NGO Another Way (Stichting Bakens Verzet), 1018 AM Amsterdam, Netherlands.

 

Edition 03: 27 August, 2010.

Edition 05 : 22 December, 2013.

 

E-course : Diploma in Integrated Development (Dip. Int. Dev)

 

Quarter 1.

 

 

SECTION A :  DEVELOPMENT PROBLEMS.

 

 

Study value : 04 points out of 18.

Indicative study time: 112 hours out of 504.

 

Study points are awarded only after the consolidated exam for Section A : Development Problems has been passed.

 


 

Second block : The problems to be solved.

 

Study points : 02 points out of 18

Expected work required: 55 hours out of 504

 

The two study points will be finally awarded on successful completion of the consolidated exam for Section A : Development problems.

 


 

Section 1. Analysis of the Millennium Goals. [22 hours]

 

[18.00 Hours] Analysis of the Millennium Goals.

[04.00 Hours] Preparation report Section 1 of Block 2.

 

Section 2: Relate the Millennium Goals to the services for a good quality of life in Section 2 of block 1. [23 hours]

 

[18.00 Hours] Analysis of the services made available by integrated development projects.

[05.00 Hours]  Preparation report Section 2 of Block 2.

 

Second block : Exam. [ 4 hours each attempt]

 

Consolidated exam for Section A : Development problems (for passage to Section B of the course :  [ 6 hours each attempt].

 


 

Section 1. Analysis of the Millennium Goals. [22 hours]

 

[18.00 Hours] Analysis of the Millennium Goals.

 

00. Summary of the Millennium Goals.

01. Eradicate extreme poverty and hunger.

02. Achieve universal primary education.

03. Promote gender equality and empower women.

04. Reduce child mortality.

05. Improve maternal health.

06. Combat HIV/aids, malaria and other diseases.

07. Target 09 : Ensure environmental sustainability.

07. Targets 10 and 11 : Water, sanitation  and slums.

08. Develop a global partnership for development.

 


 

[18.00 Hours] Analysis of the Millennium Goals.

 

05. Improve maternal health. (At least two hours)

 


 

Look at slide: Reduce by three quarters the maternity mortality ratio.

 


 

Millennium Goal 5 is about the reduction of the maternity mortality ratio.

 

It refers to women’s health.

 

On the subject of health in general, review your work on section 1 of block 1  analysis health and sanitation   and  in-depth work on health and sanitation of the course.

For a good general reference on an integrated approach to health issues refer to Costello A. et al, Managing the health effects of climate change, Lancet (The) Vol. 373, Issue 9676, pp. 1693-1733 with University College London (Institute for Global Health Commission), London, 2009.  [Registration is required for free access].

The UNDP Report on Human Development for 2007/2008 provides the following tables :

In connection with the number of births attended by qualified personnel  and maternal mortality:

 

06 Commitment to health.

08 Inequalities in maternal and child health.

10 Survival : progress and set-backs.

 

1. Research.

 

On one page describe the  statistics on maternal mortality and the proportion of births attended by qualified personnel in your chosen area and make a comparison with the statistics shown in the World Report on Human Development 2007/2008 for your country. What are your conclusions?

 

The Millennium health goals are covered in articles 53-57 in section VI : « Health and sustainable development » of the Plan of Implementation of the Millennium Goals.

 

“53. The goals of sustainable development can only be achieved in the absence of a high prevalence of debilitating diseases, while obtaining health gains for the whole population requires poverty eradication. There is an urgent need to address the causes of ill health, including environmental causes, and their impact on development, with particular emphasis on women and children, as well as vulnerable groups of society, such as people with disabilities, elderly persons and indigenous people.”

 

Paragraphs f) and i) of article 54 provide : 

 

“(f) Develop programmes and initiatives to reduce, by the year 2015, mortality rates for infants and children under 5 by two thirds, and maternal mortality rates by three quarters, of the prevailing rate in 2000, and reduce disparities between and within developed and developing countries as quickly as possible, with particular attention to eliminating the pattern of disproportionate and preventable mortality among girl infants and children;

........

“(i) Ensure equal access of women to health-care services, giving particular attention to maternal and emergency obstetric care;”

 

In Section VIII of the Plan of Implementation of the Millennium Goals, which is about sustainable development in Africa, there are no specific references to maternal mortality at all. Women are mentioned there just twice – in article 65 (on catastrophes and conflicts) and in article 67 ( access to land, tenure and credit.) 

 

The Plan of Implementation of the Millennium Goals does not make any specific reference at all to births assisted by qualified personnel.

 

Read the report on  Maternal Mortality in 2005, by Say L, Inoue M, et Mills S., published by the World Health Organisation in 2007.

 

The executive summary on page 15 of the report reads :

 

Of the estimated total of 536 000 maternal deaths worldwide, developing countries accounted for 99% (533 000) of the deaths (Table 2). Slightly more than half of the maternal deaths (270 000) occurred in the sub-Saharan Africa region alone, followed by South Asia (188 000). Thus, sub-Saharan Africa and South Asia accounted for 86% of global maternal deaths. By the broad MDG regions, the MMR in 2005 was highest in developing regions (450), in stark contrast to developed regions (9) and countries of the commonwealth of independent states (51). Among the developing regions, sub-Saharan Africa had the highest MMR at 900 maternal deaths per 100 000 live births in 2005, followed by South Asia (490), Oceania (430), South-Eastern Asia (300), Western Asia (160), Northern Africa (160), Latin America and the Caribbean (130), and Eastern Asia (50).”

 

And on page 18 :

 

“…….as shown in Table 3, maternal mortality (as measured by MMR) has decreased at the global level at an average of less than 1% annually between 1990 and 2005……. on the regional basis, none of the MDG regions achieved 5.5% between 1990 and 2005, although Eastern Asia came close to that goal with a 4.2% annual decline.”

 

Page 18 continues:

 

“Data on the second indicator identified for monitoring progress towards achievement of maternal mortality reduction – that is, the proportion of births attended by skilled health personnel (doctor, midwife, or nurse) (1) – indicate that the receipt of such care is limited where maternal deaths also constitute a major problem. In Africa, less than 50% of births are attended by a skilled health worker, according to most recent available data (34) – despite an increase from 43% to 57% between 1990 and 2005 in all developing regions, as indicated by the 2007 Millennium Development Goals Report (35). These figures are far lower than the global target for this indicator, which was set at a special session of the United Nations in 1999.”

 

The conclusion on page 3 states:

 

“It has, however, been a challenge to assess the extent of progress towards the MDG5 target, due to the lack of reliable maternal mortality data – particularly in developing-country settings where maternal mortality is high (2).”

 

The last column in table 10 of the UNDP World Report on Human Development 2007/2008  ( mortality «adjusted ») shows the figures mentioned in the report on Maternal Mortality in 2005 which gives «error margins » which are sometimes very large. For example in the case of Niger, the mortality rate is shown as 1800 deaths per 100.000 births.  Margins of error there are between 840 and 2900.     

 

2. Opinion.

 

On one page  explain if  it is so difficult to get accurate statistics on maternal mortality rates and on the number of assisted births in your project area. If so, why? If not, why not?

 

3. Research.

 

On one page describe the main causes of maternal mortality in your chosen area.

 

Millennium goal 5 is dealt with in pages 100-108 of the report Making the MDGs Work for All . Read pages 100-108 carefully. They contain the description of a series of specific actions for the reduction of maternal mortality.

 

4. Opinion.

 

On one  page make two columns. In one column describe the actions listed on pages 100-108 of the report. In the second  column note which services would be necessary in your project area to put the ideas into practice.

 

Page 99 of the report Making the MDGs Work for All reads :

 

“The foundations for maternal risk are often laid in girlhood. Women whose growth has been stunted by chronic malnutrition are vulnerable to obstructed labour. Anaemia predisposes women to haemorrhage and sepsis during delivery and has been implicated in at least 20 percent of postpartum maternal deaths in Africa and Asia.132.”

 

Page 104  reads:

 

“Since poverty, education, the health and nutrition of girls, women’s empowerment and violence against women are all relevant to Goal 5, relevant targets and indicators are also covered under goals 1, 2, 3, 4 and 5.”

 

The term «genital mutilation» (of women)  does not appear anywhere in the Plan of Implementation of the Millennium Goals.

 

5. Opinion.

 

On one page explain why, in your opinion, these links are not cited in the Plan of Implementation of the Millennium Goals.

 



 Second block :  Problems to be solved.


Index : Diploma in Integrated Development  (Dip. Int. Dev)

 List of key words.

 List of references.

  Course chart.

 Technical aspects.


 Courses available.

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