Some countries, such as Tanzania, Malawi and Ethiopia, have recently shown spectacular , according to IDS data. There are also other countries making steady progress in reducing that rate and simultaneously in the rate neonatal mortality (TMN) and maternal mortality rate, as is the case in Eritrea. (See Section I, figure I.2). Normally, we expect low-income countries to have high mortality rates, and while this is often true, there are some positive surprises.
Box IV.3 shows a graph comparing TMNs with Gross National Income (GNI) per capita. We would like to take a closer look at countries that stand out positively, countries that have progressed towards lower neonatal mortality rates, despite their low GNI per capita. We highlight these countries – Eritrea, Malawi, Burkina Faso, Tanzania, Uganda and Madagascar – to demonstrate that good news can come from Africa.
These countries are progressing
from very high NMR and mortality rates for children under 5 years old, lower parataxes and, in many cases, to lower maternal mortality ratios. In some cases, measuring TMN may be difficult, but despite this, what can we learn from your experiences so far? BOX IV.3 Despite their scarce wealth, some African countries are making progress: neonatal mortality rate versus
- National Income Gross (GNI) per capita102 03 04 05 06 070 $ 0 $ 1 000 $ 2 000 $ 3 000 $ 4 000 $ 5 000RNB per capita in dollarsMascar macawalaMalawiTa z â iarq a FasoU d aEritrea
- TMN per 1000 live beings156 Opportunities for the newly born – born in AfricaThere are many factors that can
- contribute to improvements in neonatal health.
However, for each of these countries with a lower TMN (31 per 1,000 live births or less) and also a low GNI per capita (less than $ 500 per year), it is worth pointing out certain fundamental realities that are likely related to these successes. The chart also contains indicators on the progress of these countries towards fulfilling Abuja commitments to spend at least 15 percent of the state’s general budget on health.
An important warning is that Demographic and Health Surveys (SDI) tend to underestimate neonatal deaths, so the true TMN in some of these countries is probably higher. Eritrea: (TMN = 24, GNI per capita = 180 dollars, progress towards of Abuja commitments = 5.6%) Despite being one of the poorest countries in the world, placed 157th out of 173 countries on the UNDP Human Development Index, and despite the difficulties of wars and famines, Eritrea has achieved extraordinary successes in this regard regards the health of children.
The constant reductions in the mortality rates
Of children under 5 years old that have been seen in this country have already been highlighted in Section I. How are these results being achieved? Firstly, through a strong commitment to children’s health at all levels, and secondly, because there is no corruption in Eritrea and there is strong donor collaboration, which multiplies the impact that limited resources could have. Eritrea was one of the first African countries to be certified for having eliminated neonatal tetanus
Despite these successes, difficulties remain. The coverage rate of women who give birth to specialized care, for example – only 28 percent – is still low, while the TMM is moderately high, with a value of 630 per 100 000. The Eritrean National Roadmap was created to solve the problem of its high TMM and innovative methods to solve the human resources crisis in the country are being explored. Uganda: (TMN = 32, GNI per capita = $ 270,
Progress towards Abuja commitments = 9.1%) In Uganda, the current Health Sector Strategic Plan II includes a Maternal Health Cluster and Infantile, to which a sub-group dedicated to newborn health was recently added. The objective is to improve and expand essential interventions and reach the poor. In addition, every year the results of the districts in terms of health are published in national newspapers, thus promoting the accountability of the authorities.
That families previously paid for cesarean hysterectomies.
Burkina Faso: (TMN = 31 , GNI per capita = $ 360, Progress towards Abuja commitments = 10.6%) Recent high-level actions in Burkina Faso to combat maternal and newborn deaths through the REDUCE advocacy tool , resulted in an 11 percent increase in government funding for maternal and newborn health. These actions also resulted in the publication of legislation designed to reduce from $ 120 to a maximum of $ 20 the amounts
- Tanzania: (NMR = 32, GNI per capita = $ 330, Progress towards commitments de Abuja = 14.9%) The Government of Tanzania has shown a constant
- commitment to invest in health and to decentralize decision making regarding health spending based on district priorities. At this time, district health teams
- allocate budget funds based on local charges and the coverage of some high-impact interventions has increased.
The National Roadmap is being created and it is giving even more emphasis to the health of newborns. Malawi: (TMN = 27, GNI per capita = $ 170, Progress towards Abuja commitments = 9.7%) If there are doubts about the accuracy of TMN’s calculations in the country’s most recent IDS, Malawi has undoubtedly made progress in reducing child deaths, as described in Section I. Many factors can contribute to this progress, although there are few obvious increases coverage of the most essential interventions over the same period of time.
Health sector reform in Malawi has been a participatory process that has resulted in a national consensus on the essential health package and an increase in investment in the sector. led to greater collaboration between the Ministry of Health and donors. Two donors invested an additional US $ 40 million after the costs of the National Roadmap were calculated. The level of commitment to the Roadmap is demonstrated by the fact that it will be launched by the President. Madagascar: (TMN = 32,
GNI per capita = $ 300, Progress towards Abuja commitments = 8.0%) A recent review of the Framework National Medium Term Expenditure provided an opportunity to integrate newborn health into the current MNCH plan, especially as the latest IDS revealed that the percentage of children under five in the postnatal period increased. Attention goes to family planning, prenatal control and community strategies, as well as solving the problem of human resource limitations for specialized health care and obstetric emergency.