Message of the WHO Regional Director Dr Luis Gomes Sambo on the occasion of World Health Day. 7 April 2005

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Theme: Make Every Mother and Every Child Count

Today, the world is celebrating HEALTH, which is, the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

The theme of this year's World Health Day is "Make every Mother and Child count". Health is a basic human right, but for many African women, newborns and children, this is not the case. This theme therefore is a message of hope for all mothers, newborns and children - a promise for a healthier and more productive future - if we truly make every mother, newborn and child count.

Five years into the 21st Century, African women risk death to give life as ONE in every 16 women dies while giving life. Every minute, one woman somewhere is dying of preventable pregnancy or childbirth-related conditions. Furthermore, for every maternal death, there are at least 20 to 30 women who suffer reproductive disabilities throughout life. Adolescent childbearing contributes significantly to maternal deaths and disabilities, accounting for almost half in some countries. The death of a mother not only jeopardizes the life of her children but also the well-being of the family and society.

Newborns hold every country's promise for a future, yet they are Africa's forgotten children. The death of a newborn is a common-yet preventable-tragedy in many parts of Africa. Every year, 4 million babies are stillborn globally, majority in the African Region. In our Region, 130 newborns die every hour of the day due to preventable causes. One in 6 young children die before they reach their fifth birthday, that is, 4.7 million child deaths per year.

How can we allow this silent emergency situation to continue, when the causes of the deaths and disabilities are largely avoidable?

Recently, the global community declared a commitment to "create an environment - at the national and global levels alike - which is conducive to development and to the elimination of poverty". This declaration led to an agreement on eight goals in key areas of global concern: the Millennium Development Goals (MDGs). Central among those goals are two that aim to reduce maternal and child mortality, goals 4 and 5. Investment in maternal, newborn and child health is not only a priority for saving lives, but is also critical to advancing other goals related to human welfare, equity, and poverty reduction.

At regional level, under the leadership of the African Union, the Road Map for accelerating the attainment of the MDGs relating to maternal and newborn health has been developed and adopted by the 46 Health Ministers. The World Health Organization and UNICEF have developed the Integrated Management of Childhood Illness (IMCI) - a proven child survival strategy for reducing child morbidity and mortality. Maternal, newborn and child health is a priority of the World Health Organization in its efforts to support Member States to provide Health-for-All their peoples.

From all indications, including the recent Millennium Project Report, Africa will once again miss the Millennium Development targets, unless we act now and stop doing business as usual! Today, there is no doubt that the technical knowledge and skills exist to respond to many, if not all, of the critical health problems that affect the health and survival of our mothers, newborns and children - even in poor-resource settings- as is the case in most African countries. Simple interventions like oral rehydration therapy have cut yearly diarrhoea deaths by half, while iodized salt, vitamin A supplements and breastfeeding have saved countless children from death or disability. The drive for child immunization has dramatically reduced measles deaths and eliminated neonatal tetanus in a number of African countries.

Maternal, newborn and child health can be improved without first achieving high levels of economic development. In fact, persistently high maternal, newborn and child mortality rates themselves constrain economic development because of the severe impact on the family and society in general.

Where do we go from here? 
We need a paradigm shift in the way we deliver services in our Region. Most societies support the view that everyone, and mothers, newborns and children in particular, should be able to get the health care they need, when they need it.

We must: 
REACH EVERY COUNTRY (REC) 
REACH EVERY DISTRICT (RED) and 
REACH EVERY WOMAN, NEWBORN, and CHILD (REW) 
with the proven interventions that will make a definite difference in their lives.

Today, as we launch the World Health Report 2005, I call upon all Member States to make every mother, newborn and child count by scaling up the proven interventions to reach every country, district, woman, newborn and child.

Ladies and gentlemen, how can we scale-up in the face of a weak and fragmented health system? A health workforce in crisis? A health financing system that excludes the most needy - the poor, the mothers, newborns and children? Dwindling investment in the health of mothers, newborns and children? Increasing poverty and pervasive conflicts?

Our antenatal clinics should be platforms for delivering quality prenatal services, tetanus vaccinations, family planning counseling and commodities, HIV/AIDS interventions including prevention of mother-to-child transmission, and prevention and treatment of sexually transmitted infections, tuberculosis and malaria initiatives.

Every pregnant woman, without exception, needs skilled care when giving birth to make childbirth optimally safe. Such care can at best be provided by a registered midwife or a health worker with midwifery skills operating in an enabling environment with appropriate policy and regulatory framework, adequate supplies, equipment, infrastructure and communication system. This can avert, contain or solve many of the life-threatening complications that arise during childbirth. All women need care that only a well-manned and equipped hospital can provide, should complications arise.

Postnatal care, often neglected, is not only crucial for the mother but also for her newborn. This continuum of care provided by a skilled health worker from pregnancy to newborn period, and from community to referral level, is critical to survival.

The Integrated Management of Childhood Illness if up-scaled, will ensure the delivery of child health care close to homes and communities, and improvement in referral system and hospital care. The challenge now is to take IMCI to all families with children, and to ensure access whenever such care is needed. Universal access to childhood immunization must be guaranteed for a healthy start in life for all children.

The scaling-up to REACH EVERY WOMAN, NEWBORN and CHILD requires effective partnership. This can be achieved as governments, households, communities, civil society, private sector, and development partners join forces to strengthen health systems with maternal, newborn and child health at the core of their development strategies.

Our health workforce must be trained, motivated, retained and appropriately deployed to serve the most needy.

Every Member State should develop a long-term health care financing scheme that facilitates universal coverage, with affordable services and financial protection for mothers, newborns and children. User fees need to be reviewed or eliminated to ensure access to mothers, newborns and children such that not one of them is denied care due to inability to pay.

No Government can provide all the investment required for health. Therefore, community-financing schemes that allow individuals, families and households to contribute to improved access to health care by mothers, newborns and children should be encouraged.

In the longer term, education of the girl-child is a prerequisite for an empowered population and a healthy womanhood.

I call upon Member States to become investors in health, and especially the health of the mothers, newborns and children of this Region. The returns will be worth the investments. It has been estimated that over the next 10 years, if we would scale-up to achieve universal coverage for maternal health alone, we will save at least 500,000 women's lives, avert 10 million disabilities, and save 1.5 million children's lives. Translated into productivity gains, this will mean at least US$10 billion.

The time to act is now! We must deliver on our promises to our mothers, newborns and children so that together we can achieve a more productive and sustainable development in Africa.