Class Report regarding Maternal Care in Thailand

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MATERNAL CARE INTHAILAND

GROUP 6 | SECTION APRIMARY HEALTH

CARE

September 27, 2012


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OUTLINE of the PRESENTATION

I. Definition of Maternal Care

II. Why Does Thailand Focus on Maternal Care?

III. Goal # 5: Improve Maternal Health (Thailand)

IV. Trend of Maternal Mortality Ratio

V. The Maternal Care Program of Thailand

VI. The Challenge

VII. References


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WHAT IS

MATERNAL CARE?


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WHAT IS MATERNAL CARE?

Maternal health: the health of women during pregnancy, childbirth and the

postpartum period. While motherhood is often a positive

and fulfilling experience, for too many women it isassociated with suffering, ill-health and even death

[WHO]


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WHY DOES THAILANDFOCUS ON

MATERNAL CARE?WHAT IS THE PROBLEM?


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THE PROBLEM

WORLD HEALTH

ORGANIZATION1. Globally, 500,000

women die each year

during pregnancy and

delivery


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Thailand has a population of around 63.07

million, of which:

17.88 million (29.5%) are women aged 15-49

years, 4.79 (7.59%) are children under 5 years of age.

almost 25% of the population is under 15 years of

age

A significant number of the Thai population are

women of child-bearing age


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MCH in Thailand

continually been declared as a top priority

since the 3rd National Health Development

Plan (NHDP 1972-1976)

continues to be so (9th NHDP, 2002-2006)

set ambitious targets for maternal, newborn

and child health

One of the success stories in the SE Asiaregion


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Births Attended by Skilled Health Personnel

(Percent of Births) 2005-2011

Ran

k

Country Percent

Source: WHO, World Health Statistics 2012;Lifted from: The Henry J. Kaiser Family Foundat


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GOAL # 5 OF MDG:

IMPROVEMATERNAL HEALTH

(THAILAND)


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THAILANDS SCORECARD

on MDG GOAL #5, TARGET #6

TARGET INDICATOR SCORECA

RD

REMARKS

6. Reduce

by threequarters,

between

1990 and

2015, the

Maternal

Mortality

RatioMMR

Maternal

MortalityRatio

(MMR)

Proportio

n of births

attended

by skilled

healthersonne

Target Not

Applicable

Given the

low startingpoint in

1990, this

target is

considered

not feasible,

and

therefore,not


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MATERNAL HEALTH IN

THAILAND

Thailand has made a steady progress in

maternal health.

In general, Pre-Natal care is universal.

However, Lack of Adequate Health Care is

evident primarily in the:

Remote and Mountainous Northern Provinces

Southernmost Provinces


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TREND OFMATERNAL

MORTALITY RATIO


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Maternal Mortality Ratio (90-

11)

0

10

20

30

40

50

60

70

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

MMR

Year

Maternal Mortality Ratio (MMR), Thailand 1990-2011


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0

10

20

30

40

50

60

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Maternal Deaths, Thailand1990-2011


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Causes of Maternal Death

050

100

1990

1998

2000

2001

2002

HaemorrhageHypertension

Sepsis

Amniotic Fluid

Indirect Causes


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Causes of Maternal Death

0

10

20

30

40

50

60

1990 1998 2000 2001 2002

AxisTitle

Chart Title

Haemorrhage

Hypertension

Sepsis

Amniotic Fluid

Indirect Causes


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TREND OF MATERNAL

MORTALITY RATIO

INDICATOR

S1990 1995 2000 2002

2015 MDG

TARGET

Maternal

Mortality

Ratio (per

100,000

live births)

36.2

(Initia

l

MMR

)

16.8 14.2

24

(This

increase is

the result of

improvemen

t in data

collectionrather than a

real

increase)

9.05

(Not feasible,

as explained

earlier Low

initial Maternal

Mortality Ratio

= 36.2)

MDG Target = Reduce by the MMR between 1990-

Solution: 36.2 x (3/4) = 27.15, 36.2-27.15 = 9.05

an y


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an ySKILLED HEALTH PERSONNEL,

1990-2002

1990 1991 1992 1993 1994 1995 1996

MMR 36.2 n.a. 23 n.a. n.a. n.a. 16.8

Births attended

by healthpersonnel (%)

90.8 93.2 90.4 91.1 n.a. 94.4 n.a.

1997 1998 1999 2000 2001 2002

MMR n.a. 15.8 14.2 n.a. 17.6 24

Births attended

by health

personnel (%)n.a. 99 n.a. n.a. 98 n.a.


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MATERNAL CARE

PROGRAM OF

THAILANDREACHING BEYOND THE MDG


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Success of Thailand

Can be traced to the following:

Investment in Health Infrastructure

Expansion of Health Insurance Coverage

Mandatory Public Service on Medical AlliedGraduates

MDG + Government Program

MATERNAL CARE PROGRAM


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MATERNAL CARE PROGRAM:

REACHING BEYOND THE MDG

GOAL TARGET INDICATOR

Matern

al

Health

MD

G

+

Reduce maternal

mortality ratio (MMR) to

18 per 100,00 live birthsby 2006

Reduce by half, between

2005 and 2015, the

maternal mortality ratio inhighland areas, selected

northern provinces, and

the 3 southernmost

provinces (Pattani,

Maternal

mortality

ratio inhighland

areas,

northern

provinces,and the 3

southernmo

st provinces


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Northern Provinces

3 Southernmost Provinces

(Pattani, Yala, Narathiwat)


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THE CHALLENGE


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THE CHALLENGE

In order to reach the MDG Plus targets to (i)

reduce MMR to 18 per 100,000 live births by

2006 and (ii) reduce the MMR by half,between 2005 and 2015, in highland areas of

selected northern provinces and the three

southernmost provinces, the following

priorities need attention:


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THE CHALLENGE

1. Involve both parents and health personnel in

improving health outcomes.

2. Provide healthcare for women.3. Improve the training of health service personnel

to be more effective in detecting and

responding to childbirth complications.

4. Analyze existing data to develop targeted

strategies.


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REFERENCES


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REFERENCES

Chunuan, S, S Vanaleesin, S Morkruengsai, and S

Thitimapong. "The Thai culture and women's participation in

their maternity care." medinfo.psu.ac.th. Songkla Med

Journal, n.d. Web. 21 Sept. 2012.

.

Limwattananon, Supon, Viroj Tangcharoensathien, and Phusit

Prakongsai . "WHO | Equity in maternal and child

health in Thailand." Bulletin of the World HealthOrganization. World Health Organization, 16 June

2009. Web. 21 Sept. 2012.

.


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REFERENCES

Office of the National Economic and Social Development

Board, United Nations Country Team in Thailand.

"Thailand Millennium Development Goals Report 2004."

IIEP: Planipolis. UNESCO / International Institute for

Educational Planning, n.d. Web. 22 Sept. 2012..

Sakunphanit M.D., Msc, Thawon. "Universal Halth Care

Coverage Through Pluralistic Approaches: Experiencefrom Thailand." Social-Protection.Org. International

Labour Organization, n.d. Web. 22 Sept. 2012.


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THANK YOUFOR LISTENING!

GROUP 6 SECTION A

PRIMARY HEALTH CARE

September 27, 2012

Documents

Class Report regarding Maternal Care in Thailand