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Future challenges and opportunities

Professor Address Malata outlines future challenges and opportunities in maternal health.
ADDRESS MALATA: No woman should die whilst giving life. And every child born should live until they fulfil their full potential. So I’m discussing future challenges and opportunities for maternal and newborn health care. When we look into the next 20 years and beyond, there are changes that are taking place and should be looked into seriously. I want to start by talking about the diaper disease burden. In my time in newborn health care, what we see now is that even countries where there was focus on just communicable diseases, there’s an increase in non-communicable diseases. So for example, a country like Malawi, we have to look at both aspects of disease, non-communicable diseases and communicable diseases.
And this places a lot of pressure on the health care system. I also want look at the issue of transformation that is going to take place and is already taking place. And this transformation is in the areas of social, political, environment, and even demographic aspects or changes. Each country, each member country, each member state has changes that are taking place. And these changes need to be looked in to as we address issues of maternal and newborn health care. I also want to look at health care systems. With these changes, every health care system must respond to the changing context. So we can not address issues the way we used to address them 40 years ago, 20 years ago.
Because if there’s a change in the social context, then it means the health care system has to address that change. So the health care systems must actually respond to every change that is taking place in the next 20 years. I also want to look at the issue of development assistance. So donors point to reduce and they keep reducing their assistance to member countries. Which means that every member country should find ways of raising domestic living through taxation, through levys. Domestic living actually should be used, there should be more resources from domestic revenue that are used for maternal and newborn health care.
Which means that when members of parliament meet to budget, to discuss budget, the local living from each country, from member countries, should actually be more than what is being provided for at the moment. Another change that we see in the coming 20 or more years is rapid urbanisation. Now although people are moving into cities and towns, we find that in many countries quality of care is improving. However, not everyone gets that quality of care. There are still differences within countries, even within regions. So you find that within a region, one county may provide better care. But within that same region, you will find women that are not getting better quality of care.
Therefore we may need to do more research so that we can improve quality of care even with the rapid urbanisation. I also want to address another issue is the issue of behavioural economics. A lost of changes are happening and particularly in areas of innovation, technology innovation. Even in countries, very setting countries, you will find that in a rural area, a woman will have a cell phone. Can we use this technology to improve maternal and newborn health care? And I do know that there will be more innovations. And in 20 years time, we may not even see any papers being used in any facility, because they have several facilities that has brought some technology there.
ICT is really moving at a fast rate. But we should use that opportunity to actually improve maternal and newborn health care. So we have opportunities. And of course, finally, universal health coverage is a platform that can actually help countries to provide comprehensive maternal and newborn health care. And actually, making sure that all aspects of care, including HIV and AIDS, are taken into consideration when you actually put out a package for every woman and for every newborn and every child. Every country that is serious on universal health coverage who actually made strides, actually there will be greater dividend that is going to be achieved if this emphasis and this provision of services for universal health coverage.
And this is truly looking into the future next 20 years, next 50 years, and even further than that. Thank you very much.

In this step with Professor Address Malata we will look to the next 20 years and ask how changing burdens of disease, demographic transitions, urbanisation, and other issues might impact maternal health.

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Improving the Health of Women, Children and Adolescents: from Evidence to Action

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