EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING

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1. BACKGROUND 1.1 Introduction The United Nations Commission on Life-‐Saving Commodities (UNCoLSC) was created by the UN Secretary-‐General, Mr. Ban Ki-‐moon, under the auspices of the Every Woman Every Child (EWEC) movement, and seeks to amplify efforts to save and improve the lives of 16 million women and children. This Commission aims to promote consensus around thirteen (13) affordable and effective medicines and health supplies that currently do not reach the women and children who most need them, by providing a platform to help overcome major bottlenecks. It is estimated that scaling up these 13 commodities over five years would cumulatively save over 6 million lives including 230,000 maternal deaths averted through increased access to family planning; save an extra 1.8 million child deaths a year, reducing the estimated 7.1 million deaths in 2010 to 5.3 million. Three commodity-‐specific types of barriers prevent women and children from receiving appropriate interventions: (1) the insufficient supply of high quality health commodities; (2) the inability to effectively regulate the quality of these commodities; and, (3) the lack of access and awareness of how, why and when to use them. Ten recommendations to address these barriers to access to and utilisation of the 13 essential commodities have been identified. Uganda is a signatory to the Abuja meeting ministerial communiqué committing to implement the 10 UN commission recommendations. . 1.2 The Uganda context While Uganda has made some progress towards the attainment of MDG 4 and 5, the rate of reduction is slow, compared to the set MDG target of 54 per 1000 live births and 131 per 100, 000 by the year 2015, respectively. U5MR has reduced from 137/1,000 live births in 2006 to 90 in 2011, and IMR has reduced from 90/1000 to 54/1000 live births in the same period (UDHS 2006; 2011). Similarly MMR has reduced from 505 to 435 deaths per 100,000 live births. Yet more than 200,000 children under-‐five years die every year mainly due to preventable conditions especially malaria, pneumonia, diarrhea, vaccine-‐preventable diseases (e.g. measles), HIV/AIDS, and neonatal conditions. The leading direct causes of maternal deaths are hemorrhage (26%), sepsis (22%), obstructed labor (13%), unsafe abortion (8%) and hypertensive disorders in pregnancy (6%). The major challenge in Uganda is the high fertility rate with a total fertility rate of 6.6 (UDHS 2011). This drives the other burdens namely pre-‐term delivery, post partum haemorrhage,
sepsis, pre-‐eclampsia and eclampsia. There is poor coverage of Family Planning services especially in the hard-‐to-‐reach areas with unmet need for Family Planning stands at 41%, moslty as a result of inadequate access of young people to contraceptives and inadequate use of long acting and permanent methods. Another major problem concerns newborn deaths, which have maintained the high-‐sustained levels of the IMR, making it impossible for Uganda to achieve the MDG 4 target of reducing by two-‐thirds the mortality rate among children under-five by 2015. According to the Uganda newborn situation analysis of 2008, 39% and 25% of deaths among infants and children under-‐five, respectively, are under 28 days of life. The majority of these deaths result from preventable causes like infections, birth asphyxia or injuries and complications of prematurity. A related problem is early, unplanned and unwanted pregnancy with evidence of high incidence of unsafe abortions and its related complications in the age group. The Uganda road map for acceleration of reduction of Maternal and Neonatal Morbidity and Mortality, the Reproductive Health Commodity Security Strategy and the National Child Survival Strategy were formulated in 2007, 2008 and 2009, respectively. With regard to newborn health, a detailed framework on newborn health was developed to operationalize the newborn health component of the Child Survival Strategy. In an attempt to bring services closer to the people the community treatment of malaria, pneumonia and diarrhea policy, through use of village health teams was adopted in 2010. The effective implementation of these strategies is expected to contribute significantly towards achievement of MDGs 4 and 5 by 2015. The Uganda National Drug Policy is operationalized through the Pharmaceutical Sector Strategic Plan, and aims at ensuring the availability and accessibility of adequate quantities of affordable, efficacious, safe and good quality essential medicines to all. The public sector national medicines procurement is mainly through National Medical Stores (NMS), a parastatal organization, while the Joint Medical Stores (JMS) is the major PNFP sector supplier for medicines and health supplies. The National Drug Authority (NDA) is responsible for regulating the pharmaceutical market, licensing premises, drug information, pharmaco-‐vigilance, quality assurance, import permissions and disposal of expired medicines but has a limited capacity with insufficient outreach. Global initiatives provide the bulk of reproductive health commodities. Government of Uganda distributes life saving commodities free of charge through the public health system. The public health system includes National referral Hospitals, Regional Referral Hospitals, General Hospitals, Health Centres IV, III, and II and community based distributors. 1.2 Problem Statement Major health system challenges still remain to ensure equitable and sustained access to quality
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Page 30: REFERENCES 1. Annual Health Secto

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EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING