mnchn situationer

7/26/2019 MNCHN Situationer

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MNCHN Situational & UNResponse

9thWFCI National convention

Baguio City

May 20 20!0


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We "no# that$$$$$$$$

% Woen's an( chil()en's health is valua*le*y itsel+ ,C-./W & CRC

% Investing in #oen & chil()en's health

1 a"es econoic sense1 Has political *ene+its inclu(ing social sta*ility

& huan secu)ity

1 Ma"es the health syste #o)" *ette)

% )oven an( a++o)(a*le #ays o+ saving the

lives o+ #oen & chil()en a)e availa*le


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Relatively Flat MMR Re(uction hilippines

Figure 2: Trend in Maternal Mortality Ratio

1990-2005

209 203 197 191 186 180 172 162

52.50

30

!00

!30

200

230

!990 !99! !992 !994 !995 !993 !996 2007 20!3

MMR M.8

he hilippines is one o+ 76 count)ies cont)i*uting

to 9:; ate)nal (eaths glo*ally


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%


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Causes o+ .eath in chil()en

Source: CHERG estimates of under-ve deaths,

2000-03

Under-

nutrition

53%

eonatal 37%


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178 Million ildren nder 5 +u44er

4ro! +tunting

(realen"e o4

+tunting

90% o4 ll +tunted ildren ie in u#t 36 ountrie#)

in"luding te (ili//ine#


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Key MNCHN Indicators 2008 NDHS

At least one ANC visit 91

TT2 plus coverage 75

Skilled Birth Attended Deliveries 61.8

Initiation o B! "ithin an hour 54

(ro/ortion o4 in4ant# le## tan 6 !ont# o4 age e"lu#iely*rea#t4ed

23

(ro/ortion o4 "ildren 0-59 !ont# o4 age ,o ad diarrea in te/a#t 2 ,ee# and ,ere treated ,it RT

58

(ro/ortion o4 "ildren 0-59 !ont# o4 age ,o ad #u#/e"ted/neu!onia in te /a#t 2 ,ee# and ,ere taen to an a//ro/riateealt "are /roider

50

(ro/ortion o4 one-year old "ildren 4ully i!!unied 70

Comprehensive Prevalence a!e 34

Maternal) eonatal ; ild ealt +tatu#


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Failu)e o+ Cove)age in the

Continuu o+ Ca)e 2006 N.HS


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Wi(e .ispa)ities in SB/


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=i#/aritie# a"ro## ,ealt >uintile

Wi(est poo) 1)ich gap

2006 N.HS


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Te (ro*le!: =eat# o4 eonate# *y day o4 li4e)

(ili//ine# 1998-2003) =+

.ay o+ =i+e

Nu&*e)

o+(eaths

50%o4 neonatal deat# o""ur

in te 4ir#t t,o day# o4 li4e

NDHS 2003, special tabulations


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he )is" o+ ate)nal (eath is highest (u)ing

chil(*i)th an( #ithin 25 hou)s a+te) (elive)y

0-1 day 2-7 day# 8-1$ day# 15-21 day# 22-30 day# 31-$2 day#

=ay o4 !aternal deat a4ter deliery

?. F. i et al.) @nternationalou!al o4 Ayne"ology ; *#tetri"# 5$ &1996': 1-10.

(er"ent o4 !aternal deat# in

deelo/ing "ountrie#


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Time !en Maternal Deat!s "ccur

# $%$ & 'reas, 2000 ( 2002


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Neonatal Mo)tality is high

+o) Rich an( oo) N.HS 2006


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eonatal Mortality Rate

Nation#i(e Nation#i(e Hospital

Stu(y

Ne#*o)nMo)tality

16.0

=ive Bi)ths >

16.0

=ive Bi)ths ?

NDHS 2008 * Sobel, Oliveros, Nyunt-U 2009


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urrent +tate o4 Maternal and

e,*orn are (ra"ti"e#

in (ili//ine o#/ital#


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Ne#*o)n Ca)e )actices in 3!

hilippine Hospitals 2009

% e)+o)ance an( tiing o+ evi(ence$

*ase( inte)ventions in ie(iate ne#*o)n

ca)e a)e *elo# essential ne#*o)n ca)e

stan(a)(s )ecoen(e( *y the WH@A

% Hospital p)actices p)evente( hilippine

ne#*o)ns +)o *ene+iting +)o thei)

othe)'s natu)al p)otection in the +i)st hou)o+ li+eA

+o*el ) et al) 2009


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"#s!e!ric prac!ices in Philippine Hospi!als nee$ !o reali%n &i!h

!he evi$ence'#ase( an o#serva!ional s!)$*

+c!ion , D"H'-H" S!an$ar$"*!ocin 24.8, 100,

+n!i#io!ic %iven 78.8, "nl* i/ in$ica!e$

n$ica!ion recor$e$ in char! 10.4, 100, o/ !hose %ivenan!i#io!ics

+n!ena!al s!eroi$s in P 23, 100,

Posi!ion o/ choice 0 100,

a!ernal s)ppor! 0.8, 100,Par!o%raph )se$ 3.5, 100,

Cesarean sec!ion 22.2, "nl* i/ in$ica!e$

n$ica!ion /or CS recor$e$ in char! 37.4, 100, o/ CS

Mantaring, Sobel, Silvestre, atibog, 2009


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@++ice o+ the WH@ Rep)esentativein the hilippines

n!erven!ion Percen!a%e an$

e$ian ime

D"H'-H" S!an$ar$

Cord Cla#p $2 sec%%& in ' $ #in

(ntil pulsations stop )$*+ #ins,

Drying %-& at $ #in $..& I##ediately

I##ediate Skin*to*skincontact

%/0& at 1 #in %.& )e3cept those needingresuscitation,

4ut on cold surace $2& None

Not dried 2/1& None

Head notdried 0/2& None

5ash 67& at 6 #in 0 hours

Te#p taken 8eore $-& All

+ in)!e'#*'in)!e +ssessmen! o/ Neorn Care

&i!hin !he irs! Ho)r o/ i/e in Philippines Hospi!als 2009


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n!erven!ion e$ian ime orPercen!a%e

D"H'-H" S!an$ar$

Breast eed 0%/+& at $.#in 5ithin $ hour )8ut "hen8a8y sho"s signs,

Separatedro##other %2/%& at $2 #in $ hour

5eigh $..& at $+ #in $ hour

93a# -1/-& at $- #in $ hour

Hepatitis B :accine 0%/7& at 2. #in $ hourNursery 12& at $% #in Never

;oo#ing in 6+& )$11 #in, I##ediately "ith #other

+ in)!e'#*'in)!e +ssessmen! o/ Neorn Care

&i!hin !he irs! Ho)r o/ i/e in Philippines Hospi!als 2009

So*el Silvest)e Manta)ing et al 2006


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Re#u#"itation a"tion o4 26 in4ant# ,it a/nea:+c!ion N

Suctioning 27 )%2/+&,

Bag and Mask $2 )70/$&, at $2. seconds

Slapping 8ack - )20/%&,

Intu8ation 2 )-/-&, at + and 0 #in

Chest co#pressions< 9pi 2 )-/-&, at 7 #in

Drying === $ )+/6&,

*** Should be first action, immediately, for full 30 seconds



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Unnecessa)y Resuscitation

% @+ the 533 #ho #e)e *)eathing

1 95A9; suctione( once

1 65A0; suctione( o)e than once



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.i++e)ences in )actices

% he)e #as inial (i++e)ence in tiing o)

pe)+o)ance o+ ie(iate ne#*o)n

inte)ventions )ega)(less o+ #hethe) the

atten(ant at (elive)y #as a pe(iat)iciannu)se o) i(#i+e


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Bariation in +e>uen"e o4 @nterention#

Sobel, Silvestre, Mantaring, Oliveros, 2009


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Mate)nal Ne#*o)n & Chil( Health

Mate)nal & neonatal health has +allen +a) *ehin(a(vances in chil( su)vival

Inet)ica*le lin" *et#een ate)nal an( in+ant

su)vival Mate)nal an( chil( health in(icato)s i))o) the

ove)all e++ectiveness o+ the health syste

Saving the lives o+ othe)s & thei) chil()en

)eDui)es o)e than Eust e(ical inte)ventions It )eDui)es an ena*ling envi)onent that

epo#e)s #oen an( )espects thei) )ights

CY FRCR= D id * d i t ti d


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CY FRCR=: Diden"e-*a#ed interention# and

o/erational #trategie# u#ing a li4e-"y"le a//roa"

,itin te ealt #y#te!E ealt #e"tor re4or!#E ;

rigt#-*a#ed a//roa"

e,*orn

dultood

riti"al

(y#iologi"al

+tage o4 ealt

and utrition

&/re-/regnan"y- 3 year#'

dole#"en"e

ildood(re-/regnan"y)

(regnan"y ;

*irt


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S"ille( Ca)e at )egnancy an(

.elive)y

+ill# to /ro!ote

utili#ation o4

deliery "are)

"ondu"t nor!al

delierie# e##ential

ne,*orn "are

+ill# to /roide *a#i"

e!ergen"y o*#tetri" ;

ne,*orn "are

+ill# to /roide

"o!/reen#ie

e!ergen"y

o*#tetri" ;

ne,*orn "are

Re4erral

+illed attendant#

D!/o,ered o!!unity

Dna*ling eniron!ent


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Re(uce the nu*e) o+ othe)s

#ho (ie *ecause o+ p)egnancy o)

chil(*i)th

Re(uce the nu*e) o+

ne#*o)ns #ho (ie #ithin +i)st 26

(ays o+ li+e

lanne( space( & #ante( p)egnancy

Ca)e th)oughout p)egnancy sa+e

(elive)y an( ne#*o)n ca)e

ational ealt +e"tor Re4or! genda

Maternal) e,*orn) ; ild ealt ; utrition &M'

+trategy ; (oli"y

oint (rogra!!e

on Maternal ; e,*orn +urial

&@DF F( = C'


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UN MNH SitesG)ansition hase

% ordillera Region I+ugao% ational a/ital Region Navotas

Mala*on Ma"ati a)anaDue aguig ueJon

City% Da#tern Bi#aya#-aste)n Saa) aclo*an

City

% ++RAD 8enA Santos City Sa)angani

No)th Cota*ato

% RMM Maguin(anao =anao Su)


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