CAMPAIGN ON ACCELERATED REDUCTION OF
MATERNAL AND CHILD MORTALITY IN AFRICA
(CARMMA)
10th Annual Congress of the Society of Midwives of
South Africa
St Georges Hotel - Pretoria
04 December 2012
Ms HL Mangate
Acting AU/NEPAD Coordinator
PRESENTATION OUTLINE
• Introduction and Background
– Overview of Maternal and Child Mortality
– South African Situation
• Highlights of the recommended actions to improve
maternal health and child survival from the XV AU
Summit.
• CARMMA slogan
• Objectives of CARMMA
• Progress at AU level
• Key Components of CARMMA in South Africa
• Considerations by AU Member States
INTRODUCTION AND BACKGROUND
• High maternal and child mortality in Africa
– WHO estimates 1500 women die each day
– 10 000 babies die per day within one month of life
– MMR for Africa ranges between 500 and 1 500 / 100 000
live birth
– MDG targets - Reduction of maternal deaths by 75% and
under-5 child mortality by 67% by 2015
• African Union established CARMMA in 2009
• In July 2010 the African Union Assembly
encouraged all countries to launch CARMMA “in
solidarity with women and children of Africa......”
• AU Summit recommended a list of Actions on
Maternal, Newborn and Child Health for countries to
3
implement.
SOUTH AFRICA SITUATION
• The NDoH Report of Health Data
Committee of November 2011 estimate:
–
–
–
–
Advisory
MMR at 310/100 000 LB
Under 5 mortality at 56/ 1000 LB
Infant mortality at 40/1000LB
Neonatal mortality at 14/1000 LB
• The 2015 MDG targets:
– MMR from 150/100 000 to 38 per 100 000 LB
– Under 5 from 59/ 1 000 to 20/1000 LB
( DHS, 1998)
4
HIGHLIGHTS OF THE XV AU SUMMIT
RECOMMENDED ACTION TO IMPROVE
MATERNAL AND CHILD
•
Extend the Maputo Plan of Action to 2015 to
coincide with the MDGs
•
Launch of CARMMA in countries and broaden
it as an advocacy strategy for the promotion of
maternal, newborn and child health and
involve all key stakeholders
– Institutionalize the Annual CARMMA week in
solidarity with the women and children of
Africa for the next four years.
ACTIONS CONTINUE
•
Strengthen the health system to provide
comprehensive, integrated maternal, newborn
and child health care services
– repositioning of family planning including
reproductive health commodity security,
– infrastructure development in rural areas
– skilled human resources for health to train
Community Health Workers
ACTIONS CONTINUE
•
•
•
•
Provide stewardship - national Governments
for policy coherence
Provide strong support for sharing and scaling
up of identified good practices
Provide sustainable financing - domestic
resources including 15% Abuja target
Call on Global Fund for Fight against HIV/AIDS,
Malaria, and TB to create a new window to fund
the Maternal, Newborn and Child Health
ACTIONS CONTINUE
• Institute effective monitoring and evaluation (M&E)
for accurate, reliable and timely maternal, newborn
and child data including making maternal deaths
notifiable and institute maternal deaths reviews
• Annually reporting on the progress made by
member states
• Promote programs for the total eradication of
mother to child transmission so that no child is born
with HIV and AIDS
• Extend the Abuja Call for Accelerated Action
Towards Universal access to HIV/AIDS,
Tuberculosis and Malaria services in Africa to 2015
to coincide with the MDGs
ACTIONS CONTINUE
• The AU Commission/AU Organs/RECs/Partners to
monitor and conduct an evaluation of the
implementation of the Abuja Call and to submit a
progress report in 2013 and a final report in
June/July 2015 in preparation for the review of the
MDGs in 2015.
• Commemorate an Africa Food and Nutrition Day
(AFND) on 30 October every year
THEME OR SLOGAN FOR CARMMA
“Africa Cares:
No Woman Should Die While Giving Life!”
OBJECTIVES OF CARMMA
• To enhance political leadership and commitment
at national and continental levels.
• To identify and work with national champions to
mobilize support and participation at national
level.
• To raise and maintain awareness as well as
appropriate responses at global, continental,
regional and national levels.
11
OBJECTIVES OF CARMMA CONT.
• To built linkages with global campaigns,
• Promote the recognition of maternal mortality as a key
indicator of a well-functioning health system.
• Promote exchange of experiences and practices and
adopt and replicate best practices of countries, which
have significantly reduced maternal mortality
12
CARMMA PROGRESS AT AU LEVEL
• 38 countries launched CARMMA
• Special meeting on CARMMA held in Namibia in
April 2011 made the following
recommendations:
– Ministry of Health to assume leadership
– Advocacy for increased resources for maternal &
child health concentrating of domestic sources
– Devotion in November of CARMMA week
– Task shifting to respond to increased needs
– Promotion of SRHR
– Maternal, Newborn and Child Mortality audits to
be done; operational research for planning
13
CARMMA PROGRESS AT AU LEVEL cont.
– Nutrition – promotion of breastfeeding and PMTCT
– Waiving of user fees for women and children
– NHI schemes to cover all, especially marginalised
groups
– Community efforts to reach the hard to reach
communities
– Improve transportation for better access to health
services
14
KEY COMPONENTS OF CARMMA IN SA
a) Strengthening access to comprehensive SRHR
services, with specific focus to family planning
services
b) Advocacy and promotion of early antenatal
care attendance/ booking
c) Improve access to Skilled Birth Attendance
through:
1. Allocation of obstetric ambulances to every facility
where deliveries are conducted
11. Establishment of maternity waiting homes where
necessary
15
KEY COMPONENTS OF CARMMA IN SA
CONT.
d)
Strengthening Human Resources for
Maternal and Child Health through:
I. Training on Essential Steps in
Management of Obstetric Emergencies
(ESMOE) for doctors and midwives.
II. Strengthening midwifery education and
training.
16
KEY COMPONENTS OF CARMMA IN SA
CONT.
e) Improve child survival through:
I. Promotion of breast-feeding,
II. Provision of facilities for lactating mothers (border
mother) in health facilities where
children are admitted
III. Promotion of Kangaroo Mother Care (KMC) for low
birth weight babies.
IV. Advocating for appropriate care and support of
pregnant women and lactating mothers in the
workplace.
17
KEY COMPONENTS OF CARMMA IN SA
CONT.
F) Intensifying management of HIV positive
mothers and children through:
I. Improved access to treatment for both
mothers and children
II. Improved management of co-infections
III. Elimination of Mother to Child Transmission o HIV
18
CONSIDERATION FOR CARMMA
IMPLEMENTATION BY AU MEMBER STATES
• Identification of Champions and/or Sponsors of
CARMMA
• Establishment of a Campaign Coordinating Mechanism
• Creating an Intersectoral Committee and establishing
Community Network
• Declaring and Observe a Maternal, Newborn and Child
Health Day/Week preferable during November as
recommended by Heads of State and Government
during AU Summit of July 2010
• Preparing Periodic Reports on maternal, newborn and
child mortality
19
I
THANK
YOU
20