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Pan American Health Organization Pan American Sanitary Bureau Regional Office for the Americas of the World Health Organization Family and Community Health Child and Adolescent Health. Strengthening the Catholic Health Care Network in the Americas - using the Integrated Management of - PowerPoint PPT PresentationTRANSCRIPT
Organización Panamericana de la Salud
Pan American Health OrganizationPan American Sanitary Bureau
Regional Office for the Americas of the World Health Organization
Family and Community HealthChild and Adolescent Health
Organización Panamericana de la Salud
Strengthening the Catholic Health Care Network in the Americas -
using the Integrated Management of Childhood Illness (IMCI) Strategy
Bristol-Myers Squibb Foundation Catholic Medical
Mission Board9 September 2003
New York
Organización Panamericana de la Salud
Contents
PAHO Organization
Child health situation in the Americas
Integrated Management of Childhood Illness (IMCI) strategy
Evidence to save children’s lives
CMMB/PAHO Project: Action for Family Health
Future perspectives and partnership
Organización Panamericana de la Salud
Pan American Health Organization
Mission statementThe oldest international health agency in the world.
To lead strategic collaborative efforts amongMember States and other partners to promote equity
in health, to combat disease, and to improve thequality of live of the people in the Americas.
Organización Panamericana de la Salud
Child health situation in the Americas
Thousands of children continue to die from diseases that could be prevented or treated
Two-thirds of child deaths could be prevented by using interventions that are available today and are feasible for implementation in low-income countries
Improving children’s health is a priority. Requires:Promoting healthy conditionsPreventing and treating children’s diseases
Organización Panamericana de la Salud
Child health situation in the Americas
Poor access to health services and trained personnel • 30% of population without access to
health services
• Clinical evaluation inadequate
• Excessive use of antibiotics
Low coverage of activities for PMTCT of HIV/AIDS
40% of population without access to essential
drugs
Organización Panamericana de la Salud
Tackles the major killers of children through prevention and treatment by improving skills of health staff, health systems and family and
community practices.
Organización Panamericana de la Salud
IMCI strategy
IMCI was developed by WHO and UNICEF
Focuses on the child and not on the illness
Is considered the most cost-effective strategy
Facilitates: An integrated approach for early detection
and treatment of childhood illness Prevention of illness (key family practices) Health promotion and follow-up
Organización Panamericana de la Salud
Main causes of more than 500,000 annual deaths in children under five years of age in the Region of the
Americas
Pneumonia9.0%
Diarrhea7.8%
Other infectious Diseases3.9%
Malnutrition3.1%
Other ARI1.5%
Meningitis1.1%
Anemia0.5%
Peri-Neonatal38.0%
Other (accidents, congenital, etc.)35.0%
Malnutrition is also associated with the majority of deaths from infectious diseases,
diarrhea and pneumonia
Organización Panamericana de la Salud
DiagnosisTreatmentPreventionPromotion
Lost opportunities
Early detection
Effective treatment
Educational activities
What is IMCI?What is IMCI?Integrated
Management
Health Services Family/community
Organización Panamericana de la Salud
COMPONENTS OF THE IMCI STRATEGYCOMPONENTS OF THE IMCI STRATEGY
•Planning•Health Policy•Interagency Coordination•Mobilization of Resources
Improving Health Worker Skills
Improving the Health System to Deliver IMCI
Improving Family and Community
Practices• Clinical case
management training
• Pre-service training
• Pediatric societies• Follow-up after
training• Neonatal health
•Essential drug supplies•Health services
organization• Information systems
•Training courses•Growth and child
development•Key family
practices•Social
communication•Community
networks
•Operational research•Monitoring•Evaluation•Impact
Organización Panamericana de la Salud
Between 1996-2002, 17 countries adopted IMCI
Current progress
4
1996
BoliviaRepúblicaDominican
aEcuador
Perú
9
1997
ArgentinaBrasil
El SalvadorHondurasNicaragua
12
1998
HaitíParaguayVenezuel
a
13
1999
Colombia
16
2000
Guatemala
GuyanaUruguay
17Panamá
2002
Number of countries
Organización Panamericana de la Salud
Evidence to save children’s lives
Malnutrition is associated with more than 25% of all child deaths
Child mortality could be reduced by more than 20% by intake of vitamin A
Antiretroviral drugs when administered properly could reduce the rate of mother-to-child transmission by as much as 50%
Timely and appropriate care seeking could reduce mortality causes by ARI by more than 20%
Correct home care for diarrhea could save thousands of child deaths cause by acute diarrhea
Organización Panamericana de la Salud
0
50
28
958893
0
20
40
60
80
100
Comprehensiveassessment
Nutritionalevaluation
Review ofvaccination status
Before (1997; 58 sick children) After (1999; 80 sick children)
Quality of care improves
with introduction of IMCI
Evaluations, pre-and post-IMCI health facility surveys in Bolivia
Proportion of children receiving:
Organización Panamericana de la Salud
127
70
49
0
20
40
60
80
100
How to give oral medicines At least two danger signs
Before (1997) After (1999)
…and mothers leave the facility better able to care for their child
Proportion of mothers leaving health facility who reported correctly:
Evaluations, pre-and post-IMCI health facility surveys in Bolivia
Organización Panamericana de la Salud
54.8%
23.8%
35.0%
3.7%
Reduction in the number of deaths from causes targeted by IMCI (1.6 times less)
Reduction in the percentage of deaths from causes targeted by IMCI (6.4 times less)
Proportional Reduction 1996-2000
IMCI No IMCI
Reductions in Mortality from Causes Targeted by IMCI Strategy in Departments in Peru with and without IMCI Implementation, from 1996 to 2000
Source: Regional IMCI Data Base. CA/FCH, PAHO/WHO, 2003.
Organización Panamericana de la Salud
Trends in mortality from all causes, diarrheal diseases and acute respiratory infections in children under five years of age in 18 countries of the Americas, from 1975 to 2000. Rates per 100,000 and proportional reduction per five-year
period from 1975 to 2000
Source: FCH/CA - AIS. PAHO/WHO, 2003.
Rates per 100.000 population (lines)
1975 1980 1985 1990 1995 2000 1975 1980 1985 1990 1995 2000 1975 1980 1985 1990 1995 2000
2
20
200
2000
0
20
40
60
80
100
Proportional Reduction (bars)
All Causes Diarrhea ARI
SCM Diarrhea
IMCI
SCM ARI
IMCI
Organización Panamericana de la Salud
Comparison of mortality from diseases targeted by IMCI in some countries of the Americas
• 10% of children less than 5 years of the Americas
• 40% of deaths from diseases targeted by IMCI
• 30% of children less than 5 years of the Americas
• 1.4% of deaths from diseases targeted by IMCI
154.1
152.8
132.4
46.7
37.0
CHILE
TRINIDAD Y TOBAGO
COSTA RICA
ESTADOS UNIDOS
CANADA
9065.3
3141.7
2683.2
2301.3
1718.6
HAITI
BOLIVIA
GUATEMALA
ECUADOR
PARAGUAY
Mortality rates per 100,000 live births (2000)
Organización Panamericana de la Salud
• 3 years
• CountriesDominican
RepublicEl SalvadorHaitíHondurasNicaragua
Action for Family Health2003-2005
CMMB/PAHO
Action for Family Health2003-2005
CMMB/PAHO
Organización Panamericana de la Salud
Scale-up the capacity of the Catholic health care network to increase coverage and access to:
Three components of the IMCI strategy:
• Training skills
• Health systems
• Community and family
Activities for the prevention of mother-to-child transmission of HIV/AIDS
Provide essential medicines
Project Description Project Description
Organización Panamericana de la Salud
Catholic Medical Mission Board
Catholic health care network (Pastoral, Caritas, universities)
Ministries of Health
• National IMCI Program
• National Essential Medicine Programs
• National HIV/AIDS Program
Pan American Health Organization
- Family and Community Health Area
- HIV/AIDS Unit
- Essential Drug and Technology Unit
Participating InstitutionsParticipating Institutions
Organización Panamericana de la Salud
WHO/UNICEFKey family practices
Core set of practices that contribute to a child’s survival and healthy growth at the
community levelPromote physical growth and mental developmentPrevent diseaseFacilitate appropriate home careFacilitate care seeking behaviors
Organización Panamericana de la Salud
Strengthening collaboration between the health sector and the community
CHW
++++++++
Family
Health services
Family and community
Other sectorsEffective health
system
CMMBCMMB
Catholic church Catholic church
Universities
NGOs
Caritas
Organización Panamericana de la Salud
Project Advances
Country Catholic health-care network assessments completed
Country planning visits accomplished
Country coordinating teams formed
National agreements being prepared
Development of country projects underway
Organización Panamericana de la Salud
OCEANO PACIFICO
Diócesis 8Diócesis 8
Comunidades 298Comunidades 298
ClínicasClínicas
Parroquias 346Parroquias 346
UU Campus Universitario 4Campus Universitario 4
UU
UU
UU
UU
A
Organización Panamericana de la Salud
Monitoring and evaluation
Standardized definitions of indicators
Reporting done on a routine basis to track country performance
Health facility reviews and community survey tools
Use of information/feedback
Organización Panamericana de la Salud
Value-added partnershipCMMB/PAHO
Bottom-up approach
CMMB comparative advantage lies in its ability to leverage the vast network of faith-based organizations
PAHO technical support and country network
Potential to scale-up local resources to address public health problems
Organización Panamericana de la Salud
Future perspectives
Increase access to quality health care delivery in high-risk areas, build local capacity and sustain actions
Mobilize financial resources for country and regional expansion
Establish a unique partnership which makes meaningful change and improvement in people’s lives
SAVE …children’s lives !!!
Organización Panamericana de la Salud
Millennium development goals The Project will implement activities to support
and endorse the Millennium Development Goal of:
• Reducing under-5 mortality by two thirds by 2015.
• Have halted by 2015 and begun to reverse the spread of HIV/AIDS
• In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
These child survival goals can be achieved, but only if strategies for delivery
interventions are greatly improved and scaled-up.
Organización Panamericana de la Salud
Lancet Child Survival Series
The first four articles provided a technical basis for a new approach to child health, moving from epidemiology of child deaths to saving lives using currently available interventions
The fifth paper addressed what should be done in terms of leadership, health systems, resources, and public awareness
Lead to debate and action to sustain momentum in child health
Organización Panamericana de la Salud
Pan American Health Organization Regional Office for the Americas for the
World Health Organization
Celebrating 100 Years of Health