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Consultation on maternal and child health inequities held in New York

© UNICEF/HQ05-2415/ Khemka
Newborns are vaccinated against polio on being discharged from Purulia District Hospital in West Bengal State, India.

By Karin Shankar

NEW YORK, USA, 12 February 2008 – Ensuring that poor and marginalized children and mothers have access to quality health care services was the main subject at the UNICEF-convened consultation, ‘Increasing the Contribution of Health Systems to Health Equity’, held last week at the organization’s New York headquarters.

Health equity removes differences in access to health care that are systematic, socially produced and unfair. 

The theme of the consultation was to raise awareness of the existence of health inequalities and recognize that approaches exist to improve the situation. Guests included leading international specialists, UNICEF partners, regional and country representatives, and senior staff members.

Improving essential services

UNICEF Chief of Health Peter Salama stressed the significance of the consultation to future health programmes and the achievement of the Millennium Development Goals.

“While progress in child survival is clear in certain areas, an acceleration of efforts is required to achieve the health-related MDGs, and since poor children will not automatically benefit from accelerated efforts, health systems ought to be strengthened for better health outcomes as well as equity," Mr. Salama said.

The attendees focused on ways of improving delivery of essential services to poor and excluded children, especially those from households with incomes under the global poverty line of $1 per day. Roughly 600 million people in Asia and 300 million in Africa fall into this category.

In middle-income countries, where fewer people live below the global poverty line, the focus of such initiatives will be on the poorest 20 per cent of the population.

© UNICEF/HQ07-1480/ Khemka
Anita Mukhiya, 16, lies in bed with her one-day-old infant at Panchthar District Hospital in the remote village of Phidim, Nepal. The night before, she walked with her parents for three hours to reach the hospital.

Strengthening health systems

Discussions also addressed the issue of exclusion from essential health services related to non-economic factors such as gender, ethnicity and geographical location.

International experts underscored the urgent need to accelerate progress on child and maternal survival and health. Professor of Epidemiology Cesar Victora, from the Federal University of Pelotas, Brazil, pointed out that more lives might potentially be saved by achieving universal coverage with few interventions than by adding new ones to an inequitable situation.

“Packaging of key interventions is usually efficient,” Dr. Victora explained, “but unless coverage is very high it may increase inequities.”

Davidson Gwatkin from the Health, Nutrition and Population Department of the World Bank highlighted that inequalities within poor countries contributed as much to global health inequity as did inequalities between poor and rich countries.

Meeting the MDGs

The consultation follows the January 2008 launch of UNICEF’s flagship report ‘The State of the World’s Children 2008’, which calls on governments, donors and other key stakeholders to unite in support of child survival.

The report outlines strategies for sharply accelerating overall progress in this direction, noting that formidable barriers exist to reaching the poorest, most excluded families and that overcoming these will require new approaches.

To review ‘The State of the World’s Children 2008’, see www.unicef.org/sowc08.




February 2008: Cesar Victora, Professor of Epidemiology at the Federal University of Pelotas, Brazil, explains the issues related to health equity presented at the UNICEF-convened consultation, "Increasing the Contribution of Health Systems to Health Equity'.
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Davidson Gwatkin, a consultant on health and poverty to the World Bank, discusses the difference between inequalities within countries and inequalities between countries.
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