The H4 partnershiop represents an intensified joint effort by four international agencies, WHO, UNFPA, UNICEF and the World Bank, to support countries in improving maternal and newborn health and saving the lives of mothers and babies.
Ethiopia has one of the highest maternal mortality rates in Africa. According to the most recent estimates and findings only 6 per cent of pregnant women in Ethiopia have access to professional assistance during pregnancy and child birth, the lifetime risk for dying in pregnancy or childbirth is 1 in 27, compared to 17000 in Sweden, and the under-5 mortality risk is more than 1 in 10.
A 10-day H4 mission to Ethiopia concluded with a meeting in Addis Ababa on 9 December, involving UN agencies, officials from the Ethiopian Federal Ministry of Health, and the Health Population and Nutrition Donor Group - and a plan for how to tackle the challenges.
Scaling up and building momentum
"It was a very fruitful meeting and a very good visit to Ethiopia. The momentum and interest for taking action to save the lives of women and babies is truly there, and a good plan was developed," said Dr. Luc de Bernis, Senior Maternal Health Adviser, UNFPA. He highlighted the strong leadership of the Minister of Health in Ethiopia, Dr. Tedros Adhanom Ghebreyesus, and the commitment in the donor community, civil society and the UN agencies, including UNAIDS, to join hands and implement the plan.
The Joint UN Flagship Program on Maternal and Newborn Health will scale-up the efforts in Ethiopia and focuses on both immediate and long-term interventions. It involves four strategies:
- Increase demand, access and utilization of quality maternal and newborn health services
- Improve the quality of maternal and newborn health services
- Strengthen monitoring and evaluation of the services
- Improve managerial and institutional capacity, advocacy and partnerships in order to encourage increased political and financial commitment to save the lives of mothers and babies.
Working together to save lives
About 50 per cent of all maternal deaths annually occur in sub-Saharan Africa, as do deaths among children under five. Since 1990, the number of estimated annual global maternal deaths has remained around 500,000, while the absolute number of child deaths in 2008 declined to an estimated 8.8 million from 12.5 million in 1990, the base line year for the Millennium Development Goals (MDGs).
During the coming years, the four agencies in the H4 will enhance their collaboration with and support to the countries with the highest rates of maternal mortality. Work is ongoing, with a special focus in six countries (Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, India and Nigeria). A joint work plan for scaling-up of national maternal and newborn health efforts in 25 countries and eventually to 60 countries is in the works.
The H4 is focusing on helping countries strengthen their health systems through developing maternal and newborn health services so that they can reduce the maternal mortality ratio by 75 percent and achieve universal access to reproductive health, the two targets included in Millennium Development Goal 5, to improve maternal health.
The joint effort will also contribute to reducing child mortality as called for by MDG 4, as there is a demonstrated link between a mother's health and the survival, health and welfare of her children, particularly newborns. When a woman and mother is healthy and survive, her children, family, community and nation thrive.