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Essential Healthcare Packages; Effect on Malawi’s Maternal HealthMercedes Currie, Casey Wilson & Emily Woudstra UNIV 1200*5
Context Evidence Results
Recommendations
Description of Country• Malawi is a landlocked country in Southern/Central Africa with
a population of approximately 15.2 million people. • The country ranks 166 out of 177 countries and is classified as
one of the low human development countries• 52.4% of Malawi's population is poor
Background of Topic• Although advancing, health care is poor• Shortage of physicians and care workers• Resources in urban setting• 27th for the highest maternal mortality ratio (510
deaths/100,000 live births)• 5th Millennium Development Goal
Content• infant mortality rate of 79.02 deaths/1,000 live births• ‘Improving Maternal Health’ as Malawi’s fifth Millennium
Development Goals. • This led to the creation and distribution of ‘The Essential
Health Care Packages’• Since the packages have been established, we want to
research if there have been any significant improvements, if they have been effective and what other areas need to be looked it to further improve maternal health in Malawi.
The ProblemHave the Essential Health Packages been effective?• Hospital, health clinics and physicians are majorly located in
urban settings• 80% of population are located in rural settings• Over half of population do not have access to basic medical
needs• Lack of education and resources
References
What are Essential Health Packages (EHPs)?The health care packages were established by the World Bank and the Ministry of Health with the contribution of the Government of Malawi to target the main contributors to maternal health. There are 3 objective:
1. Delivery of EHPs: improvement of distribution 2. Human Resource Development: increasing the number of staff available 3. Health Care and Referral Support: improvement of the effectiveness of the
health system and referral support system
Within these objectives, 11 components were made in order to achieve their goals. 1. Prevention and treatment of vaccine-preventable diseases 2. Management of acute respiratory infections (ARI)3. Malaria prevention and treatment4. Reproductive health interventions to address adverse maternal/neonatal
outcomes 5. Prevention and control of tuberculosis. 6. Prevention and treatment of acute diarrhoeal diseases7. Prevention and treatment of HIV/AIDS and other sexually transmitted
infections 8. Prevention and treatment of schistosomiasis. 9. Prevention and treatment of malnutrition and nutritional deficiencies. 10. Prevention and management of common eye, ear and skin conditions. 11. Treatment of common injuries and emergencies.
As shown in the graph above, maternal mortality ratio has declined overtime. With the contribution of the EHPs, there hasn’t been a substantial decrease. From looking at 2002-2006 to 2007-2011, (the time between being when the EHPs were established) show a steady, but not an exception decrease. In our results, there’s a table showing the ‘before’ and ‘after’ of different aspects the EHPs helped improve.
Causes• Rural poor do not have access• Lack of medical staff • Lack of female awareness/education
Solutions• Decentralize • Increasing numbers and working hours of staff• Started family service and referral centers
To Government of Malawi• Educate citizens of the importance of health care• More GDP toward healthcare • Skilled attendants and post partum care• Availability
To International Agencies• Reduce costs for services• Target problem areas
To You• Maternal Health is a concern in every country • Epidemic of AIDS/HIV• Educate yourself about risks and proper procedures through pregnancy • Skilled doctors are important• Use resources that are available
1. McTavish, S., Moore, S., Harper, S., & Lynch, J. (2010, September 29). National female literacy, individual socio-economic status, and maternal health care use in sub-Saharan Africa. Social Science and Medicine. Retrieved January 26, 2012, from <http://journals1.scholarsportal.info/tmp/10378699496620384675.pdf>2. Data: Malawi . (2011). In The World Bank. Retrieved January 30, 2012, from <http://data.worldbank.org/country/malawi>3.Malawi. (n.d.). In CIA: The World Fact Book. Retrieved January 30, 2012, from https://www.cia.gov/library/publications/the-world-factbook/geos/mi.html4. Makoka, D. (2009). Towards an understanding of regional disparities in social inequities in maternal health in Malawi. African health sciences, 9(4), 234-241. Retrieved from http://search.proquest.com/docview/862789203?accountid=112335. Dutta S. (2009) Implementation Completion and Results Report. The World Bank. Retrieved March 13, 2012 from<http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2009/04/09/000334955_20090409015756/Rendered/PDF/ICR9320P08340110Disclosed0041081091.pdf>