Accelerating Maternal and Child Health Gains in Papua New Guinea: Modelled Predictions from Closing the Equity Gap Using
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Accelerating Maternal and Child Health Gains in Papua New Guinea: Modelled Predictions from Closing the Equity Gap Using LiST Abbey Byrne1,2 • Andrew Hodge2 • Eliana Jimenez-Soto2
Ó Springer Science+Business Media New York 2015
Abstract Background Many priority countries in the countdown to the millennium development goals deadline are lagging in progress towards maternal and child health (MCH) targets. Papua New Guinea (PNG) is one such country beset by challenges of geographical inaccessibility, inequity and health system weakness. Several countries, however, have made progress through focused initiatives which align with the burden of disease and overcome specific inequities. This study identifies the potential impact on maternal and child mortality through increased coverage of prioritised interventions within the PNG health system. Methods The burden of disease and health system environment of PNG was documented to inform prioritised MCH interventions at community, outreach, and clinical levels. Potential reductions in maternal and child mortality through increased intervention coverage to close the geographical equity gap were estimated with the lives saved tool. Results A set community-level interventions, with highest feasibility, would yield significant reductions in
Electronic supplementary material The online version of this article (doi:10.1007/s10995-015-1762-6) contains supplementary material, which is available to authorized users. & Abbey Byrne [email protected] 1
The Nossal Institute for Global Health, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3010, Australia
2
School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD 4006, Australia
newborn and child mortality. Adding the outreach group delivers gains for maternal mortality, particularly through family planning. The clinical services group of interventions demands greater investment but are essential to reach MCH targets. Cumulatively, the increased coverage is estimated to reduce the rates of under-five mortality by 19 %, neonatal mortality by 26 %, maternal mortality ratio by 10 % and maternal mortality by 33 %. Conclusions Modest investments in health systems focused on disadvantaged populations can accelerate progress in maternal and child survival even in fragile health systems like PNG. The critical approach may be to target interventions and implementation appropriately to the sensitive context of lagging countries. Keywords Maternal health Child health Papua New Guinea Equity LiST
Introduction In the pursuit of the millennium development goals (MDG) for maternal and child health—i.e. MDG 4 aimed to reduce the under-five mortality rate by two thirds, and MDG 5 designed to reduce the maternal morality ratio by three quarters and achieve universal access to reproductive health between 1990 and 2015—the 75 countries in which 95 % of maternal and child deaths take place have been pr
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