Countdown to 2015: a report card on maternal, newborn, and child survival

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• 作者：Richard Horton
• 关键词：Computer-aided personalized system of instruction ; Self-pacing ; Procrastination ; Early- vs. Late-Massed performance ; Measure of educational performance ; Essay tests ; Student peer reviewers ; Online instruction ; Instructional technology
• 刊名：The Lancet
• 出版年：2008
• 期刊代码：182_01406736
• 类别：med
• 出版时间：12 April 2008-18 April 2008
• 卷：371
• 期：9620
• 页码：1217-1219
• 文件大小：724 K

摘要

We selected countries with high rates of maternal and child deaths, and interventions with the most potential to avert such deaths. We analysed country-specific data for maternal and child mortality and coverage of selected interventions. We also tracked cause-of-death profiles; indicators of nutritional status; the presence of supportive policies; financial flows to maternal, newborn, and child health; and equity in coverage of interventions.

Findings

Of the 68 priority countries, 16 were on track to meet MDG 4. Of these, seven had been on track in 2005 when the Countdown initiative was launched, three (including China) moved into the on-track category in 2008, and six were included in the Countdown process for the first time in 2008. Trends in maternal mortality that would indicate progress towards MDG 5 were not available, but in most (56 of 68) countries, maternal mortality was high or very high. Coverage of different interventions varied widely both between and within countries. Interventions that can be routinely scheduled, such as immunisation and antenatal care, had much higher coverage than those that rely on functional health systems and 24-hour availability of clinical services, such as skilled or emergency care at birth and care of ill newborn babies and children. Data for postnatal care were either unavailable or showed poor coverage in almost all 68 countries. The most rapid increases in coverage were seen for immunisation, which also received significant investment during this period.

Interpretation

Rapid progress is possible, but much more can and must be done. Focused efforts will be needed to improve coverage, especially for priorities such as contraceptive services, care in childbirth, postnatal care, and clinical case management of illnesses in newborn babies and children.

Funding

Bill & Melinda Gates Foundation, UK Department for International Development, Norwegian Agency for Development Cooperation, Partnership for Maternal, Newborn and Child Health, Save the Children US and UK, United Nations Children's Fund, United Nations Population Fund, and World Health Organization.