Slide 1

Improving Child Survival MATERNAL AND CHILD HEALTH INDABA July 16 th 2012 Dr Siobhan Crowley UNICEF South Africa Slide 2 Our major gaps to address QualityCoverageEquity Slide 3 Closing in on CARMMA targets known best buys IndicatorKey bottlenecksBest buys U5MRLimited preventionI nadequate coverage of RV/PCV Access to care for sick kids Poor diagnosis + access ped ART TB older kids Breastfeeding, improve infant feeding, Vit A ETAT, NBC,Case Mx SAM + HIV PCV+ RV (EPI) EID /PICT ART INH IMRPoor access + quality of Neonatal care No routine post natal KMC, Neonatal resucit Post natal care EPI Immunisation coverage @1YR % immunised against measles Supply poor forecasting planning and VM Demand limited promotion, no f/up baby in community/PHCCS Micro-planning /coordination Enhance leadership /management Community outreach of services IEC Life expectancy at birth M+F Composite of aboveFor SA - and paediatric ART/TB Access to quality CS services Supply- limited IMCI providers Demand poor care seeking/unsafe ETAT /NCP IMNCI SAM Slide 4 Closing quality gaps CLINICAL GOVERNANCE WHO: DISTRICT CLINICAL SPECIALISTS (+DMT) IMPROVE CLINICAL PERFORMANCE AND EVALUATION REDUCE + MANAGE CLINICAL RISK DEVELOP + MAINTAIN PROFESSIONAL STANDARDS INVOLVE AND ENGAGE PATIENTS Apply NCP ETAT IMCI Slide 5 Closing coverage gaps Demand Supply WHO: PHC outreach teams, PHC supervisors/facilitators WHO: DMT/PHC OP MANAGERS Promote knowledge of key family practices and care seeking Incentivize /reward health promoting activities Outreach and scheduled child health events Flexible responsive organization of services Consistent secure supplies Improve staff responsiveness Integration of services Slide 6 Closing equity gaps Addressing inequity Know who, how many and where these children are REDUCE COST BARRIERS Insurance/vouchers/subsidy REDUCE LOCAL ATTITUDE BARRIERS Conditional cash transfers Understand why they are excluded or missing services REDUCE LOCAL PHYSICAL BARRIERS e.g. transport voucher, GLOBALLY- FOR SCEDULABLE/NON ACUTE SERVICES PHC/OUTREACH IS BEST BUY TO REACH EXCLUDED RESOURCES ALLOCATED by population size, local resources + healthcare needs Slide 7 Other key ingredients Leadership and coordination ( why we are here!) Accountability (beyond clinical governance) Improving data quality + use within programming True integration - at point of service delivery and in planning Recognizing role of community + women Targeted communication on healthcare + health promotion messages