TY - JOUR
T1 - Maternal, neonatal, and child health in southeast Asia
T2 - Towards greater regional collaboration
AU - Acuin, Cecilia S.
AU - Khor, Geok Lin
AU - Liabsuetrakul, Tippawan
AU - Achadi, Endang L.
AU - Htay, Thein Thein
AU - Firestone, Rebecca
AU - Bhutta, Zulfiqar A.
N1 - Funding Information:
This paper is part of a Series funded by the China Medical Board, Rockefeller Foundation, and Atlantic Philanthropies. The authors thank the following individuals for their assistance: Virasakdi Chongsuvivatwong, Edward McNeil (Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand), Marian Valera, Bryan Lim, Joan Javellana-Ottao (University of the Philippines, National Institutes of Health), and Arjumand Rizvi (Aga Khan University, Pakistan).
PY - 2011
Y1 - 2011
N2 - Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals.
AB - Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals.
UR - http://www.scopus.com/inward/record.url?scp=79551685183&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(10)62049-1
DO - 10.1016/S0140-6736(10)62049-1
M3 - Review article
C2 - 21269675
AN - SCOPUS:79551685183
SN - 0140-6736
VL - 377
SP - 516
EP - 525
JO - The Lancet
JF - The Lancet
IS - 9764
ER -