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Supervivencia infantil: Un imperativo de los sistemas de salud

Cristian Baeza's picture

Child Survival Call to Action

La semana pasada, los Gobiernos de India, Etiopía y Estados Unidos organizaron una Cumbre de Llamamiento a la Acción para la Supervivencia Infantil, con la participación de líderes mundiales y nacionales. Se trata de un evento oportuno y fundamental, destinado a fortalecer aún más el compromiso mundial y de los países y la responsabilidad de estos en el logro del objetivo de desarrollo del milenio (ODM) 4: reducir la mortalidad infantil. Aunque hemos observado una mejora sustancial en esta meta, los países que requie renmás de nuestro apoyo y asociación podrían no alcanzarla para 2015.

Child survival: A health systems imperative

Cristian Baeza's picture

Child Survival Call to Action

This week, the governments of India, Ethiopia and the United States will host a Child Survival Call to Action summit, with the participation of country and global leaders. This is a timely and critical event, aimed at further strengthening global and country commitment and country accountability for MDG4, to reduce child mortality. Though we’ve seen substantial improvement on this goal, the countries that need our support and partnership most may not reach it by 2015.

ICTs to transform health in Africa: Can we scale up governance and accountability?

Meera Shekar's picture

Uganda man sends health SMS.

Start-up eHealth innovations are popping up all over Africa, providing a glimpse of how ICTs can transform the delivery and governance of health services in the region. Many of these pilots show promise, but their rapid growth also poses challenges: At an eHealth conference held in Nairobi in May and co-organized by the World Bank, health professionals and development partners discussed how to identify the best of these evolving tools and bring them to scale.

Circumcision and smoking bans: Can policies nudge people toward healthy behaviors?

Patricio V. Marquez's picture

Walking through river. Mali. Photo: © Curt Carnemark / World Bank

The scaling up of voluntary medical male circumcision, particularly in high HIV prevalence settings, is a highly cost-effective intervention to fight the epidemic—randomized controlled trials have found a 60% protective effect against HIV for men who became circumcised.

But, the supply of this medical service is just one part of the picture. Without active involvement from individuals and communities to deal with social and cultural factors that influence service acceptability, the demand for this common surgical procedure will be low.

Indeed, on a recent visit to Botswana, a country with high HIV prevalence and low levels of male circumcision, my World Bank colleagues and I had a good discussion with the National HIV/AIDS Commission about ways to address the low uptake of voluntary, safe male circumcision services in spite of a well-funded program by the government.  It was obvious to all that if the demand for, and uptake of, this service were not strengthened through creative mechanisms that foster acceptance, ownership, and active participation of individuals and community organizations, the program would not help control the spread of HIV through increased funding of facilities, equipment, and staff alone.

So, what do we need to do to ensure that need, demand, utilization, and supply of services are fully aligned to improve health conditions?

Food and nutrition: How do we balance the equation?

Leslie Elder's picture

Although the world produces a surplus of food, we have yet to achieve the right balance between the production of food and achievement of good nutrition. A new World Bank-hosted knowledge platform will generate better understanding of the links between agriculture, food security and nutrition, to help countries reach the Millennium Development Goal on hunger (MDG 1). Read more on the SecureNutrition blog.

Maternal mortality: Why have some regions seen progress while others struggle?

Samuel Mills's picture

Nursing mother in Sri Lanka hospital (Credit: Simone D. McCourtie/World Bank)

New estimates released today by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), and the World Bank show that the number of women dying due to complications in pregnancy and childbirth has almost halved in 20 years—from more than 540,000 in 1990 to less than 290,000 in 2010.

This is good news, but it doesn’t tell the whole story. While substantial progress has been achieved at the global level, many countries, particularly in sub-Saharan Africa, will still fail to reach the Millennium Development Goal (MDG 5) target of reducing maternal mortality by 75% from 1990 to 2015.

Malaria is a preventable and treatable disease, but for how long?

Maryse Pierre-Louis's picture

www.worldbank.org/malaria

This year, on World Malaria Day, April 25, the global health community has reason to celebrate. Indeed, thanks to substantial investments from partners and countries over the last decade, the scorecard on malaria reports good news:  a reduction of more than 50% in confirmed malaria cases or malaria admissions and deaths in recent years in at least 11 countries south of the Sahara, and in 32 endemic countries outside of Africa. Overall, the number of deaths due to malaria is estimated to have decreased from 985,000 in 2000 to 655,000 in 2010. 

The fact that an estimated 1.1 million African children were saved from the deadly grip of malaria over the last decade is an extraordinary achievement. By the end of 2010, a total of 289 million insecticide-treated nets were delivered to sub-Saharan Africa, enough to cover 76% of the 765 million persons at risk.

Over the past 5 years, four countries were certified as having eliminated malaria: Morocco, Turkmenistan, the UAE and Armenia.  In southern Africa, health ministers of eight countries -- Botswana, Namibia, South Africa, Swaziland, Angola, Mozambique, Zambia, Zimbabwe--have developed a regional strategy to progress towards E8 malaria elimination status.  

Justice in health care delivery: a role for Sierra Leone’s paralegals

Margaux Hall's picture

I recently attended a community paralegal training on promoting accountability in health care delivery in Makeni, Sierra Leone. During the training, a community paralegal named Elizabeth Massalay talked about bringing her niece to a clinic in Moyamba district to receive immunizations that the government provides free of charge thanks to the Free Health Care Initiative (FHCI), which offers free health services to pregnant and breastfeeding women and children under five. Mothers queued for free immunizations, painting a hopeful picture for a country that ranks 180 out of 187 in the 2011 Human Development Index and where almost one in three children die before reaching the age of five.

However, against this promising backdrop, Elizabeth saw that the nurse was demanding six cups of rice from each mother before providing the immunization. Elizabeth was witnessing how breakdowns within state institutions—including absent nurses, improper user fees, and “leakage” of up to 30% of FHCI drugs (according to government and UNICEF statistics)—undermine health care delivery. Responding to such breakdowns requires an understanding of health policy and regulations—what the state must provide and to whom—and knowing where and how to apply pressure when the state fails to do so.

A recipe for good health: safe water and sanitation

Patricio V. Marquez's picture

Also available in: Français中文 Drinking water from a pump in Mali (credit: Curt Carnemark).

On the eve of World Water Day (March 22), there is some good public health news that is unrelated to medical care for the “sick,” but to a critical investment that makes people healthier and more productive, and promises a higher quality of life, particularly among the poor.

The 2012 UNICEF/World Health Organization report, Progress on Drinking Water and Sanitation, says that at the end of 2010, 89% of the world’s population, or 6.1 billion people, had access to improved drinking water. This means that the related Millennium Development Goal (MDG) has been met well ahead of the 2015 deadline. The report also predicts that by 2015, 92% of people will have access to better drinking water.

But, the not-so-good news is that only 63% of the world has improved sanitation access, a figure projected to increase only to 67% by 2015, well below the 75% MDG aim. Currently 2.5 billion people lack improved sanitation.  The report also highlights the fact that the global figures mask big disparities between regions and countries, and within countries (e.g., only 61% of the people in Sub-Saharan Africa have access to safe water).

Filling empty stomachs: when enough food is not enough

Leslie Elder's picture

Children having a bowl of soup (credit: Jamie Martin).

Save the Children’s recent report, A Life Free from Hunger: Tackling Child Malnutrition, reminds us that undernutrition is not a new crisis—and that the crisis will deepen if the global community fails to take serious action. If current trends persist, 11.7 million more children will be stunted in Sub-Saharan Africa by 2025, compared to 2010.

 

What can we do? Food is part of the answer, but it’s about the right food, at the right time—not just starchy staple foods that fill empty stomachs. According to Save the Children, more than half of children in some countries are eating diets of just three items: a staple food, a legume, and a vegetable (usually green leaves).

 

Availability of food and access to food are necessary but insufficient to ensure good nutrition. Insidiously, malnutrition (undernutrition) is not hunger, although malnourished children are often hungry. And undernutrition is frequently invisible, but increases the risk of child death; steals children’s growth; decreases cognitive potential, school performance, and adult productivity; and contributes to the development of non-communicable diseases later in life.

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