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Towards achieving Millennium Development
Goals
WHO initiatives in Material and Child
Health
While
better health is central to the achievement of all Millennium Development
Goals (MDGs), 3 out of 8 goals, 8 of the 18 targets
and 18 of the 48 indicators are directly related to health. Of the 18
quantitative health indicators for monitoring progress, 17 are monitored by
WHO in collaboration with UNICEF, UNAIDS and UNFPA. The WHO India office has
undertaken, through its core clusters, various initiatives aimed at
supporting the achievement of MDGs.
Challenges and Initiatives in Maternal
& Child Health
The
fourth MDG calls for reducing child mortality. Progress is assessed against
the target of reducing by two-thirds, between 1990 and 2015, the under-five
mortality rate. Child mortality in India has been declining gradually but
with 27 million births and 2.2 million under-5 child deaths each year, India
continues to face an enormous child health challenge. A related fifth goal is improving maternal
health wherein progress is assessed against the target of reducing by
three-quarters, between 1990 and 2015, the maternal mortality ratio.
WHO
is providing technical support to the Ministry of Health & Family
Welfare, in implementing several programmes and
schemes to address issues of high infant, child and maternal mortality. Support
is provided in the following key initiatives:
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Initiative
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Nature of technical assistance
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Child Health
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Integrated Management
of Newborn and Childhood Illness (IMNCI)
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Adaptation of Integrated Management of Childhood
Illnesses (IMCI) strategy to include the care of children from 0-7 days
Pilot testing of the material developed
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Development of National Operational Plan for initiating
IMNCI
Pre-service IMNCI teaching at undergraduate medical
education level through development of material & its piloting and
subsequent evaluation in 4 medical colleges.
Training for private practitioners in partnership with
UNICEF and IAP
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Training of trainers of Post Graduate Diploma in
Maternal & Child Health course in IMNCI
Orientation of senior faculty members of medical
colleges in collaboration with Indian Academy of Paediatrics,
UNICEF & Indira Gandhi National Open
University.
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Streamlining of micronutrient
supplementation policy
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Streamlining of Iron, Vitamin A and Zinc supplementation
guidelines as per IMNCI guidelines in collaboration with GOI, ICMR and
expert groups.
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District Newborn Care
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Training of 140 district teams in partnership with GOI and
Neonatology Forum and supply of essential newborn care equipments.
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Low osmolarity ORS & Zinc as an adjunct to ORS
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Launch of low osmolarity ORS
Supply of dispersible Zinc tablets to all public health
treatment centres, in collaboration with GOI
& Department of Biotechnology
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Improving
immunization coverage and safety
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Training & planning to improve access to
immunization services
Advocacy for Safe Injection Practices including safe
disposal of immunization waste and Patient Safety
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Building the capacity
of the National Regulatory Authority (NRA)
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The assessment, review & support for capacity
building of the NRA
Strengthening GMP standards & inspections and AEFI
Surveillance
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New vaccine
introduction & strengthening indigenous vaccine
development
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Advocacy and promoting the introduction of essential new
vaccines in UIP
Capacity building for clinical trials in collaboration
with ICMR & NRA (strengthening
GCP, GLP and Ethical practices, Schedule Y)
Strengthening capacities of public & private vaccine
producers
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Strengthening Measles
Control activities
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Capacity building in surveillance for measles, outbreak
control and response
Improving measles vaccine coverage and supplementary
immunization activities.
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Neonatal Tetanus
Elimination
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Validation of MNT elimination in a phased manner
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Control of Japanese
Encephalitis (JE)
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Strategy & guidelines for vaccine introduction
Monitoring of vaccine effectiveness, safety and JE
surveillance
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Maternal Health
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Advocacy & Policy
Development
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Lead development partner to support development of
technical guidelines especially on skilled attendance at birth &
Emergency Obstetrics Care. Other partners included, UNFPA and White Ribbon
Alliance of India.
Expansion of safe abortion services at PHC and its
multi-site demonstration of use of safe techniques for abortion at Primary
Health Centres.
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Technical &
operational guidelines
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Development of several guidelines in collaboration with
other partners (GOI, UNFPA, UNICEF and WRAI); their dissemination to States
and assistance in developing implementation plans of maternal health
interventions.
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Training &
reading material
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Review & development of training and reading
material for ASHA in partnership with UNFPA
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Review & revision
of curriculum
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Review of undergraduate curriculum for medical and
nursing education for ANMs, general nursing and
midwifery courses.
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Adolescent Sexual
& Reproductive Health
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Design, development of training strategy, operational
guide for implementation of Adolescent Sexual & Reproductive Health
Strategy, state planning & dissemination.
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In
summary, efforts are underway towards achieving the MDGs.
However, issues of inequality in health status and access to quality services
are critical to ensure their achievement. Improvements in health outcomes
need to be accompanied by improvements in health care delivery systems.
Progress will also depend on availability and effective utilization of
resources and adaptation of an inter and cross sectoral approach.
The WHO is committed to working towards the achievement of MDGs along with the government, non governmental
organizations, civil society and the private sector.
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