Closing the Gap; Millennium Development Goals 8,7,6,5,4,3,2,1

By Victoria Melhado, Women Deliver 100 Young Leader

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”

-Margaret Mead

Today, I say proudly that nurses are changing the world.

In 2000, the United Nations adopted the Millennium Declaration, which laid out the framework for the Millennium Development Goals (MDGs). The eight MDGs take a holistic approach to poverty reduction, covering education, gender equality, health, environmental sustainability and the need for a global partnership to facilitate the realization of these goals.

Without tackling all these angles simultaneously, sustainable reductions in poverty cannot be achieved.  Hence, the MDGs indicate a “people-centered” approach to development. A timeframe was also postulated for their accomplishment by the year 2015; yet the world has also begun to discuss the post-2015 agenda, also known as the Sustainable Development Goals (SDGs).

Three goals in particular are specifically related to health: MDG 4 (reduce child mortality) MDG 5 (improve maternal health), and MDG 6 (combat HIV/AIDS, malaria and other diseases). There has been measurable progress in each of these areas both globally and in Jamaica. However, challenges remain.

The World Bank 2013 report shows that maternal mortality in Jamaica remains high, at 110 per 100,000 births. Adolescent birth rates also remain consistently high at 71.2%. This data tells us that more nurses must engage in scientific research to unveil evidence and must take action on the preventable contributory factors which we encounter firsthand.  Midwives in primary and secondary care often encounter young mothers with frequent pregnancies before age 25, high levels of non-compliance to prenatal clinics and postnatal follow-up, and many excuses for avoiding family planning and planned parenthood.

Nurses, we must become more vigilant. Husbands and partners, you must empower the females in your lives to plan their families and practice responsible parenting.  Our children are our responsibility first; thereafter everyone else in the village can assist to raise each child well.

We must hold our government and health ministry responsible to provide the necessary physical resources and equipment to work with, such as ultrasound and cardiotocograph machines and sphygmomanometers.  Governments must find strategic ways to improve frontline healthworkers’ environments, boost morale, ensure stability of tenure, and provide a decent standard of living, especially for Jamaican nurses who often must innovate and improvise with the limited resources and machinery available. Then, and only then, will we begin to see a significant decrease in the number of mothers and teenagers who die from complications surrounding a pregnancy.

To close the gap and successfully achieve the MDGs, I believe that Jamaica should embrace some applicable strategies outlined in the 2012 Women Deliver Report on Regional Consultations:

• Health services need to be integrated, because women lack the time and resources to visit multiple service providers for their health care needs. “One-stop shops” are proven to save time and money, increase quality and help address underlying causes of maternal mortality.
• Greater focus is needed increasing access and diversity in family planning services.  Family planning is a proven lifesaving solution, with the potential to decrease unintended pregnancies by more than two-thirds and avert 70% of maternal deaths. Access to affordable, stigma-free family planning information and services should be made available to all.  We also need to expand access to contraception among young people.
• Youth engagement is critical because adolescent girls have the highest rate of unmet need for modern contraception. Health services should therefore ensure youth accessibility and youth should be free from discrimination when they attempt to access care.
• Strong partnerships and adequate funding is essential. Forming multisectoral partnerships is key to tackling maternal deaths holistically. Providing access to family planning and quality health services depends on adequate and sustainable funding.  “It takes cash to care” is an indigenous expression that is true in every regard.
• Greater political will is crucial to completing the unfinished agendas of the ICPD Programme of Action, the Beijing Platform for Action, the MDGs, SDGs and all other human rights treaties.

The International Council of Nurses (ICN) recognizes that for the world to truly "close the gap" in several areas of deficiency in the health delivery system, we must, as an international health vanguard, place greater emphasis on the MDGs, especially the health-related goals. National nurses associations, like the Nurses Association of Jamaica along with ICN, also recognize the critical role that nurses play as the mitochondrion of the health delivery system.  Hence, nurses must lead the way forward in reducing child mortality (MDG 4), improving maternal health (MDG 5) and implementing creative and innovative primary and secondary care strategies to reduce the transmission of HIV (MDG 6).

We must remain united as we close the gap to achieving our goals with our Jamaican people and with the global community.