USAIDIraq Delivering Vital Health Services and Strengthening the Iraqi Health System

1
USAID/Iraq Delivering Vital Health Services and
Strengthening the IraqiHealth System

• Presentation for the Mini University
• May 10, 2004

2
Impact of Recent History on Health in Iraq
Health status relatively good
Health status rapidly worsens
Health status gradually improves, but not to
pre-1991 levels
1980 1985 1990
1995 2000
2003
Year
3
Health Conditions Years of Neglect
2002 World Health Report, World Health
Organization 2002 World Population Data Sheet
and 2002 Women of Our World Data Sheet,
Population Reference Bureau 2001 Statistical
Overview of Newborn Health, Save the Children.
4
Health Status of Iraqis Prior to 3/03

• 70 of child deaths caused by acute respiratory
  infections and diarrheal disease.
• Only 30 of infants are exclusively breastfed
• 25 of babies have low-birth weight
• 60 of women are anemic
• Access to clean water is limited

UNICEF
5
Health Conditions - Years of neglect

• 0.72 per person for health care (1996)
• 17 suffered moderate to severe malnutrition
• Maternal Mortality 294/100,000

6
Iraqi Health Resources

• Highly focused on tertiary care
• 53 physicians per 100,000 people
• 44 nurses per 100,000 people
• Facilities
• 282 Hospitals (with approx. 28,000 beds)
• Approximately 1,600 Primary Health Centers
• Approx. 2800 Nutritional Rehabilitation Centers

7
USAID Programming- Start Up

• Planning began in fall 2002
• Grantees on the ground - April 2003
• USAID Mission opened in Baghdad July 2003
• Funding for health programs first 12 months
• approximately 129 million

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USAID Programming First 12 Months

• Humanitarian Assistance
• 74.9 million
• Reconstruction
• 53.9 million

9
Results of Humanitarian Assistance

• Projects were in every governorate of Iraq.
  Examples include
• Over 200 compact water treatment units and 7
  water plants
• Over 100 hospital and clinics rehabilitated
• More than 2,000 health care professionals trained

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USAID Health ReconstructionMarch 2003-April 2004

• Contract to Abt Associates for 20.9 million
• Equip and train staff in 600 PHC
• Technical assistance to the MOH for policy
  development, financial systems, logistics
• Small grants program
• Grant to UNICEF for 36.7 million
• Immunizations
• Water and Sanitation
• ORS
• Grant to WHO for 10 million
• Donor Coordination and national health strategy
  development
• Laboratories rehabilitated

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UNICEF( 36.7 million grant)

• UNICEF has had continuous presence
• More than 3 million vaccines administered
• ORS distributed to treat diarrhea
• More than 325 metric tons of high protein
  biscuits distributed to malnourished children and
  breastfeeding mothers
• Over 8000 health workers undergoing training
• 20 delivery rooms in hospitals and primary health
  care centers rehabilitated

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Abt Associates( 20.9 million contract)

• Focus on 3 key areas
• Training and re-equipping 600 PHC facilities
• Health Facilities data base
• Health policy systems development with MOH and CPA

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WHO(10 million grant)

• National Strategy process assisted
• OFF drug transition accomplished
• National laboratories rehabilitated
• Polio Laboratory completely functional

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Health Progress

• RESTORING AND PROVIDING HEALTH SERVICES
• More than 240,000 pregnant, nursing mothers and
  malnourished children under 5 years have received
  2.5 kg of high protein rations.
• 70 of children have been immunized

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USAID Approach for Phase II

• Focus on Maternal and Child Health through
• Capacity building of the MOH
• Technical advisors- finance, logistics, policy
  and support to the MOH working groups
• Human resources capacity building
• Nursing, family practice medical specialty,
  public health and management