World Family Summit6-9 Dec. 2004

“Family and Child Health, Youth and Elderly”

H.E. Senator Dr. Rowaida Al Maaitah

Upper Parliament - Jordan

Goal 4: Reduce child mortality

Target 5: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

Goal 4: cutting under-five mortality by two-thirds

Technical interventions Technical interventions must focus on malnutrition, must focus on malnutrition,

infectious and parasitic infectious and parasitic diseases and immunizations, diseases and immunizations,

delivered through a strengtheneddelivered through a strengthened basic health care system.basic health care system.

addressing the main causesaddressing the main causes of child mortality is essentialof child mortality is essential

Reducing child mortality

The highest-priority countriesThe highest-priority countries are in Sub-Saharan Africa andare in Sub-Saharan Africa and

South AsiaSouth Asia

South Asia is making progressSouth Asia is making progress , ,with child mortality falling fromwith child mortality falling from

12.6%12.6% to around 10.0%to around 10.0% during the 1990'sduring the 1990's

In Sub-Saharan Africa 17% ofIn Sub-Saharan Africa 17% of children do not reach age fivechildren do not reach age five

Every day more than 30,000Every day more than 30,000of the world's children die fromof the world's children die from

preventable causes-dehydrationpreventable causes-dehydration,, hunger, diseasehunger, disease

In Sierra Leone, an urgent In Sierra Leone, an urgent priority country, 18% of children priority country, 18% of children

will not see their first birthday.will not see their first birthday.

Number of under-5 deaths, 2000

(millions)

Sub-Saharan Africa 4.5

South Asia 3.6

East Asia and the Pacific 1.4

Arab States 0.6

Latin America and the Caribbean 0.4

Central and Eastern Europe and the CIS 0.2

South Asia

34%

Sub- Saharan Africa

42%

Central & Eastern Europe & the CIS 2%

Latin America & the Caribbean 4%

Arab States 6%

13% East Asia & the Pacific

Regional distribution of under-5 deaths

Global total – 10.8 million in

2000

survival : Progress and setbacks

HDI rank Life expectancy at birth(years)

IMR(per 1,000 live births)

<5 MR(per 1,000 live births)

Probability at birth of surviving to age 65

1970-1975 2000-2005 1970 2001 1970 2001 Female%of cohort

2000-2005

Male%of cohort

2000-2005

High – income OECD

71.5 -- 22 5 28 7 89.5 80.9

High human Development

70.2 -- 32 9 42 11 88.3 78.8

Medium human development

56.9 67.4 102 45 155 61 74.4 65.3

Low human development

43.5 -- 139 104 226 162 41.7 39.1

High income 71.5 -- 22 5 28 7 89.5 80.9

Middle income 62.3 70.7 86 31 122 38 79.5 68.6

Low income 48.7 59.6 127 80 203 119 59.6 54.2

World 58.4 66.6 96 56 147 81 72.9 64.4

Reducing child mortality

Every year more than 500,000Every year more than 500,000 women die in pregnancy andwomen die in pregnancy and

childbirth-one every minute of the daychildbirth-one every minute of the day

The HIV/AIDS has killed the motherThe HIV/AIDS has killed the mother or both parents of 13 million childrenor both parents of 13 million children..

Malnutrition

Low birth-weight Malnutrition

Monitor mother's health before and during pregnancy

Exclusively breastfeeding

infants

Expanding access to reproductive health care and ensuring adequate nutrition greatly enhance the health of mothers and their children.

micronutrient (vitamin A, iron, zinc and iodine) deficiency

supplementation (such as iodization of salt)

two high-dose vitamin A capsules a year

mass vaccination campaigns. In 1999 such methods enabled the least developed countries to achieve 80% supplementation coverage.

Nutrition

% ofhouseholdsconsumingiodized salt

1997-2002

Vitamin ASupplem. coverage

rate (6-59

months)2001

% Of under-fives (1995-2002)suffering from: % of children (1995-2002) who are:

%of infantswith LBW1998-2002

Stunting Wasting Underweight Stillbreastfeeding

(20-23 months)

Breastfed withcomplementary

food(6-9 months)

exclusively breastfed

(<6 months)

Moderate & severe

Moderate &

severe

sever moderate & severe

Sub-Saharan Africa 66 75 38 9 8 29 50 65 28 14

Middle East and North Africa

51 - 22 6 4 14   25 59 37 15

South Asia 49 46 44 15 17 46 67 46 36 30

East Asia pacific 82 - 20 - - 17   - - 54 8

Latin America and Caribbean

84 - 16 2 1 8 25 48 38 10

CEE/CIS and Baltic States

39 - 16 4 1 7   23 41 14 9

Industrialized countries

- - - - - - - - - 7

Developing countries 66 59 32 10 10 27   51 55 39 17

Least developed countries

52 78 43 11 10 36 63 66 35 18

World 66 59 31 10 10 27   51 55 39 16

Infectious and parasitic diseases

diarrhea

under-five deaths from diarrhea fell in

the 1990s, the disease continues to

be a challenge

every year malaria kills more than 400,000 children-making it another priority in many

countries

FamilyRole

In the worst-affected areas under-five mortality from HIV/AIDS is expected to

more than double by 2010

Infectious and parasitic diseases

account for nearly 20% of child deaths in developing countries, yet most are easily

preventable

Solid accessible health system in underserved areas

Data from 42 countries show that only half of children with such infections are

taken to health care providers.

Immunizations

After increasing for many years, immunizations in South Asia have stagnated at their 1990 level- and in Sub-Saharan Africa

they have dropped

mass public education campaigns and better routine immunization and surveillance.

Commitment to health: access, services and resources

Pop.with

access toimprovessanitation

(%)2000

Pop.with

sustainableaccess to an

improveswater

source(%)

2000

One-year-oldfully immunized

Birthsattended by

skilledhealth

personnel(%)

1995-2001HDI rank

Againsttuberculosis

(%)2001

Againstmeasles

(%)2001

Developing countries 51 78 78 69 56

Least developed countries 44 62 77 63 31

High human development .. .. .. 91 96

Medium human development 51 82 80 74 64

Low human development 51 62 73 57 31

High income .. .. .. 89 99

Middle income 60 82 85 86 84

Low income 44 76 75 60 40

World 61 82 79 72 60

HIV/AIDS.

Children (0- 14) living with HIV/AIDS = 3000000

One of the most crippling plagues in modern history, AIDS has struck every country, devastating many in Sub-Saharan Africa.

Leading global health crises and challenges

Under-nourished

peopleas %

of totalpop.

1998/2000

People living with HIV/AIDS

TB

casesper

100,000people2001HDI rank

Adults(% age15-49)2001

Women(age 15-49)

2001

Children(age 0-14)

2001

High income .. 0.30 330,000 16,000 9

Middle income 10 0.60 4,200,000 390,000 85

Low income 25 2.10 14,000,000 2,500,000 197

World .. 1.20 18,500,000 3,000,000 119

Many of these deaths are readily preventable

At current rates the region will not achieve the Goal for child mortality for almost

150 years.

•Eighty-seven percent of young people 15-24 live in the developing world.

• People under age 15 constitute 31 percent of the population in developing

countries.

• 43 percent in the least developed.

• In 2002, adolescents and young people between 10 and 24 were 29

percent in the least developed, compared to 20 percent in developed

countries.

Health of the Adolescents and young people

Demographic trends

Total Pop.(millions)

__________________________

AnnualPop.

Growth rate

Urban population(as % of total)

Pop.<15

(as % of total)

Pop. >65 ( as % of

total)

Total fertility rate / woman_______________

HDI rank 1975 2001b 2015b 1975-2001 2001-15b 1975 2001b

2015b

2001b

2015b

2001b

2015b

1970-75b 2000-05b

High income

782.0 T 935.9 T 997.7 T 0.7 0.5 73.8 79.4 82.6 18.5 16.6 14.4 17.7 2.2 1.7

Middle income

1.847.5 T 2.694.8 T 3.027.9 T 1.5 0.8 35.0 51.6 60.7 27.1 22.5 6.8 8.5 4.6 2.1

Low income

1.437.1 T 2.515.0 T 3.169.0 T 2.2 1.7 22.1 31.5 38.1 36.9 32.5 4.4 5.1 5.7 3.7

World 4.068.1 Te

6.148.1 Te

7.197.2 Te

1.6 1.1 37.9 47.7 53.7 29.8 26.1 7.0 8.3 4.5 2.7

• Women and girls under 20 still account for 17 percent of all births in the least-developed countries and for 14 million births worldwide each year.

• Women give birth before age 20 range from 8 percent in East Asia to 55 percent in West Africa.

• Pregnancy is a leading cause of death for those aged 15 to 19 account for at least one fourth of the estimated 20 million unsafe abortions and nearly 70.000 abortion-related deaths each year.

• For both physiological and social reasons, mothers aged 15 to 19 are twice as likely to die in childbirth as women in their 20s.

• Every 14 seconds, a young person is infected with HIV/AIDS.

• Two thirds of newly infected young people in sub-Saharan Africa are females.

• One third of new cases of curable STIs each year- more than 100 million-

are among women and men younger than 25.

• 82 Million girls in developing countries who are now between ages 10

and 17 will be married before their 18th birthday.

• More educational efforts to promote responsible attitudes and healthier

sexual behavior.

• Need for Youth-friendly reproductive health services.

• Need for Training and life skills education.

• The rights of women and girls.

MEETING YOUNG PEOPLE’s NEEDS

• Promoting Health Behaviour

• Participation and Partnership

Youth participation needs to be institutionalization in programme and

policy development processes

Youth must be empowered

• Global aging is going to present unprecedented challenges for the 21St

century. By 2050, for the first time, the number of older people in the

world will exceed the population of children.

Main causes:

Drastically falling fertility rates combined with advances in nutrition

and healthcare.

• According to the 2002 Second world assembly on aging, one million

people worldwide cross the 60 year age mark every month.

Health of the Elderly

• The world has experienced a gradual demographic transition from

patterns of high fertility and mortality rates to low fertility and delayed

mortality.

Lower childhood mortality contributes initially to a longer life expectancy

and a younger population.

Declines in fertility rates generally follow, and improvements in adult

health lead to an older population.

As a result of demographic transitions, the shape of the global age

distribution is changing.

Demographic Transition

• By 1990, the age distribution in developed countries represented similar

proportions of younger and older persons.

• For developing countries, age distribution is projected to have similar

proportions by 2030.

Demographic Transition

• Chronic disease and degenerative illness.

• Cardiovascular diseases.

• Respiratory diseases and injuries

• Infectious and parasitic diseases.

• Respiratory infections

• Parental conditions.

• Cardiovascular diseases.

• Cancer.

• Injuries.

• Mental Problems

Epidemiologic Transition

• Approximately 80% of all persons aged> 65 years have at least one chronic condition, and 50% have at least two.

• Diabetes affects approximately one in five (18.7%)persons aged> 65 years

• Alzheimer’s disease, which doubles every 5 years after age 65, also is expected to increase.

• Approximately 10% of adults aged >65 years and 47% of adults aged>85 years suffer from this degenerative and debilitating disease.

• Chronic conditions also can lead to severe disability

Epidemiologic Transition

• Health – care spending

• The demands associated with long-term care might pose the greatest

challenge for both personal / Family resources and public resources.

Impact on Medical and Social Services

• Public health concerns:

• Public health agencies and community organizations should

continue expanding their traditional scope from infectious diseases and

maternal/child health to include health promotion in older adults.

• Prevention of disability.

• Maintenance of capacity in those with frailties and disabilities.

• Enhancement of quality of life

• Develop and support better methods and systems to monitor additional

health outcomes that related to order adults, such as functioning and quality of life

Preface

The National Council for Family Affairs

was founded by a Royal Decree Chaired by Her Majesty Queen Rania Al-

Abdullah gained its official capacity under law no.

( 27) of year2001

GOAL

Contribute to ensuring

a better quality of life for

Jordanian families

OBJECTIVES, ROLES, and APPROACHES

POLICY THINK TANK

PARTNERSHIP

PROACTIVE ADVISORY BODY

research

advocacy

outreach

monitoring

coordination

facilitation

INTEGRITY, STABILITY, SELF-SUFFICIENCY

LEGISLATIVE, SOCIAL, ECONOMIC, AND

CULTURAL ENVIRONMENT

GLOBAL AND REGIONAL

INTERACTION

ROLES APPROACHES OBJECTIVES

ROLES AND APPROACHES

POLICYTHINK TANK

POLICY ADVISORY

BODY

PARTNERSHIP

research

advocacy

outreach

monitoring

coordination

facilitation

APPROACHES ROLES

FAMILYINDIVIDUAL

S

HOUSING, INFRASTRUCTURE AND ENVIRONMENT

EDUCATION

HEALTH

ECONOMIC SITUATION

EMPLOYMENT

SOCIAL NETWORK

CULTURAL LIFE AND

RECREATION

PUBLIC LIFE

SERVICE AND RESOURCE DOMAINS

NATIONAL STRATEGY for FAMILY

Housing, Infrastructure, and Environment Education Health

Economic Situation Employment

Social Network

Cultural Life and Recreation

Public Life

Family

Early Lifeprebirth - 8

Adolescence9 - 18 years

Early Adult19 - 24 years

Adult25 - 44 years

Mature Adult45 - 59 years

Senior60 yearson

Issues Problems Priorities

LIFE CYCLES

STRATEGIC PRIORITIES for FAMILY

Housing etc Education Health Economic Situation Employment

Family

Early Life

Adolescence

Early Adult

Adult

Mature Adult

Senior

DOMAINS

…..

CRITERIA forPRIORITIZATION

FAMILY PROTECTION

EQUITY

FAMILY and INDIVIDUAL INVOLVEMENT

- internal- external

- gender- geographic location- special needs

CommunityNeighborhood associationsInstitutional programmes

Informalgroups

Culturalgroups

Teaching plans

Rights councils

Media

Student associations

School councils

School

Public policy decisions

Society

Forums

Elections

Family

(Family competencies)

Child participation

Multi-sectoral (multi-discipline) approach.High level of inter-agency cooperation.

health

EducationIncome

Decisions and actions that are responsive to policy / program needs

LINK

Identify priority issues, research &

Interventions

Research that is relevant to

program/community needs

Process for Strategy Development & Implementation

Research

Develop Strategy

/Action Plan

Identify priority Interventions

Monitor and Evaluate

Identify a Problem

Implement

Key Points for Success

• Interdisciplinary

• Politicians

• NGOs

• Academia Service• Councils