2014年-世界发展银行全球_Maldives___Maternal_and_Reproductive_Health_at_a_Glance_4页_1mb

报告摘要

Maldives: Maternal and Reproductive Health at a Glance

Core Content

Maldives is a middle-income country that has made significant progress in improving maternal health and has achieved the Millennium Development Goal (MDG) 5. Despite this, challenges such as gender gaps and unmet family planning needs persist.

Key Messages

Maldives is on track to meet most MDGs, including maternal health.
The country has achieved MDG 5, with a maternal mortality ratio (MMR) of 31 per 100,000 live births in 2013, down from 430 in 1990.
The total fertility rate (TFR) declined from 6.1 in 1990 to 2.3 in 2012.
Contraceptive use has increased, but unmet need remains at 28.1 percent.
Skilled birth attendance (SBA) is high at 94.8 percent.
Access to maternal health services is relatively equitable by residence and wealth quintile, though geographical access remains a challenge.
Unwanted pregnancies among young women are on the rise.

Country Context

Maldives consists of 1,192 small tropical islands with a strategic location along shipping routes.
It has transitioned from one of the world's poorest countries to a middle-income nation with a GNI per capita of over $7,177.
The population has grown from 156,000 in the early 1980s to over 326,000.
Approximately 9 percent of the population lives below the poverty line (US$1.25 per day), and youth unemployment is high.

MDG 5 Status

Maldives has achieved MDG 5, which aimed to reduce maternal mortality by three-quarters between 1990 and 2015.
The MMR declined from 430 in 1990 to 31 in 2013, with an average annual decline of 10.8 percent.
The country is classified as "on track" for achieving MDG 5, indicating a decline of at least 5.5 percent annually.

Fertility Trends

Fertility rates have declined over the past two decades, from 6.1 in 1990 to 2.3 in 2012.
Contraceptive prevalence rate (CPR) increased from 29 percent in 1991 to 34.7 percent in 2009.
Modern contraceptive methods are the primary choice, with female sterilization, male condoms, and the pill being the most common.
Unmet need for family planning remains at 28.1 percent.
Early childbearing is not a major issue in Maldives, with the median age at first marriage being 19 and first birth being 21.2 among women aged 25-49.

Pregnancy Outcomes

Complete and timely antenatal care (ANC) is essential for positive pregnancy outcomes.
In 2009, 99.2 percent of women sought ANC from skilled providers, with 85.1 percent receiving four or more visits.
Blood pressure measurement during ANC is nearly universal, with 99.6 percent of women having it done.
SBA is high, with 94.8 percent of births attended by skilled providers in 2009.
Postnatal care within the first two days of delivery is provided by 67.1 percent of women.

Equity in Access to Maternal Health Services

Access to maternal health services is relatively equitable across residence and wealth quintiles.
CPR shows minimal variation, with only a 2 percentage point difference between rural and urban areas.
SBA is also fairly equitable, with a 6 percentage point difference between urban and rural areas, which is negligible given the high overall rate.
There is a larger gap in SBA across wealth quintiles, with 88.6 percent of the poorest quintile having SBA compared to 99.3 percent of the richest.

Adolescent and Sexual Health

Nearly half of the population is under 25, making youth health a critical focus.
3.2 percent of unmarried women and 9.8 percent of unmarried men aged 15-24 have had sexual intercourse.
Limited knowledge and access to reproductive health information among youth is a concern.
Unwanted pregnancies are a growing issue, particularly among young women aged 18-24.

Key Strategies to Improve Maternal and Reproductive Health Outcomes

Addressing youth/adolescent health needs: Interventions include the Youth Health Strategy, standards for adolescent-friendly health services, and life skills education in schools.
Improving quality of RMNCH services: The government has implemented guidelines, standards, and interventions to reduce stockouts of life-saving medicines and improve counseling quality.
Increasing utilization of peripheral health services: Upgrading atoll hospitals with comprehensive EmONC facilities, ensuring availability of medicines and equipment, and mapping health facilities to understand service utilization are ongoing efforts.
Strengthening health system linkages: Linking reproductive health (RH) and family planning (FP) services is a priority.

References

World Bank. World Development Indicators 2014: Accessed 19 May 2014
Maldives: Country Program Snapshot. March 2014, the World Bank
UNDP. 2013 Human Development Report Gender Inequality Index
WHO, UNICEF, UNFPA and The World Bank. 2014. Trends in Maternal Mortality: 1990 to 2013: World Health Organization
Ministry of Health and Family (MOHF) [Maldives] and ICF Macro. 2010. Maldives Demographic and Health Survey 2009. Calverton, Maryland: MOHF and ICF Macro.
UNFPA. Reproductive Health Knowledge and Behavior of Young Unmarried Women in the Maldives. UNFPA; Malé, Maldives. September 2011.

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