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Health Research Policy and Systems

, 8:5

First Online: 12 February 2010Received: 10 July 2009Accepted: 12 February 2010DOI: 10.1186-1478-4505-8-5

Cite this article as: Cattaneo, A., Gafurov, I., Bomestar, T. et al. Health Res Policy Sys 2010 8: 5. doi:10.1186-1478-4505-8-5


Data on under five mortality in the twelve countries of the Commonwealth of Independent States show important fluctuations over time due to variations in quality of data, definitions of neonatal deaths and methods of mortality estimation. Despite the uncertainties regarding mortality trends, the analysis of health and social information from different sources offers clues to identify priority areas and key strategic directions for accelerating the achievement of the 4 Millennium Development Goal. Neonatal deaths represent from 40% to over 50% of under five deaths in all these countries. Maternal mortality was above 50 per 100,000 in 2005, despite the good coverage with antenatal care and births assisted by skilled birth attendants. The scanty information on quality of perinatal care indicates widespread substandard care at all levels. Stunting in children under five is above 10% in ten out of twelve countries and coexists with emerging overweight. Exclusivity and duration of breastfeeding fall short of what is recommended. There are important inequalities in child and maternal mortality, malnutrition and access and use of health services within countries. Taken as a whole, the available information clearly indicates that priority should be given to improvement of the health of women in reproductive age and of the quality of perinatal care, including the establishment of reliable data collection systems. To achieve this, action will need to focus on strengthening the capacity of the health system to improve the technical content of service provision, and on improving access and appropriate use of services by the most disadvantaged groups. The involvement of other sectors will be necessary to improve reproductive health and nutrition at community level and to tackle inequity. Comparisons between countries with similar socioeconomic background but different health policies seem to indicate that gradual progression towards universal coverage with essential health care through a national health insurance system is associated with larger reduction of child mortality than troubled transition towards a privatized and unregulated health system.

Adriano Cattaneo, Ilkhom Gafurov, Tamara Bomestar, Marianna Bacci, Sanjiv Kumar, Dragoslav Popovic and Giorgio Tamburlini contributed equally to this work.

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Author: Adriano Cattaneo - Ilkhom Gafurov - Tamara Bomestar - Marianna Bacci - Sanjiv Kumar - Dragoslav Popovic - Giorgio Tamburlin



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