WHO Director-General Roundtable with Women Leaders on Millennium Development Goal 5 Panama Country profile For Demographic and Health Surveys, the years refer to when the Surveys were conducted. Estimates from the Surveys refer to three or five years before the Surveys. Panama and the world 1. Maternal mortality ratio: global, regional and 2. Lifetime risk of maternal death (1 in N), 2005 country data, 2005 A maternal death is defined as the death of a woman while pregnant or The lifetime risk of maternal death is the estimated risk of an individual within 42 days of termination of pregnancy, from any cause related to woman dying from pregnancy or childbirth during her adult lifetime the pregnancy or its management but not from accidental or incidental based on maternal mortality and the fertility rate in the country. The causes. The maternal mortality ratio is the number of maternal deaths lifetime risk of dying from pregnancy-related causes in Panama is 1 in per 100 000 live births per year. The ratio in Panama is 130 per 100 000 270, slightly lower than the average of 1 in 290 for Latin America and the live births, which is the same as the average of 130 per 100 000 live births Caribbean and lower than the global figure of 1 in 92. in Latin America and the Caribbean and lower than the global average of 400 per 100 000 live births. 3/250 1/92 4 5 0 1/100 400 4 0 0 3 5 0 1/125 3 0 0 2 5 0 3/500 2 0 0 1/270 1/290 death (1 in N) live births 130 130 1/250 1 5 0 Lifetime risk of 1 0 0 Deaths per 100 000 1/500 5 0 0 0 Panama Latin America World Panama Latin America World and the Caribbean and the Caribbean Source: Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 Source: Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html). (http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html). Demographic and health data 3. Total population (in thousands)1 3 288 (2006) 2 Lifetime risk of maternal death (1 in N) 270 (2005) 2 Total maternal deaths 91 (2005) Source: 1 World Health Organization 2008, World Health Statistics 2008 Geneva, Switzerland (http://www.who.int/whosis/whostat/EN_WHS08_Full.pdf). 2 Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html). 4. Causes of maternal deaths 1997–2002 5. Total fertility A maternal death is defined as the death of a woman while pregnant The total fertility is the average number of children that would be born or within 42 days of termination of pregnancy from any cause related to a woman over her lifetime. The total fertility rate can be separated to the pregnancy or its management but not from accidental or into the births that were planned (wanted total fertility rate) and those incidental causes. The most frequent causes of maternal deaths in that were unintended (unwanted total fertility rate). In Panama, a survey Latin America and the Caribbean (for 1997–2002) were haemorrhage conducted in 2006 indicated a total fertility rate of 2.6 per woman. (uncontrolled bleeding), hypertensive disorders (high blood pressure) and obstructed labour. 6 Other causes 20.0% 5 Ectopic pregnancy 0% Haemorrhage 4 21.0% 3.0 2.7 2.6 3 Anaemia 0.1% 2 Obstructed labour 13.0% Hypertensive 1 disorders 26.0% fertility rate (per woman) Total 0 1990 2000 2006 Abortion 12.0% Year Latin America and the Caribbean Sepsis/infections including HIV/AIDS 8.0% Source: Khan KS et al. WHO analysis of causes of maternal death: a systematic review. Lancet, 2006, 367:1066–1074. Source: World Health Organization 2008, World Health Statistics 2008 Geneva, Switzerland (http://www.who.int/whosis/whostat/EN_WHS08_Full.pdf). Lead the fight for MDG 5 2 6. Annual live births 7. Neonatal mortality rate, 2004 Perinatal mortality refers to deaths of fetuses in the womb and of The total number of births (in thousands): 70 (2005) newborn babies early after delivery. It includes (1) the death of a fetus in the womb after 22 weeks of gestation and during childbirth and (2) the death of a live-born child within the first seven days of life. The perinatal mortality rate reflects the availability and quality of both maternal and newborn health care. Neonatal mortality refers to the number of newborn deaths during the first 28 completed days of life per 1000 live births in a given year or other period. In Panama, the neonatal mortality 80 70 rate in 2004 was 11 per 1000 pregnancies. 60 40 11 12 10 20 8 Total number of births (in thousands) Total 0 6 2005 4 Year 2 Deaths per 1000 live births 0 2004 Year Source: World population prospects: the 2006 revision. CD-ROM edition – extended dataset in Excel and ASCII formats. New York, United Nations Sources: Bureau of Statistics and Census, Office of the Comptroller of the Republic Department of Economic and Social Affairs, Population Division, 2007 (United Nations publications, ST/ESA/SER.A/266). World health statistics 2008. Geneva, World Health Organization, 2008 (http://www.who.int/whosis/whostat/EN_WHS08_Full.pdf). 8. Adolescent pregnancy rate by age for girls 9. Adolescent pregnancy rate by urban versus rural 15–19 years old location Adolescent pregnancy is pregnancy in an adolescent girl (girls 10–19 years old). The adolescent pregnancy rate indicates the proportion of adolescent girls who become pregnant among all girls in the same age group in a given year. In 2006, the adolescent pregnancy rate increased steadily with age, peaking at 29.5% at age 19 years. 35 29.5 30 Adolescent pregnancy rates tend to vary between urban and rural 24.8 parts within countries. The rates can vary for many reasons including 25 cultural norms, socioeconomic deprivation, education, access to sexual 19.8 20 health information and contraceptive services and supplies. There are no country-specific data on urban versus rural differences in adolescent 13.9 15 pregnancy for Panama. 10 7.9 pregnant with their first child % of women (15-19 years old) 5 0 15 16 17 18 19 Sources: Bureau of Statistics and Census, Office of the Comptroller of the Republic 10. Adolescent pregnancy by subregion Adolescent pregnancy rates also vary between different areas within countries. In 2006 in Panama the rate varied from 26% in Chiriquí to about 34% in Bocas del Toro. 4 0 . 0 34.1 32.9 3 5 . 0 32.0 28.7 29.8 3 0 . 0 26.5 26.0 26.1 26.0 26.1 26.1 2 5 . 0 2 0 . 0 1 5 . 0 1 0 . 0 5 . 0 0 . 0 % of pregnancy in adolescents Coclé Colón Darién Herréra Chiriquí Panama Veraguas Kuna Yala Los Santos Ngobe Bugle Bocas del toro Source: Bureau of Statistics and Census, Office of the Comptroller of the Republic Panama 3 Intervention coverage for mothers and newborns 11. Unmet need for family planning Unknown 13. Contraceptive use by urban versus rural location The unmet need for family planning is the proportion of all women who are at risk of pregnancy and who want to space or limit their childbearing but are not using contraceptives. 12. Family planning: modern contraceptive use by age group The prevalence of contraceptive use can vary between rural and urban areas within countries. There are no country-specific data on contraceptive use by urban versus rural location in Panama. Modern contraceptive methods include oral and injectable hormones, intrauterine devices, diaphragms, hormonal implants, female and male sterilization, spermicides and condoms. In 2006, 10% of currently married women used modern contraceptives. Source: Ministry of Health, Department of Health Analysis and Trends, Medical and Statistical Records Section. 14. Contraceptive use by subregion 15. Antenatal care Antenatal care visits include all visits made by the pregnant woman (15–49 years old) to a skilled health worker for reasons relating to pregnancy among all women who gave birth in a given time period. In 2006, about 85% of women in Panama attending public health facilities received antenatal care during pregnancy from a skilled health-care worker. 90 85.2 80 70 The prevalence of contraceptive use also tends to vary in different 60 subregions within countries. There are no country-specific data on 50 contraceptive use by subregion for Panama. 40 30 once for antenatal care 20 % of women who attended at least 10 0 2006 Year Source: Ministry of Health, Department of Health Analysis and Trends, Medical and Statistical Records Section 16. Utilization of skilled birth attendants A skilled birth attendant is an accredited health professional – such as 9 2 a midwife, doctor or nurse – who has been educated and trained to 9 1 proficiency in the skills needed to manage normal (uncomplicated) 9 0 pregnancies, childbirth and the immediate postnatal period, and in 8 9 the identification, management and referral of complications among 8 8 8 7 women and newborns. All women should have access to skilled care 8 6 during pregnancy and at delivery to ensure that complications are 8 5 skilled birth attendant detected and managed. In Panama, according to a survey conducted in % of births assisted by 8 4 2000–2006 , 91% of births are assisted by a skilled birth attendant.