While the past ten years have seen accelerated declines in child and maternal mortality, rates of decline are not sufficient to reach the United Nations (UN) Millennium Development Goals (MDGs). These shortfalls in decline are greatest where mortality is highest, making MDGs 4 (reduce child mortality) and 5 (reduce maternal mortality) the farthest from achieving their 2015 targets.
Children continue to die of causes such as pneumonia and diarrhoea – for which proven, low-cost interventions are available – and also bear a disproportionately high burden of malaria. In high-burden countries, HIV and malaria exacerbate high maternal mortality rates. High-impact and low-cost interventions proven to save the lives of mothers, newborns and children continue to remain at low to very low coverage levels in most priority countries. Yet, progress in MDGs 4 and 5 is inextricably linked to the extent of success in attaining MDG 6 (combat HIV, malaria and other diseases). Weaknesses in health systems constrain progress towards these Goals.
Global, high-level support for actions to improve maternal, newborn and child health (MNCH) has gained momentum, with the UN MDG summit of September 2010 culminating in pledges of more than US$ 40 billion over the next five years to address women’s and children’s health.
Investments by The Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) are already making a significant contribution to attaining MDGs 4 and 5, and have helped expand key services. The Global Fund Board – within its core mandate – encourages countries to strengthen the MNCH content of Global Fund-supported programmes and has requested the Secretariat to develop clear guidance for such programming.
This paper offers a guide to Global Fund-programme implementers to optimally utilise existing opportunities in Global Fund-supported country programmes to maximise MNCH outcomes. It examines each stage in the lifecycle and provides, as an annex, a menu of interventions within programmes for the three diseases to address ways in which these diseases affect MNCH outcomes, along with MNCH interventions that can be added on to disease-specific interventions of Global Fund-supported programmes. It also presents an array of linkages and actions from national health systems to community levels that, together, can effectively deliver the range of MNCH interventions within disease programmes, with particular attention to organisational “preparedness” of health systems, to enable integrated service delivery.