THE WORLD BANK’S REPRODUCTIVE HEALTH ACTION PLAN 2010-2015

THE WORLD BANK’S REPRODUCTIVE HEALTH ACTION PLAN 2010-2015 APRIL 2010 The World Bank Contents I. INTRODUCTION ..............................................................................................................................1 II. THE CONTEXT.................................................................................................................................3 III. CHALLENGES AND SOLUTIONS...............................................................................................12 IV. THE BANK’S ACTION PLAN.......................................................................................................22 COUNTRY FOCUS................................................................................................................................22 FOCUS ON HEALTH SYSTEMS STRENGTHENING .......................................................................25 FOCUS ON REACHING THE POOR....................................................................................................29 FOCUS ON ADOLESCENTS................................................................................................................33 WORKING WITH PARTNERS AND CIVIL SOCIETY......................................................................34 V. RESULTS FRAMEWORK .............................................................................................................35 Figures Figure 1. Trends in Fertility by Region, 1950-2000.....................................................................................6 Figure 2. Trends in Fertility Rates, Chad, Mali, Niger and Uganda, 1960-2007..........................................7 Figure 3. Infant Mortality versus Total Fertility Rate in Developing Countries, 2005.................................8 Figure 4. Desired versus Actual Total Fertility Rate in Selected Countries.................................................9 Figure 5 Official Development Assistance for Health and its Composition, 1995-2007 ...........................13 Figure 6. Percent of Deliveries by C-Section .............................................................................................17 Figure 7. Physicians per 10,000 of Population ...........................................................................................19 Figure 8. Percent Births Attended by Skilled Personnel and MMR (per 100,000 births) ..........................19 Figure 9. Government Effectiveness (percentile rank)...............................................................................20 Figure 10. Maternal Mortality versus Total Fertility Rates in Developing Countries, 2005......................23 Tables Table 1. Fertility rates by wealth quintiles (selected countries)....................................................................7 Table 2. Proportion of births attended by skilled health personnel.............................................................15 Table 3. Country characteristics based on MMR and TFR classifications.................................................24 Table 4. Percent of currently married women (15–49) using a modern family planning method..............30 Table 5. Menu of pro-poor policies ............................................................................................................31 Table 6. Results Framework for Reproductive Health Action Plan............................................................37 Boxes How Many Maternal Deaths Are There In The World?...............................................................................4 Countries Classified according to MMR and TFR .....................................................................................25 Reaching the Poor -- Lessons from Success Stories...................................................................................32 Annexes Annex A: Consultations on the reproductive health action plan......................................................42 Annex B: Outline of Africa region population and reproductive health strategic plan................54 Annex C: Global consensus on maternal, newborn and child health...............................................60 Annex D: Joint World Bank, WHO, UNICEF and UNFPA statement on MNCH..........................61 ii Acronyms AAA AFR CAS CCT CSO DALY DEC DHS DPT 3 EAP ECA FIGO GAVI GDP GFATM GNI HDN HDNHE HIV HIV/AIDS HLTF HNP HSO HSS ICM ICPD ICR IDA IEG IHME IHP IHP+ IUD LCR MDG MMR MNA MNH MTCT MTR NGO ODA PMNCH Analytic and Advisory Services Africa Country Assistance Strategy Conditional Cash Transfers Civil Society Organization Disability Adjusted Life Years Development Economics Demographic and Health Survey Diphtheria Polio Tetanus 3 East Asia and Pacific Europe and Central Asia International Federation of Gynecology and Obstetrics Global Alliance for Vaccines and Immunization Gross Domestic Product Global Fund for AIDS, Tuberculosis and Malaria Gross National Income Human Development Network Human Development Network Health Human Immunodeficiency Virus Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome High Level Task Force on Innovative Financing Health, Nutrition, and Population Health Systems for Outcomes Health Systems Strengthening International Council of Midwives International Conference on Population and Development Implementation Completion Report International Development Association Independent Evaluation Group Institute for Health Metrics and Evaluation International Health Partnership International Health Partnership and related initiatives Intra-uterine Device Latin America and Caribbean Millennium Development Goal Maternal Mortality Ratio Middle East and North Africa Maternal and Neonatal Health Mother to Child Transmission Mid Term Review Non-governmental organization Official Development Assistance Partnership for Maternal, Newborn and Child Health iii PMTCT Prevention of Mother to Child Transmission PREMGE Poverty Reduction and Economic Management Network, Gender QER Quality Enhancement Review RBF Results Based Financing RH Reproductive Health RHAP Reproductive Health Action Plan RHSC Reproductive Health Supplies Coalition SAR South Asia Region SBA Skilled Birth Attendant SGA Small for Gestational Age SRH Sexual and reproductive health SSA Sub-Saharan Africa STI Sexually Transmitted Infection TFR Total Fertility Rate UNAIDS United Nations Joint Programme on HIV/AIDS UNFPA United Nations Population Fund UNICEF United Nations Children‟s Fund USAID United States Agency for International Development WBI World Bank Institute WDI World Development Indicators WHO World Health Organization iv THE WORLD BANK’S REPRODUCTIVE HEALTH ACTION PLAN:2010-2015 I. Introduction 1. Reproductive health (RH) is a key facet of human development. Improved RH outcomes – lower fertility rates, improved pregnancy outcomes, and lower sexually-transmitted infections (STIs) – have broader individual, family, and societal benefits, including a healthier and more productive work force; greater financial and other resources for each child in smaller families; and as a means for enabling young women to delay childbearing until they have achieved educational and other goals.1 Many studies have demonstrated that poor RH outcomes – early pregnancies, unintended pregnancies, excess fertility, poorly managed obstetric complications – adversely affect the opportunities for poor women and their families to escape poverty.2 Women‟s full and equal participation in the development process is contingent on accessing essential RH services, including the ability to make voluntary and informed decisions about fertility. Men, too, play an important role in supporting a couple`s reproductive health needs, especially since effective use of contraceptive methods as well as seeking maternal health care services are often influenced by men.3 One consequence of high fertility is high population growth which can constrain countries at low levels of socio-economic development. Reductions in fertility lead to low youth dependency and a high ratio of working people to total population, creating a demographic window of opportunity during which output per capita rises and countries enjoy a demographic dividend. 2. Improvements in RH have generally lagged improvements in other health outcomes in many low-income countries. The Millennium Development Goal (MDG) for maternal health is one where the least amount of progress of all the MDGs has been made to date globally.4 Many low-income countries continue to have high fertility, and rates of unmet need for contraceptive services, and very high maternal mortality. Twenty-eight countries – mostly in sub-Saharan African – have fertility rates in excess of five births per woman.5 Even within countries with relatively good RH outcomes, access to family planning, antenatal care, and delivery assistance among the poor and other vulnerable groups tend to be far worse than the national average.6 3. RH issues only recently have begun to be prioritized in the development agenda, and even though levels of official development assistance (ODA) for RH have increased, the 1 Singh, S, JE Darroch, M Vlassoff, and J Nadeau (2004), Adding it up: the Benefits of Investing in Sexual and Reproductive Health Care, New York: UNFPA /Alan Guttmacher Institute 2 Greene, ME and TW Merrick (2005), Poverty Reduction: Does Reproductive Health Matter? HNP Discussion Paper Series, Washington, DC: World Bank. 3 Family Health International (1998), Men and Reproductive Health, Network Quarterly Bulletin, Vol. 18 (3), Spring 1998, Durham NC: FHI 4 The maternal mortality MDG calls for a three-fourths reduction in the maternal mortality ratio over the period 1990-2015. For recent update on status of MDGs, see World Bank (2009), Global Monitoring Report: A Global Emergency, Washington, DC: World Bank. 5 This is based on 2005 data from the World Development Indicators database. 2005 is the latest year for which data on both total fertility rates and maternal mortality rates are available. 6 Gwatkin, DR, S Rutstein, K Johnson, E Suliman, A Wagstaff, and A Amouzou (2007), Socio-Economic Differences in Health, Nutrition, and Population within Developing Countries, Washington, DC: World Bank. 1 ... - tailieumienphi.vn