Countdown to 2015:
Mexico
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adapting this presentation
• Personalise with photos, charts
• Data presented are based on best available data up
to mid-2014. When presenting, mention more recent
studies or data. (2013 mortality on slide #18 added)
• Select which slides are appropriate for the audience.
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depending on needs)
• Sub-national data can be substituted as appropriate
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• Review the Speaker Notes, adapt according to your
audience and purpose
Purpose of this presentation
• To stimulate discussion about Mexico country data,
especially about progress, where we lag behind, and
where there are opportunities to scale up
• To provide some background about Countdown to
2015 for MNCH, the indicators, and data sources in the
country profiles
• To showcase the country profile as a tool for
monitoring progress, sharing information and
improving accountability
Outline
1. Countdown to 2015: Background
2. Mexico Countdown profile
Part I
Countdown to 2015:
Background
What is Countdown?
A global movement initiated in 2003 that tracks
progress in maternal, newborn & child health in
the 75 highest burden countries to promote action
and accountability
Countdown aims
•
To disseminate the best and most recent
information on country-level progress
•
To take stock of progress and propose new
actions
•
To hold governments, partners and donors
accountable wherever progress is lacking
What does Countdown do?
•
Analyze country-level coverage and trends for
interventions proven to reduce maternal, newborn and
child mortality
•
Track indicators for determinants of coverage (policies and
health system strength; financial flows; equity)
•
Identify knowledge and data gaps across the RMNCH
continuum of care
•
Conduct research and analysis
•
Support country-level Countdowns
•
Produce materials, organize global conferences and
develop web site to share findings
9
75 countries that together account for > 95% of maternal
and child deaths worldwide
Who is Countdown?
• Individuals:
scientists/academics,
policymakers, public health
workers, communications
experts, teachers…
• Governments:
RMNCH policymakers,
members of Parliament…
• Organizations:
NGOs, UN agencies,
health care professional
associations, donors,
medical journals…
12
Countdown moving forward
Four streams of work to promote accountability,
2011-2015
• Responsive to global accountability frameworks
-Annual reporting on 11 indicators for the Commission on
Information and Accountability for Women’s and Children’s
Health (COIA)
-Contribute to follow-up of A Promise Renewed/Call to
Action
• Production of country profiles/report and global
event(s)
• Cross-cutting analyses
• Country-level engagement
Part 2
Mexico Countdown
country profile
Main findings
data on the profile
WhatRange
doesofCountdown
monitor?
• Progress in coverage for critical interventions across
reproductive, maternal, newborn & child health
continuum of care
• Health Systems and Policies – important context for
assessing coverage gains
• Financial flows to reproductive, maternal, newborn
and child health
• Equity in intervention coverage
Sources of data
The national-level profile uses data from global databases:
• Population-based household surveys
• UNICEF-supported MICS
• USAID-supported DHS
• Other national-level household surveys (MIS, RHS and
others)
• Provide disaggregated data - by household wealth, urbanrural residence, gender, educational attainment and
geographic location
•
Interagency adjusted estimates
U5MR, MMR, immunization, water/sanitation
•
Other data sources (e.g. administrative data, country reports
on policy and systems indicators, country health accounts, and
global reporting on external resource flows etc.)
National progress towards
MDGs 4 & 5
Mortality data through 2012:
2013 child mortality data was released in late 2014:
Under-five mortality rate (U5MR)= 15 deaths per 1000 live births
Infant mortality rate (IMR) = 13 deaths per 1000 live births
Neonatal mortality rate (NMR) = 7 deaths per 1000 live births
Why do mothers in the LAC
region die?
Leading direct causes:
Hypertension –23%
Haemorrhage – 22%
Unsafe abortion – 10%
Sepsis – 8%
Embolism – 3%
Understanding the cause of death distribution is
important for program development and monitoring
M
exi
c
o
Why do Mexican children die?
DEMOGRAPHICS
Causes of under-five deaths, 2012
Pneumonia
Leading causes:
Neonatal – 44%
Pneumonia – 9%
Injuries – 7%
Diarrhoea – 3%
9%
Preterm 16%
2%
Other 36%
Neonatal
death: 44%
Ca
Globally nearly
half of child
deaths are
attributable to
undernutrition
Asphyxia* 6%
Other 3%
Congenital
11%
Sepsis** 6%
HIV/AIDS 0%
Malaria 0%
Injuries 7%
0%
3%
Measles 0%
* Intrapartum-related events
Diarrhoea
Source: WHO/CHERG 2014
** Sepsis/ Tetanus/ Meningitis/ Encephalitis
MATERNAL
AND
NEWBORN
HEALTH
Undernutrition is a major underlying cause of child
deaths
Antenatal care
Percent women aged 15-49 years attended at least once by a
Dem
Demographics
Countdown to 2015 Report. 2014.
Variable coverage along the continuum of care
Maternal and newborn health
Maternal and newborn health
* Intrapartum-related events
Source: WHO/CHERG 2014
** Sepsis/ Tetanus/ Meningitis/ Encephalitis
Maternal and newborn health
MATERNAL AND NEWBORN HEALTH
Antenatal care
Demand fo
Percent women aged 15-49 years attended at least once by a
skilled health provider during pregnancy
Antenatal c
100
Percent
80
78
86
96
98
Malaria du
treatment
C-section r
(Minimum ta
60
Neonatal te
40
Postnatal v
(within 2 day
20
Postnatal v
(within 2 day
0
1987
Other NS
1995
Other NS
2004-2009
Other NS
2006
Other NS
Women wi
(<18.5 kg/m2
alitis
birthw
Other maternal and newborn health indicatorsAnten
ALTH
mana
Demand for family planning satisfied (%)
88
(2009)
Antenatal care (4 or more visits, %)
86
(2009)
-
-
46, 49, 36
(2012)
Low o
mana
88
(2012)
-
-
SYS
Malaria during pregnancy - intermittent preventive
treatment (%)
C-section rate (total, urban, rural; %)
(Minimum target is 5% and maximum target is 15%)
Neonatal tetanus vaccine
Postnatal visit for baby
(within 2 days for home births, %)
Postnatal visit for mother
-
-
-
-
(within 2 days for home births, %)
NS
Women with low body mass index
(<18.5 kg/m2, %)
Countdown to 2015 Report. 2012.
Inter
Breas
Comm
with
Coste
plan(
child
Life S
Rep
Mat
Child health
Child health
Child health
CHILD HEALTH
Ma
Percent of children <5 years with diarrhoea:
receiving oral rehydration therapy/increased fluids
with continued feeding
treated with ORS
Perce
those
Per
Percent
Diarrhoeal disease treatment
100
80
60
40
20
0
81
52
1996-1997
Other NS
2012
Other NS
Child health
Child health
Child health
2012
Other NS
1996-1997
Other NS
Water and sanitation
WATER AND SANITATION
Improved drinking water coverage
Improved s
Percent of population by type of drinking water source, 1990-2012
Other improved
Piped on premises
Surface water
Unimproved
Percent of popula
Improved facil
Unimproved f
Percent
13
5
80 7
0
1 4
4
4
6
0
9
35
91
40 75
86
95
77
60
40
66
49
20
22
80 4
8
14
6
10
60
100
Percent
0
5
4
100
20
0
0
2012
1990
Total
Source: WHO/UNICEF JMP 2014
2012 1990
1990
Urban
2012
Rural
1990
Tot
Source: WHO/UNICE
NS
Out of poc
expenditur
Water and sanitation
Reproducti
and child h
Improved sanitation coverage
1990-2012
Percent of population by type of sanitation facility, 1990-2012
Improved facilities
Shared facilities
Open defecation
Unimproved facilities
100
0
9
22
80 4
8
77
Percent
14
1
3
11
10
2
10
General
3
51
8
10
40
85
87
78
20
9
5
79
35
Rural
1990
2012
Total
Source: WHO/UNICEF JMP 2014
1990
2012
Urban
ODA to chil
Note: See anne
0
2012
Out-of-p
Other
ODA to ma
per live bir
60
66
9
0
2
11
Externa
1990
2012
Rural
MNCH policies
• PARTIAL - Maternity protection in accordance with
Convention 183
• YES - Specific notifications of maternal deaths
• NO - Midwifery personnel authorized to administer core set of
life saving interventions
• PARTIAL - International Code of Marketing of Breastmilk
Substitutes
• NO - Postnatal home visits in first week of life
• YES - Community treatment of pneumonia with antibiotics
• -- - Low osmolarity ORS and zinc for diarrhoea management
• YES - Rotavirus vaccine
• YES - Pneumococcal vaccine
Systems and financing for MNCH
• Costed national implementation plans for MNCH: -• Density of doctors, nurses and midwives (per 10,000
population): 46.2 (2011)
• National availability of EmOC services: - (% of recommended minimum)
• Per capita total expenditure on health (Int$): $1062 (2010)
• Government spending on health: 16 (2012)
(as % of total govt spending)
• Out-of-pocket spending on health: 44 (2012)
(as % of total health spending)
• Official development assistance to child health per child
(US$): $0 (2011)
• Official development assistance to maternal and newborn
health per live birth (US$): $0 (2011)
Who is left
behind?
Mexico
There was not
sufficient information
to show coverage
rates according to
wealth groups.
Thank you!