A VALUABLE GUIDE
The World Health Report 2005: Make very mother and child count. soft cover, 8" x 10".
World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland, Publication Date 2005, xiv + 229 pages, ISBN 9241562900, ISSN 1020-3311, NLM classification: WA 540.1: Price: CHF 40.00 / US$36.00; Developing countries: CHF 15.00
It is a well known fact that a healthy mother gives birth to a healthy child and together mothers and children represent the well-being of a society and the potential for future. Still, in 21st century, over 10 million children and half a million mothers die each year, the main reason being exclusion from care. Public health programs focusing on maternal and child health in the past have failed to make an impact due to selection of wrong technical and strategic choices made by them. As a result the health indicators for mothers, newborn and children have either stagnated or reversed in many countries. The internationally agreed millennium development goals, to be met by 2015, have also drawn global focus on these issues.
This 252 paged world health report presents an excellent view of what went wrong in our pursuit of maternal and child health and the approaches that should be adopted to ensure universal access to health services. The report also advocates the repositioning of MCH as MNCH (maternal, newborn and child health). There are seven chapters in the report followed by a statistical annex which contains eight tables as well as explanatory notes for them.
The first chapter highlights the current situation regarding the health of mothers, newborn and children. It assesses the patchy progress, stagnation and reversals in their health against their historical background. It also brings to light the newborn deaths that went unnoticed.
Chapter two seeks to explain the reasons for poor performance in reducing maternal and child health indicators by many countries. It explains the negative impact of poverty, HIV/AIDS and humanitarian crises on progress made. It goes on to state that universal access to goods, services and opportunities is still a distant goal and describes the sources and patterns for such exclusion.
The third chapter goes on to review the three most important ways to improve the outcome of pregnancies: good ante-natal care, coping with unwanted pregnancies and building societies that support women who are pregnant. It explains the unrealized potential of ante-natal care and the need to rationalize the many of the "rituals of care" provided during ante-natal visits. The chapter provides critical directions for future, including the need to improve quality of care, increase further coverage and address the issues of gender based violence and discrimination. The next chapter then deals with the most crucial moment in the life of a mother and baby - the childbirth. It examines the main complications of childbirth and the interventions to reduce them. It states the importance of receiving skilled care by each and every mother and newborn not only at birth but also in the immediate post-partum period.
Due to the lack of continuity between maternal and child health programs, newborn care has largely been ignored. Chapter five lays emphasizes on the urgent need for filling up these cracks and maintaining a continuum of care. It presents a set of benchmarks for the needs in human resources and service networks to provide first level and back-up maternal and newborn care to all. The next chapter highlights the need for integrating child care and the cost for scaling up such a program to reach universal implementation.
Finally, the last chapter looks at the place of maternal, newborn and child health within a wider context of health system development. It discusses the need to reduce financial barriers in accessing the health services. Contrary to expectations, this chapter states that the introduction of user fees is not a viable answer to the under funding of health sector. In fact, universal access and financial protection can only be guaranteed through generalized prepayment and pooling schemes.
This world health report should be read by all public health professionals working in the field of maternal and child health. It also provides an excellent reading for students, policy makers and other health professionals. It defines the technical choices that should be put in place effectively if we want to transform the lives of millions of people for decades to come.
-Rahul Malhotra and Chetna Malhotra
Department of Community Medicine,
Maulana Azad Medical College,
New Delhi, India
Dr. Rahul Malhotra is currently working as a Senior Resident in the Department of Community Medicine, Maulana Azad Medical College, New Delhi. He did his graduation and post graduation in Community Medicine from the same institute. He has written a very exhaustive thesis on food hygiene, titled "Study of food handlers working in food service establishments within the premises of Maulana Azad Medical College, and associated hospitals". This thesis won him the prestigious gold medal for the best thesis. He can be contacted at firstname.lastname@example.org
Dr Chetna Malhotra is a medical graduate from the Rabindra Nath Tagore Medical College, Udaipur, India. She is currently pursuing her post graduation in Community Medicine at the Department of Community Medicine, Maulana Azad Medical College, New Delhi. Her dissertation for post graduation is on the epidemiological profile of road traffic accident cases admitted in a tertiary care hospital of Delhi. In addition, her other interests in the field of public health include nutrition, reproductive and child health and communicable diseases. She can be contacted at email@example.com
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