The association Geo Expertise is your partner for:

• The collection of geographic databases and relevant information for making reasoned decisions in the following areas:
  • Sustainable Development,
  • Natural resource management,
  • Promotion of human rights.
• The production of thematic maps.
• The publication of directories and statistical reports.

World Health Organization

Project Summary

Operationalizing the UN Secretary General’s Joint Action Plan for women and children’s health.

Investing the marginal dollar for MNH: Geographic Accessibility Analysis methodology and implementation process.

Progress on MDG5a to reduce maternal mortality is lagging behind in many countries and a key constraint is access to skilled care at birth including emergency obstetric care (EmOC) services. This document describes the methodology and implementation process proposed for assessing geographic accessibility to essential maternal health services, and specifically EmOC, in selected countries. The objective of this analysis is to identify local health system supply side constraints to scaling up maternal and newborn health care. A cost analysis subsequently estimates the marginal investment needed to expand coverage and uptake of services.

This work is undertaken to inform policy discussions on how to optimize or target the spending of the marginal dollar for maternal health at country level; in particular to examine the infrastructure requirements for scaling up coverage of institutional delivery with skilled attendance.

The analysis will be undertaken for at least 5 countries, selected based on criteria that include current maternal mortality burden (MMR) as well as availability of data. A process is currently ongoing to identify the final list of countries. The list of countries for consideration includes: Burundi, Cambodia, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Nepal, Sierra Leone, and Zambia. The work is done as a desk review, making use of already collected and available data. Discussions on interpretation and policy messages will be undertaken in collaboration with country level maternal health experts in the selected countries.

The analysis will produce estimates on the percentage of pregnant women located within 2 hours of travel time from the nearest EmOC facility, and the implications that this will have for reaching MDG5a. The analysis will provide information to inform current policy discussions at country and global level, specifically:

• Recommendations on health system output indicators and benchmarks on EmOC.
• A discussion on current health system barriers to care from the supply perspective and their implications for expanding universal access to MNH services.
• Guidance on the relative financial resource requirements for different scenarios aiming at expanding access to, and use of, quality skilled care at birth taking place in health facilities.