The African Union Commission wishes to express its appreciation to Member States for their commitment to the implementation of the Maputo Plan of Action (MPOA) on the Continental Policy Framework on Sexual and Reproductive Health and Rights (SRHR) and for submitting their national implementation reports. The AU Conference of Ministers of Health is also commended for coordinating this process as well as reviewing the continental progress report.
The Commission also wishes to express its appreciation to members of the AU/UN Cluster on Human and Social Development and other partners for their technical contributions to this review of the status of implementation of the Maputo POA and other related activities.
The Commission wishes to particularly thank the UN Population Fund (UNFPA) for its technical and financial support and for the advisory role it has played before and during the review process, as well as in facilitating the implementation of the Maputo POA at national and regional levels.
The Commission further extends its appreciation to the International Planned Parenthood Federation Africa Regional Office (IPPF/AFRO) for the technical and financial support, as well as in facilitating the implementation of the Maputo POA at national and regional levels. Thanks are also due to the Partners in Population and Development Africa Regional Office (PPD/ARO) for technical and financial support for preparatory activities for the review.
Reaffirming that “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”, the historic 1978 Alma Ata Declaration on “Health for All” through access to primary health care (PHC) proclaimed that health is a fundamental human right. The declaration addressed comprehensive strategies to promote health, and covered such issues as the social determinants of health, maternal and child health, and family planning. It also emphasized the need to focus on disadvantaged populations.
Three decades later, universal access to PHC is still a core concept for the promotion of global health, and has been a major component of other policy commitments that have been adopted over the years. These include the 1992 Dakar/Ngoro Declaration on Population, Family and Sustainable Development, which endorsed, among others, the establishment of the African Population Commission (APC) and was Africa’s Common Position for the 1994 Cairo International Conference on Population and Development (ICPD). The ICPD Programme of Action (POA) emphasized universal access to health care, including reproductive health , safe motherhood, treatment and prevention of sexually transmitted infections (STIs), and protection from violence. Other relevant forums include the World Summit on Children, World Conferences on Women and Development, International Year of the Family; the Copenhagen World Summit on Social Development, and the Abuja Special Summit on HIV/AIDS, TB and Malaria.
The Millennium Development Goals
Eradicate extreme poverty and hunger.
Achieve universal primary education.
Promote gender equality and empower women.
Reduce child mortality.
Improve maternal health.
Combat HIV/AIDS, malaria and other diseases.
Ensure environmental sustainability.
Develop a global partnership for development.
The Millennium Development Goals (MDGs) adopted in 2000 at the Millennium Summit were the culmination of decades of work that addressed diverse issues, including health and social development, human rights, and the environment. The eight MDGs comprise a framework for efforts to alleviate the suffering of poor, vulnerable and marginalized people in developing countries, and are all directly or indirectly linked to maternal and child health, including reproductive health (RH). Empowering women, which includes access to reproductive health services, is vital to strong and viable families and communities, able to collectively fight poverty and ensure neonatal, infant and child survival and development. In this regard, it is important to underscore that maternal, neonatal and infant morbidity and mortality rates are essential indicators of development.
Although much has been accomplished during the last decade towards universal access to health services, much remains to be done. Africa still carries the heaviest global burden of disease. These diseases are largely preventable, yet they have led to the pervasive poverty on the continent. Women and children bear the brunt of these diseases and remain the groups most vulnerable to causes of high morbidity and mortality rates in Africa.
Consequently, the continent lags behind others in progress towards the achievement of the MDGs, particularly MDG 1 (Eradicate extreme poverty and hunger), MDG 4 (Reduce child mortality), MDG 5 (Improve maternal health) and MDG 6 (Combat HIV/AIDS, malaria and other diseases). To attain the MDG targets, Africa must invest more in its people’s health and strengthen its health care delivery systems. This is in line with the recommendations of the 2000 WHO Commission on Macro-Economics and Health: Investing in Health for Economic Development (WHO, 2001).
Despite the foregoing challenges, it is essential not to lose sight of the accomplishments. As indicated in this report, some countries have indeed increased the proportion of their national budget allocations to health. Steps are also being taken in a number of countries to stem the outflow of health and medical personnel, to create new personnel structures and to build capacity for better health service delivery. Besides increased emphasis on emergency obstetric and neonatal care, maternal death audits feature in annual operational plans. Health management information systems are improving and progressive policies on gender are in place. In some countries the Paris Declaration is operational, giving better scope for government ownership of the process. Progress may still be spotty, but for a continent coping with the disease, poverty and governance challenges that confront Africa, it is commendable.
In Mauritius Contraceptive prevalence is 75%; specialized obstetrics and gynaecological services are provided at first contact level (primary health care); and there is 1 midwife per 5,000 population.
Clearly, while countries must be commended for progress made they are urged to take further action to accelerate the implementation of the MPOA . The Continental Policy Framework on Sexual and Reproductive Health and Rights (SRHR), adopted at the 2nd Session of the AU Conference of Ministers of Health, which was held in Gaborone, Botswana, in 2005, was a call for the reduction of maternal and infant mortality in Africa (MDGs 4 and 5). In 2006, the Maputo Plan of Action (2007–2010) for the implementation of the Continental Policy Framework was adopted. These are closely linked to the Declaration and Plan of Action on Africa Fit for Children (2001), which also comprised Africa’s Common Position to the UN General Assembly Special Session on Children (2002).