Limits...
Sexual and reproductive health: progress and outstanding needs.

Snow RC, Laski L, Mutumba M - Glob Public Health (2015)

Bottom Line: Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile.While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning.Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor.

View Article: PubMed Central - PubMed

Affiliation: a School of Public Health , University of Michigan , Ann Arbor , MI , USA.

ABSTRACT
We examine progress towards the 1994 International Conference on Population and Development (ICPD) commitment to provide universal access to sexual and reproductive health (SRH) services by 2014, with an emphasis on changes for those living in poor and emerging economies. Accomplishments include a 45% decline in the maternal mortality ratio (MMR) between 1990 and 2013; 11.5% decline in global unmet need for modern contraception; ~21% increase in skilled birth attendance; and declines in both the case fatality rate and rate of abortion. Yet aggregate gains mask stark inequalities, with low coverage of services for the poorest women. Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile. While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning. Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor.

Show MeSH

Related in: MedlinePlus

Proportion of women in select Asian countries with access to management of post-partum haemorrhage in 2005, with specific focus on urban versus rural access.Source: UN-ECOSOC (2014b); Analysis based on data from the Maternal and Neonatal Program Effort Index (MNPI): http://www.policyproject.com/pubs/mnpi/getmnpi.cfm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4318113&req=5

f0003: Proportion of women in select Asian countries with access to management of post-partum haemorrhage in 2005, with specific focus on urban versus rural access.Source: UN-ECOSOC (2014b); Analysis based on data from the Maternal and Neonatal Program Effort Index (MNPI): http://www.policyproject.com/pubs/mnpi/getmnpi.cfm.

Mentions: A majority of facilities that offer maternity care still fail to provide all functions required for classification as an EmONC facility (basic or comprehensive), and geographic and financial barriers persist (Gabrysch et al., 2012). Management of basic obstetric and neonatal emergencies includes the administration of oxytocics, antibiotics, anticonvulsants, manual extraction of the placenta, removal of retained products and neonatal resuscitation, while management of comprehensive EmONC includes capacity to perform C-section surgery in cases of obstructed labour, and blood transfusions. The rural versus urban differential in key components of EmONC (e.g. management of PPH) (Figure 3), reflect the continuing challenges of delivering services to women with structural obstacles to care (e.g. few or no transport options and poor or seasonal roads) (Gabrysch et al., 2012). The recommended minimum density of basic and comprehensive EmONC facilities differs depending on the metrics used (e.g. facilities per births or per population), but given the unpredictable nature of complications, the need for skilled care that can either manage all complications, or provide timely referral to comprehensive emergency care if complications arise, is not disputed (Campbell & Graham, 2006), only underscoring the continuing need to address the structural inadequacies in health systems (UN-ECOSOC, 2014a, 2014b).


Sexual and reproductive health: progress and outstanding needs.

Snow RC, Laski L, Mutumba M - Glob Public Health (2015)

Proportion of women in select Asian countries with access to management of post-partum haemorrhage in 2005, with specific focus on urban versus rural access.Source: UN-ECOSOC (2014b); Analysis based on data from the Maternal and Neonatal Program Effort Index (MNPI): http://www.policyproject.com/pubs/mnpi/getmnpi.cfm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318113&req=5

f0003: Proportion of women in select Asian countries with access to management of post-partum haemorrhage in 2005, with specific focus on urban versus rural access.Source: UN-ECOSOC (2014b); Analysis based on data from the Maternal and Neonatal Program Effort Index (MNPI): http://www.policyproject.com/pubs/mnpi/getmnpi.cfm.
Mentions: A majority of facilities that offer maternity care still fail to provide all functions required for classification as an EmONC facility (basic or comprehensive), and geographic and financial barriers persist (Gabrysch et al., 2012). Management of basic obstetric and neonatal emergencies includes the administration of oxytocics, antibiotics, anticonvulsants, manual extraction of the placenta, removal of retained products and neonatal resuscitation, while management of comprehensive EmONC includes capacity to perform C-section surgery in cases of obstructed labour, and blood transfusions. The rural versus urban differential in key components of EmONC (e.g. management of PPH) (Figure 3), reflect the continuing challenges of delivering services to women with structural obstacles to care (e.g. few or no transport options and poor or seasonal roads) (Gabrysch et al., 2012). The recommended minimum density of basic and comprehensive EmONC facilities differs depending on the metrics used (e.g. facilities per births or per population), but given the unpredictable nature of complications, the need for skilled care that can either manage all complications, or provide timely referral to comprehensive emergency care if complications arise, is not disputed (Campbell & Graham, 2006), only underscoring the continuing need to address the structural inadequacies in health systems (UN-ECOSOC, 2014a, 2014b).

Bottom Line: Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile.While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning.Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor.

View Article: PubMed Central - PubMed

Affiliation: a School of Public Health , University of Michigan , Ann Arbor , MI , USA.

ABSTRACT
We examine progress towards the 1994 International Conference on Population and Development (ICPD) commitment to provide universal access to sexual and reproductive health (SRH) services by 2014, with an emphasis on changes for those living in poor and emerging economies. Accomplishments include a 45% decline in the maternal mortality ratio (MMR) between 1990 and 2013; 11.5% decline in global unmet need for modern contraception; ~21% increase in skilled birth attendance; and declines in both the case fatality rate and rate of abortion. Yet aggregate gains mask stark inequalities, with low coverage of services for the poorest women. Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile. While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning. Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor.

Show MeSH
Related in: MedlinePlus