A regional report on Millennium Development Health related Goals in Economic Cooperation Organizations (ECO) countries (Goals 4, 5 and 6) |
| June. 2010
Institute of Public Health Research (Recently renamed as National Institute of Health Research (NIHR)) Tehran University of Medical Sciences
Economic Cooperation Organization (ECO) The United Nations Children's Fund (UNICE\ The project has been offered by The Economic Cooperation Organization (ECO) Secretariat to Institute of Public Health Research (Recently renamed as National Institute of Health Research (NIHR)), Tehran University of Medical Science to prepare an analytical regional report on Millennium Development Goals Numbers 4, 5, and 6. UNICEF has covered the consultancy costs. The consultancy team included: · Professor Hossein Malekafzali Ardakani, MD, PhD The project manager Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Email: malekafzali@sina.tums.ac.ir http://www.tums.ac.ir/faculties/malekafzali
· Professor Kourosh Holakouie Naieni MD, PhD The executive manager of the project Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Email: holakoin@tums.ac.ir http://www.tums.ac.ir/faculties/holakoin
· Assistant Professor Arash Rashidian, MD, PhD The member of the project’s team Director, National Institute of Health Research (NIHR) Health Management and Economics Department, School of Public Health Tehran University of Medical Sciences, Tehran, Iran, Email: arashidian@tums.ac.ir
· Dr Parviz Vazirian, MD , MPH The member of the project’s team Consultant officer, World Health Organization Email: parviz_vazirian@yahoo.com
· Dr Ghobad Moradi, MD, MPH The member of the project’s team PhD student of Epidemiology Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Email: gh.moradi@gmail.com
· Dr Ali Mirzazadeh, MD, MPH The member of the project’s team PhD student of Epidemiology Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Educational Manager, Regional Knowledge Hub for HIV/AIDS Surveillance, Iran Email: ali.mirzazadeh@hivhub.ir http://www.hivhub.ir/en/staff/mirzazadeh
We would like to express our gratitude to all those who help us to complete this project. We want to thank the ECO secretariat, especially Dr Davoud Rezaie and Dr Muzaffer Alacaogullari for their kind and intensive efforts to arrange the country visits with the best knowledgeable persons on MDGs from the both governmental and nongovernmental health sectors. We have furthermore to thank the Iranian Embassy and Consulate in the visited countries, in supporting the team members in the countries by providing the transportation, translator and arranging the visits of the related stakeholders in the country. Our colleagues in WHO and UNICEF offices in the ECO countries supported us scientifically in the research work. We want to thank them for all their help, support, interest and valuable hints.
Please cite this document as A regional report on Millennium Development Health related Goals in Economic Cooperation Organizations (ECO) countries (Goals 4, 5 and 6), National Institute of Health Research (NIHR) [formerly the Institute of Public Health Research], Tehran University of Medical Sciences, 2010 Economic Cooperation Organization (ECO) is an intergovernmental regional organization established in 1985 by the Islamic Republic in Iran, the Islamic Republic of Pakistan and Republic of Turkey. In 1992, ECO developed and evolved into a dynamic organization with 10 Member States to include seven new members, namely: Islamic Republic of Afghanistan, Republic of Azerbaijan, Republic of Kazakhstan, Kyrgyz Republic, Republic of Tajikistan, Turkmenistan and Republic of Uzbekistan. The ECO has already entered into new areas for cooperation which are important for all member states and they have shown interest. Among others these new areas include reactivation of health section and MDGs within the secretariat. Relevant international organizations also supported this new orientation. Millennium Development Goals (MDGs) emanating from the United Nations Millennium Summit held in December 2000 have emerged as the key strategic tools for raising awareness, advocacy, alliance building, and renewing the political commitment towards the promotion of Sustainable Human Development at the country level based on a global consensus. The fight against poverty in all its dimensions, and the promotion of sustainable development particularly within the context of the MDGs remain the overall priority of the Governments of Economic Cooperation Organization (ECO) member states and ECO. In this regard, ECO organized two High Level Expert Group (HLEG) Meetings to overview MDGs implementation in December 2006 and February 2008 in Ankara and Islamabad, respectively and the third one is going to be held on 12-13 January 2010 in Tehran. The 2nd ECO HLEG Meeting on Human Resource Development and MDGs (Islamabad, 11-12 February, 2008) while reviewing the current situation of MDGs implementation in the region, came to the conclusion to recommend selection of three health-related MDGs i.e. MDG numbers 4, 5, and 6, as priority areas within organization’s further activities in this field. Therefore, based on the recommendation of the afore-mentioned event and also other main ECO decision-making meetings, the ECO has benefited from expertise an international consultant involved on these issues and as a result this descriptive and analytical regional report on current trends and progress reports of ECO member states on these MDGs has been prepared. Under the agreed MoU between UNICEF and ECO to promote mutual cooperation and exchange of information, UNICEF has supported ECO in successful accomplishment of this activity. I must thank the UNICEF and the Consultant Team for their cooperation and support in accomplishing this task successfully. I hope that the valuable recommendations of this report would be materialized. Based on the findings and recommendations of the report, the Secretariat with the help of the concerned authorities of the member states as well as with that of the International organizations, will continue to identify Regional projects which are beneficial for the member states.
Mohammed Yahya Maroofi ECO Secretary General
AIDS Acquired immunodeficiency syndrome DOTS Directly Observed Treatment, Short Course GDP Gross Domestic Product DHS Demographic Health survey ECO Economic Cooperation Organization EECAR Division of Eastern Europe and Central Asian Republics FP Family Planning GF Global fund HIV Human immunodeficiency virus IMR Infant Mortality rate MDG Millennium Development Goals MH Maternal health MICS Multiple Indicator Cluster Survey MoH Ministry of Health MMR Maternal Mortality rate NGO Non-Governmental Organization PHC Primary Health Care PLWHA People living with HIV/AIDS RH Reproductive health STI Sexual Transmitted Infection TB Tuberculosis U5MR Under 5 Mortality rate UN United Nations UNAIDS the Joint UN Program on HI UNGASS United Nations General Assembly Special Session UNCT United Nations Country Team UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund UNIFEM United Nations Development Fund for Women USAID United States Agency for International Development UNDAF United Nations Development Assistance Framework UNDP United Nations Development Program WHO World Health Organization VCT Voluntary Counseling and Testing (for HIV) XDR-TB Extensively Drug-Resistant Tuberculosis
The present report on ECO countries’ progress toward achieving the health related MDGs (4, 5 and 6) is a joint initiative of National Institute of Health Research (NIHR) affiliated to Tehran University of Medical Sciences and the ECO secretariat. MDGs have emerged as the key strategic tools for raising awareness, advocacy, alliance building, and renewing the political commitment towards the promotion of Sustainable Human Development at the country level based on a global consensus. In the Millennium Declaration member states committed themselves to reducing human poverty by 2015. Due to identical economic and social conditions in most of the member states, there is a similarity in problems faced by their health sectors. Thus, there is a vast scope to benefit from each other’s experiences in strengthening health facilities for the benefit of the people in the ECO region. The consultancy project has been done in several phases. The first phase included a critically and deeply review of the last country’s MDG report and check the reported trend for each goal. To complete the available data and update the country situation regarding the MDGs objectives, a comprehensive literature review has been done. In the next phase, the main stakeholders, from both governmental and international organizations, in the country has been visited and interviewed by the research team. A specific data extraction toolkit was applied to extract the findings into tables and list all the important pros and cons regarding the country health care services and public health programs. Beside the situation analysis, the main objective of the report is to provide evidence based recommendations to every country and the whole region to raise the portability of achieving the MDGs in 2015. The main actions in preparing the report are listed as: 1. Literature review included scientific journals, databases and reports (Gray Literature), 2. Reviewing documents available from MOH in the country (published and unpublished sources) 3. Reviewing documents available from the UN agencies in the country (published and unpublished sources) 4. Visit the country and interview with stakeholders and experts in MOH and UN agencies 5. Interview with the key informants 6. Discussion in expert groups about results and methods 7. Reviewing WHO and UN MDG-related documents and electronic sources 8. Reviewing international and national related sources and services 9. Data cleaning and collation 10. Illustrate the trend and create the appropriate tables and graphs accordingly. 11. Suggesting the evidence-based recommendations based on the valid well-defined sources findings. This report includes twelve chapters. In the beginning chapter a brief review of the report, executive summary and the methodology which has been applied in the project is presented. In the next ten chapters, the health system and the current situation regarding the MDGs of the ECO countries has been reviewed in details. Each country report consists of the following subheading:
· Demographic and socioeconomic status The major demographic, socioeconomic and health indicators as well as population pyramid has been reported for each country. · Methodology and visits: Countries which have been visited by the research team, a list of countries’ stakeholders in both governmental and nongovernmental organizations have been mentioned here. The other countries which were not visited directly by the research team, the main search strategy to find out the health status and MDGs indicators level were reported. · MDGs and indicators related to health status: In every country, 4, 5 and 6 MDGs has been reported in details as well as their indicators. The exact definition and the target of each goal have been mentioned and the health system was evaluated weather they have applied and report the same definition. From the beginning of 1990 to the end of 2008, all the reported statistics on each indicator has been summarized in a table. · 26 Recommendations based on the level of indicators for each goal for each country Based on the available statistics, the in-depth interviews and literature review, specific recommendation to improve the health system to achieve the MDGs has been listed at the end of each section.
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