Photo: © UNICEF/NYHQ2005-0252/Giacomo Pirozzi © UNICEF/NYHQ2005-0252/Giacomo Photo: CHAPTER 3 MDG-4, MDG-5, MDG-6 CHILD MORTALITY, MATERNAL HEALTH AND COMBATING DISEASES MDG GOOD PRACTICES CHAPTER 3 MDG-4: CHILD MOrtaLITY MDG-5: MaterNAL HEALTH MDG-6: COMBatING DISeaSeS OBJECTIVE, SCOPE AND LIMITATIONS OF THE PUBLICATION This MDG good practice publication presents a list of various constraints and challenges to the achievement of the MDGs, which each good practice has addressed in a national and/or local context. The publication does not claim to be an exhaustive list of ‘best practices’ with self-claimed objectivity. Instead, it presents a diverse range of nationally-led programmes, policy interventions, and/or locally- tailored support to address those specific challenges. It is hoped that this publication will serve as a practical reference to context– specific approaches addressing these constraints. Photo: UNICEF/NYHQ2007-0119/Giacomo Pirozzi UNICEF/NYHQ2007-0119/Giacomo Photo: Photo: Photo: JUNE 2010 Foreword A decade has passed since world leaders adopted the Millennium Declaration at the General Assembly of the United Nations. Recognizing the urgent need to reduce poverty and address development challenges for long-lasting peace and security, time-bound development goals – coined as the Millennium Development Goals – were established with specific targets and indicators. At the 10th anniversary of the Millennium Summit, marked at the High Level Plenary Meeting on the MDGs in September 2010, world leaders and other stakeholders will be seeking concrete evidence of programmes and policies that have worked well and can be considered for adaptation and scaling up. The High Level Plenary Meeting will provide a unique opportunity to mobilize political will, re-energize the global MDG effort and agree on effective measures to accelerate and sustain progress. Much has been achieved during the past decade. In order to take stock of some of the country level evidence and experience, I am pleased to present the MDG Good Practices publication developed by the United Nations Development Group (UNDG). Good practices covered in this publication have sought to address specific constraints and challenges in achieving the Goals, in each country’s context. The publication provides evidence on different approaches to achieving the various MDGs and the importance of recognizing the synergies between these and the Internationally Agreed Development Goals. Some case studies may be familiar while others may serve as technical references for development practitioners. They demonstrate that, even under resource-constrained circumstances, there are innovative ways of overcoming obstacles to accelerate progress. It is our hope that this collection can serve as a practical tool for governments, non- governmental organizations, research institutes, the private sector and the UNDG agencies – and that it will contribute to evidence-based discussions in preparation for the High Level Plenary Meeting and in our collective efforts beyond. Richard Morgan Chair United Nations Development Group Task Force on the MDGs MDG GOOD PRACTiceS 3 Table of Contents Acronyms and Abbreviations 6 Acknowledgements 8 Introduction and Analysis of MDG 4, 5 & 6 Good Practice Cases 9 The Cases MDG 4: Reduce Child Mortality Inadequate Health Policy Framework Botswana: Accelerated Child Survival and Development Strategic Plan 23 Lack of Data for Health Sector Planning Malawi: RapidSMS 25 The Gambia: Integration of Birth Registration into Maternal and Child Health Clinics 27 Lack of Procurement Capacity Argentina: Strengthening the Health Management System of La Matanza Municipality 29 Insufficient Public Health Facilities and Skilled Providers Democratic Republic of Congo: Water, Sanitation and Hygiene (WASH) 31 Inadequate Interventions to Prevent, Diagnose and Treat Disease Global: Global Strategy on Measles 33 Togo: Campaign to Provide Vaccinations 35 Poor Utilization of Health Services West and Central Africa Region: Accelerated Child Survival and Development 37 MDG 5: Improve Maternal Health Inadequate Health Policy Framework Cambodia: Improving Local Service and Infrastructure Delivery for the MDGs 39 Ethiopia: Emergency Obstetric and Neonatal Care 41 Lack of Data for Health Sector Planning Rwanda: Analysing Maternal Deaths to Make Pregnancy Safer 43 Insufficient Public Health Facilities and Skilled Providers Ghana: The Millennium Villages Project in Bonsasso 45 Haiti: Nurse-Midwives Programme 47 India: Innovative Model of Public Private Partnership for Reduction of Maternal Mortality in Gujarat 49 Kenya: Community Post-Abortion Care 51 Poor Utilization of Health Services Cambodia: Fast Track Initiative for Achievement of MDG 5 53 Global: Global Campaign to End Fistula 55 Mongolia: Support to the 3rd National Reproductive Health Programme 2007 – 2011 57 Lack of Awareness, Advocacy and Public Knowledge Malawi: Campaign on Acceleration of Reduction of Maternal Mortality 59 Nepal: Reproductive Health for Married Adolescent Couples 61 Lack of Specialized Health Services for Targeted Groups Ethiopia: Berhane Hewan Programme (‘Light for Eve’) 63 4 MDG GOOD PRACTiceS Inadequate Interventions to Prevent, Diagnose and Treat Disease Romania: Comprehensive Sexual and Reproductive Health Programme 65 MDG 6: Combat HIV/AIDS, Malaria and Other Diseases Inadequate Health Policy Framework Kyrgyzstan: Formulation of Policy Framework to Respond to HIV and AIDS 67 Various (Global): Joint Technical Missions to Prevent Mother-to-Child Transmission 69 Insufficient Public Health Facilities and Skilled Providers Burundi: Strengthening Infrastructure and Capacity to Combat HIV and AIDS 71 Cambodia: Integration of Pediatric HIV Treatment and Care within the Continuum of Care 73 Inadequate Interventions to Prevent, Diagnose and Treat Disease Bangladesh: Safe Blood Transfusion 75 Indonesia: Integrating Malaria Treatment and Prevention into Maternal and Child Health Services 77 Kazakhstan: Scaling-Up and Improving the Quality of Prevention of Mother-to-Child Transmission 79 Sudan: National Malaria Prevention and Control Programme 81 Various (Global): Millennium Villages Malaria Prevention and Control 83 Viet Nam: Strengthening Care, Counseling and Support to People Living with HIV and AIDS 85 Thailand: Strengthening National Prevention and Care of HIV and AIDS 87 Poor Utilization of Health Services Rwanda: Community Health Insurance Scheme 89 Lack of Specialized Health Services for Targeted Groups Kyrgyzstan: Legal Empowerment of People Living with HIV 91 Nine East and South African Countries: Wellness Centres 93 Thailand: Public Health Workers and NGOs Partner to Provide Paediatric HIV Treatment, Care and Support 95 Lack of Awareness, Advocacy and Public Knowledge Botswana, Swaziland, Zambia and Zimbabwe: Gender, Post-literacy and HIV and AIDS 97 Global: The Network of Young TV Producers on HIV and AIDS 99 Arab States Region: HIV and AIDS Prevention through Education 101 Mongolia: Sexually Transmitted Illnesses (STI) and HIV Prevention among Vulnerable Groups in Ulaanbaatar 103 Mozambique: Strengthening the Impact of HIV and AIDS Prevention through Appropriate Socio-Cultural Approaches 105 Myanmar: Exploring Culturally Sensitive and Effective Communications for HIV and AIDS 107 Namibia: My Future is My Choice 109 Sudan: HIV Prevention and Care Programme 111 Weak Partnerships for Coordinated Health Responses Bhutan: Fighting Against the Spread of HIV through Multi-Sectoral Task Forces 113 Lao PDR: Multi-Sectoral Programme on HIV and AIDS 115 Rwanda: ‘Going for the Gold’ in Involving Men in the National Prevention of Mother-to-Child HIV Transmission 117 Global: Youth Peer Education Network, Y-PEER 119 Somalia: Mainstreaming Gender in the Coordination of the Somali AIDS Response 121 Limited Resources Available to Strengthen Health Systems The Philippines: Bolstering and Sustaining Proven and Innovative Malaria Control through Corporate-Public Partnership 123 MDG GOOD PRACTiceS 5 Acronyms and Abbreviations ACCESS- AIDS Access Foundation of Thailand GAVI- Global Alliance for Vaccines and Immunisations ACSD- Accelerated Child Survival and Development GBV- Gender Based Violence ACT- Artemisinin Combination Therapy GFATM- Global Fund to Fight AIDS, Tuberculosis and Malaria ADB- Asian Development Bank GHS- Ghana Health Service ADC- Area Development Committee GIPA- Greater Involvement of People living with HIV and AIDS AFC- Adolescent Future Centre GMAP- Global Malaria Action Plan AIDS- Acquired Immune Deficiency Syndrome GoSS- Government of Southern Sudan AMDD- Averting Maternal Death and Disability GTZ- Deutsche Gesellschaft für Technische Zusammenarbeit (Germany) ANC- Antenatal Care HiB- Haemophilus InfluenzaeT ype b ART- Anti-Retroviral Therapy HIV- Human Immunodeficiency Virus ARV- Antiretrovirals IATT- Interagency Task Team AU- African Union ICC- Interagency Coordinating Committee AusAID- Australian Agency for International Development IEC- Information, Education and Communication BDMR- Births, Deaths and Marriages Registration IMNCI- Integrated Management of Neonatal and CBO- Community Based Organization Childhood Illnesses CCC- Comprehensive and Continuous Care centers IPI- Intermittent Preventative Therapy CDC- Centers for Disease Control IRS- Indoor Residual Spraying CHEW- Community Health Extension Workers ISESCO- Islamic Educational, Scientific and Cultural Organization CHW- Community Health Worker ITN- Insecticide Treated Nets CIDA- Canadian International Development Agency JICA- Japan