Assessment : Aspiration 4


By 2020, States -

  • should have reduced by one-third premature mortality from non-communicable diseases through prevention and treatment and promoted mental health and wellbeing;
  • should have ensured universal access to sexual and reproductive health-care services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes;
  • should have achieved universal health coverage, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all;
  • should have achieved the immunisation against measles and polio of all infants; and should strengthen the health care system to allow for effective routine immunisation of all children for all major diseases, in line with the Global Vaccine Action Plan (GVAP) 2011-2020; should, in line with the Immunisation Declaration, have achieved the GVAP target of at least 90 per cent national coverage and at least 80 per cent coverage in every district for all nationally-available vaccines.
  • should have ended preventable deaths of newborn children and children under five years of age;
  • should have put in place programmes to educate and sensitise parents to enable and capacitate them to take care of their newborn children;
  • should have achieved the goal of providing anti-retroviral medicines to at least 90 per cent of pregnant women living with HIV;
  • should have eliminated new HIV infections among children by 90 per cent, and have achieved a reduction in the number of AIDS-related maternal deaths by 50 per cent;
  • should have improved programmes to ensure a sustained reduction in HIV prevalence and incidence among adolescents;
  • should have improved programmes to strengthen basic health care systems in order to provide quality maternal and child health services;
  • should have developed health centres and hospitals dedicated to children, and should have ensured that all health centres and hospitals are child friendly;
  • should have provided all children living with HIV with anti-retroviral treatment;
  • should have prioritised the treatment and prevention of HIV, tuberculosis, malaria, pneumonia and diarrhea, so as to reduce under-5 mortality;
  • should have improved a minimum package of proven childhood interventions based on successful strategies such as Accelerated Child Survival and Development (ACSD) and Integrated Management of Childhood and Neonatal Illnesses (IMNCI) as part of national health policies and plans, poverty reduction strategies and health sector reforms;
  • should have made insecticide-treated nets available to all
  • children under five in malaria-endemic areas;
  • should have reduced the maternal mortality rate in their countries to below at least 500 per 100 000 live births;
  • should have improved access of women to attending antenatal care, resulting in a significant increase in the percentage of women attending antenatal care;
  • should have increased the number and accessibility of birth attendants and should have sensitised communities to the benefits of birth attendants, so as to achieve a significant increase in the number of pregnant mothers who are attended to by health care workers during birth;
  • should have allocated at least 15 per cent of the national budget to health, in line with the Abuja and Dakar budgetary targets;
  • should have set up a fully-functional health infrastructure equipped to deal with children’s health concerns; States should ensure that the health infrastructure is able to effectively respond to emergency situations such as the outbreak of Ebola in Guinea, Liberia and Sierra Leone;
  • should be supporting communities, particularly by improving the conditions giving rise to disease.Ministries of Health should play a leadership role in co-ordinating multi- sectoral and multidisciplinary interventions to address the social determinants of health. The responsibility for action with respect to health should rest with the highest level of government.

By 2020, the African Union -

  • political organs should have reinvigorated their political commitment to maternal mortality, in line with the AU’s Campaign on Accelerated Reduction of Maternal Mortality (CARMMA), and should have embarked on a continental campaign for the dramatic decrease in infant mortality; political organs should have targeted countries with a maternal mortality rate of more than 500 (Sierra Leone (1 100); Chad (980); Central African Republic (880); Somalia (850); Burundi (740); DRC (730); South Sudan (730); Côte d’Ivoire (720); Guinea (650); Liberia (640); Niger (630); Cameroon (590); Guinea-Bissau (560); Nigeria (560); Mali (550); and Malawi (510)), to assist them to significantly reduce the maternal mortality rate in their countries;
  • should have put a clear strategy in place for responding to health emergencies such as the outbreak of Ebola in West Africa;
  • should have facilitated a common African position on the migration of health professionals and led engagement with Organisation for Economic Co-operation and Development (OECD) countries to overcome the devastating impact this migration is having on Africa’s health systems.