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Well you've had the immense good sense to give up every other event and come to this
breakfast this morning
uh... this is by far the best breakfast you will come to all week while in New York.
So congratulations.
Now, we've had fine introductions,
but we need to really focus in the next
twenty five minutes or so
on what are we going to do differently when we leave this room.
great breakfast fabulous
but we need to change and why do we need to change
because what we're doing currently is not working fast enough!
In one analysis,
that was completed by the Institute of Health Metrics and Evaluation in Seattle
the new center of Global Health.
only four countries out to seventy-five priority countries are going to reach
MDG5 by 2015. Only 4 countries! Now that
is
an abomination
despite all of the great work that you do,
and many others do
we are just not getting it right.
so we need to pause
we need to step back
and we need to honestly ask ourselves:
what has worked
what hasn't worked
and when we leave this breakfast room this morning
what are we going to pledge
to do differently?
and this panel
are going to give you the answers!
For me the interventions that work are the interventions that has reached the most
undeserved.
which is reached the poorest and reached the most vulnerable.
your interventions will not work till we reach the last mile
the second point I want to make is that wherever interventions have is an example
of an integrated approach.
so just technical intentions are good but won't take us to whole way so what are we
doing
to put the technical interventions in place?
What are we doing to generate demand? what the reading of the community level
ivy adopting rights based approach
eight hours again please so i'd i would vote for integrated interventions
not very sure i can name a country which has successfully produce mpg five
but in june we heard about my levy and yesterday we have heard about meter
which has brought about would be so you know kind of different said in times of
anger and if you look at both of the models it does an integrated approach
because they have a look at committee level they've looked at systems there
but the government's and put and creation of political in so those are my
two points fabulous thank you very much karo
well wonderful writer bill goes to key points
they've had to choose a practical political division i would go with
family planning
i think pretty pretty close to being ke to the success that we are now
accounting in global health disability production of the totality when this
value in bangladesh is one of the can't exactly will needed to use in this
regard and where israel mossad forty one percent decline in in the totality over
the last uh... award number of mathilde it's in the last decade and half of that
deal was due to the fertility declines that was the best
ke fry first of course many other things as we heard before but uh... postpartum
hemorrhage in uh... he atlantic lancia i_t_n_ i think the u_n_ commission
commodities with that was being now ensured that allows mile has house uh...
they all of the supplies for well-trained and stillbirth but then
there's the really delivered those assailants
so we should not be reinventing the wheel
we know what was
we just need to skin it dot bugged lastly and i would like to
to take your point about the uniquely demand
and get into the last night
who was it was i was in somalia
and
so my eyes one other couple in the highest montana maternity
and we can see in somalia why do you have been harassment and abducted we are
having
basically it's grades today
too many pregnancies
to often
too slow
u_s_ on family planning
the organization i like guinea uh... faulkner the elected uh... issuable
initial
was to make sure
avery
pregnancies wanted
every bit insist
and every no bess and professionalism
and i think if we did this approach
will actually breakdown negotiable died
the correct rate not instant translate everything that is happening at the
global level the pledges the promises the policies
now i think whether civil society or everybody else packing our job right
nice to you you hold
people who make the promises to account
hardly ensuring that the woman and a child and the family for whom this
pledges are being made
they're being actually you don't have to work on i'm in for a moment i forget
that we are experts in their own for you and alexei you were a man on the woman
about to give birth in the village
do i care about whether my kind is going to the beach and eighty-five
i don't
am i invested in a percentage drop in and then mine
what i want to do it i don't want to die while giving birth to my child
so how do we bring bad feeling and how to reconcile too
and eighty-five dot that said this time it at that time but i think and civil
society along with other what people intermediaries elected representatives
media at the property sector i think also safety review now
uh... but i had to get it entertained yes lots of the promises promises hardly
hold into account
we uh... arnelle scene
kent is themself taking increasingly a responsibility to come to be at the end
funding of that all health problems so that you fact your cd may very well be
uh... blood leading problems we have been other teams programs in many
successful had just left in america central europe and now issue uh... so we
see that the system success of great accomplishments greater country
ownership as a delicate leasing in uh... in in in the ngos we now need to really
you chief the can of health advocacy to with uh... to the local hormones they
did not come more resources and people are spending a pocket as you know and
does not the way to finance health gore was willing to step out the plate form
or do they have in the past and this is happening and some optimistic about the
resources from a touch of health but we have different equation in the future
one big love what you do that i see uh... but that will have a major impact
on saving women's last is what happened addict clinic level
i'd just visited recently was on the
the government that is committed to what the court immunization of care
one of the major reason why women
it's not just cost it's not just cultural where women are not going to be
given the facility is record they feel but there must be to properly all
respect for the as what what was on because doing is that women are coming
with their houses one with the that in-laws i've got to have a better deccan
deliver anyway they want they can stand up the config mckinley about thought its
military at another mostly yet but is being creative uh...
before we can remember delivering with respect and with being properly treated
by but providers
and because of that there is a word of mouth
and what we have seen is we have seen an optic
you deliver it is not facility in was on the because there was a father-son
receptive the government was providing funding for the benefit of a because of
hope
we have changed the way we provide services
so we've been we've been hearing this morning and about where we are now
what's working
uh... in and what we want to do with the second panelist is talk about what is it
take
to bring this to the next level is a is a matter of taking what's currently
being done and expanding on it
or to it she v the uh... the engage eagles
using it takes something something more
uh... so it's my privilege to to facilitate a conversation among our
panelists but also
with with you the audience
i'm no expert in in maternal child health and so on but i'm going to be
playing the role
uh... that i currently play of of the journalist moderator uh... which is
uh... which is a lot of fun actually
so the the first question for for all of our panelists uh... his is
is really a big one and i'm asked them to keep it short so that we have time
for the rest the program but it's what are the the being unsolved challenges
indian maternal health
and and all our go down the line on this and and and uh... i'll use the
moderators pride of of cutting off to do it if it goes way too long
the robber where do you want to take it first thanks
and uh... first bank for the organizes for this session it's really great to be
with all of you
i think there's some real obvious challenges that we have access issues we
have human resource issues with issues of really coming up with uh... the
evidence to convince donors and and uh... the champions really for for our
cause
but i'd like to focus really on an issue which i don't think it's as much
attention and that is how we leak this all together
we heard a bit about family planning uh... and its importance for maternal
health uh... h_i_v_-aids obviously is killing a lot of women and and africa
needs to be linkedin with our work
but also beyond just the health sector
uh... we need to be looking at issues such as education a school education we
know is very important for women uh... economic empowerment a having the
resources so that they can actually deal with some of the issues in their lives
and then gender issues and these are all i think issues that we and at u_s_ the
ideas of development agency
really try to bring together and
we've done some of this and i think some countries are better than others
but we have a lot along ways to go and i think the h h_i_v_-aids um...
uh... community has as shown is how we can look at this much more at the mall
expect all approach because it does affect
of our programs electricity what then
in-country in indonesia
and is that we look at that uh... access to what that and sanitation s one-half
the major dreyfus that we are being down let them know marked empty
uh... we need to insure that each uh... community has sent that's valid and
community led by a half access to
didn't want them sanitation and and that's the electricity twenty four hours
before
that that portray for hours that we have backed down might that not much that'd
be great uh... by
by far
maternal mortality gone is seems like it's a medical diagnosis
and we've heard that it's actually more than one medical diagnosis ters several
problems but that's actually not the reality the reality is it's much more
than a medical diagnosis is as we've been hearing it's a convergence of
social economic cultural infrastructure factors all of which
a kind of converged to create the problem of putting a woman at risk
at the time of uh... delivery for child or during pregnancy
and so the solutions for that kind of very complicated
problem is going to require new kind of collaboration and cooperation that we
haven't had before and we're gonna have to break down the barriers that have
stood between us between for-profit companies governments ngos that set
report really gonna wake this problem we're gonna have to have shed a lot of
what's interfered with our working together
and have really meaningful partnerships to address this problem
but i think only for a different we're not gonna have individual interventions
that are going on
radically change what we do and how we achieve
i think what we need to is string putting those interventions together
strengthening the health system and and going forward looking at abroad arrayed
of things
for me what a what i think is going to be the game changer going forward is
quality of care
because
we have the puck potential before it's for generational shift
in women's thinking about the place of birth there a number of of initiatives
globally the jais weiss team in india health equity fund in cambodia that have
really increased utilization of health services
but the problem is right now women are not yet seen the added value
of going to a facility
they don't necessarily benefit from the quality of care that they need when they
get to the facility
the past generations
yun norm was delivered home
we'll only get the next generation's norm to be delivered the facility if we
can provide them with good quality care and make it worth their while
that's why when a lot was talking about though worked that we've done in
mozambique to to improve human ization of care and improved quality of care
those things are fundamentally important as well as much as the beat incentives
for promoting institutional birth we also have to make it worth women's while