the social determinants of health, specifically targeting most under resourced districts, as well as commit to strengthening the country’s health system, with a specific focus on primary health care services. Support from key stakeholders will be crucial, including the National Department of Health, Provincial Departments of Health, developmental partners and civil society. Resource mobilisation should be undertaken, in terms of financial support and human resources and MNCWH and Nutrition capacity should be strengthened at national, provincial, district and sub-district levels.
In this study, researchers investigated whether maternal obesity is a risk factor for neonatal death in sub-Saharan Africa and the effect on the detailed timing of death within the neonatal period. Cross-sectional Demographic and Health Surveys from 27 sub-Saharan countries (2003-09) were pooled, comprising a total of 81,126 women. Of these women, 15,518 were overweight, 4,266 were obese, 52,006 had an optimum body mass index (BMI) and 13,602 were underweight. Maternal obesity was associated with an increased odds of neonatal death after adjustment for confounding factors, and it was a significant risk factor for neonatal deaths occurring during the first two days of life. Strategies to prevent and reduce obesity need to be considered, the authors argue, and obese women should be advised to deliver in a health-care facility that can provide emergency obstetric and neonatal care.
The aims of this study were to assess international shortfall inequalities in life expectancy among women and men and to quantify how much specific geographic regions and country income groups contribute to them. Researchers used estimates of life expectancy at birth by sex for the 12 five-year periods between 1950–1955 and 2005–2010. Data for life expectancy at birth by sex were available for 179 of the 193 Member States of the World Health Organization (WHO) (as of 2010). Results indicated large shortfall inequalities in life expectancy among women in low-income countries. Additionally, there were large differences between shortfall inequalities of women and men in low-income countries. The authors call for urgent action is necessary to reduce these inequities. Although they acknowledge that behaviour change policies and programmes focusing on the individual are important in improving the health of women, action at economic, social, cultural and environmental levels is equally vital. Broader strategies such as poverty reduction, increased labour force participation, increased literacy, training and education, improvements in the provision of and access to health services (including reproductive health care), and increased opportunities for participation in economic, social and political activities will contribute to progress in women’s health.
After the United Nations announced the members of its new High-level Panel to advise on the global development agenda beyond 2015, Oxfam responded by calling on the Panel to accelerate delivery on the Millennium Development Goals (MDGs) first. There are still three years left before the MDGs expire, and with declining contributions from external funders, Oxfam argues that one way to finance the MDGs is to introduce a financial transaction tax in Europe, with at least 50% of the revenues committed to development and climate change.
This report measures progress on the health Millennium Development Goals (MDGs) to 2015 and beyond. The authors gathered data from a combination of literature reviews, interviews with key stakeholders in the health field, and a roundtable discussion. They found that the past decades have seen a gradual shift from a focus on a single disease to a more systemic approach by including a variety of health (and non-health) inputs which have to be integrated at the national, district and local levels. Although the authors predict that achievement of the health MDGs will almost surely be uneven, the available evidence suggests that the health MDGs have been effective in accelerating progress on target indicators, in stimulating global political support in the creation of significant global institutions dedicated to helping countries achieve the MDGs and in stimulating research and debate on systemic approaches to improving health outcomes. The authors argue that the current health MDGs will need continued focus beyond 2015 and must be included in some form in the post-2015 goals. The new goals should be simple enough to be politically intelligible and acceptable, and meaningful to politicians and laypeople. The report recommends that a mechanism be set up to ensure decision-makers and external funders are held accountable and to help countries get back on track.
In this study, researchers quantified and compared education- and wealth-based inequalities in the prevalence of five non-communicable diseases in low- and middle-income country groups: angina, arthritis, asthma, depression and diabetes. Using 2002-04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above was analysed by wealth quintile, education level, sex and country income group. Results indicated that wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality.
South Africa fares worse on health than the residents of any other BRICS country, according to the country’s Health Minister Aaron Motsoaledi. In a speech delivered on 29 July 2012, the Minister presented standard health indicators for life expectancy, with the average South African expected to live until 54, far behind the Chinese at 74, Brazilians at 73, Russians at 68 and Indians at 65. He quoted South Africa’s maternal mortality rates at 410 per 100,000 births, almost double India’s rate of 230, which lags behind Brazil (58), Russia (39) and China (38).