Reproductive, maternal, newborn and child health (RMNCH) represents an unfinished agenda. Much progress in areas of RMNCH have been made, yet within countries, groups of girls, women and children are left behind.
As with infectious/communicable diseases, reproductive, maternal, newborn and child health (RMNCH) represents an unfinished agenda. In this section key issues of gender and equity are highlighted to illustrate where increased and accelerated effort is required to begin to reduce inequities and reach the unreached. Since 2009 the maternal mortality ratio (SDG target 3.1.1) in the Region fell from 61 to 41 deaths per 100 000, and the under-5 child mortality ratio (SDG target 3.2.1) fell from 35 to 13 per 1000 live births. However, progress varies across countries within the Region (5). The Western Pacific UHC and SDG country profiles include the following indicators for measuring progress for RMNCH:
In the Western Pacific Region, much progress was made in the areas of reproductive, maternal, newborn and child health via country efforts to meet the Millennium Development Goals (MDGs) in these areas. However as with other Regions while targets around maternal and infant mortality improved overall, within countries there were groups of girls, women and children who were left behind creating inequities in coverage and outcomes. The UHC and SDG indicators for RMNCH highlight gender and equity issues of health systems. This includes looking at the availability, accessibility, acceptability, quality (AAAQ) and effectiveness of health services – preventive, primary and care – for girls, women and children.
As illustrated in previous sections, both women’s and men’s access to services varies based on gender-related factors, with women and girls sometimes being at a disadvantage. Women’s access to a skilled birth attendant during delivery is not equitable across countries of the Region. Although most (100% in 2007-2017) women in high-income countries are assisted by skilled health personnel, home deliveries in the absence of a skilled attendant still account for a significant share of births in countries such as Lao People’s Democratic Republic and Papua New Guinea (both 60%) (35,186). There has been important progress in countries like Cambodia where 89% of births are now attended by skilled health personnel compared to 44% reported in 2010. Living in rural areas, the mother’s education level and household income are major determinants of whether a woman will be assisted by a skilled professional during birth (187). Although childbearing is a biological function, the likelihood of a mother being assisted by a skilled attendant and thereby surviving childbirth depends partly on the value society places on women and their well-being.
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