Maternal, newborn health
Neonatal causes contribute to over 60 per cet of under 5 mortality in all countries in this region (UNICEF SOWC 2010). Prematurity is the first cause of neonatal death in all countries, with asphyxia and infection coming second and third in Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, Tajikistan and Turkmenistan), while in the remaining countries congenital diseases come second (Cattaneo et al., 2010).
As reported by several assessments carried out at country level (WHO EURO, 2009 and 2010), the main causes of maternal mortality in this region are haemorrage, obstructed labour, sepsis and eclampsia, which means that in most countries the maternal mortality profile is still similar to that in developing countries. The rates and the distribution of the main causes of maternal and neonatal mortality, in a context of improved living conditions, decreasing fertility and very high coverage with antenatal care and institutional births, point to problems in the quality of care for pregnant women and newborn babies, and again in inequitable access by disadvantaged population groups.
To improve maternal and newborn child care in this region, health care must have continuity and integration. Health care for everyone along the life cycle - from before conception into adolescence - must also be timely and have effective links between all levels.
Equity and quality are important as universal access all essential health services should be preserved. This means removing financial, geographical and cultural barriers. Besides access, quality must be improved; ensuring safe, effective, family and child-centred care are available at levels for the households. Generating demand for access and quality of care is paramount.