• Maternal mortality ratio: 84 deaths per 100000 live births according to the Iraq Family Health Survey (IFHS 2006/7)
• Total fertility rate: 4.9% according to the Ministry of Health (MoH 2006 and MICS 4 2011)
• Percentage of caesarean sections of all deliveries: 21% (MoH 2009)

Improvement of women’s health is clearly articulated in 2009-2013 Strategic Plan of the Iraqi Ministry of Health. Also, the National Development Strategy and the MDGs have enunciated that women and children have the right to universal access to health services, education, nutrition, and shelter. The reproductive health services in Iraq deteriorated severely immediately after 2003 conflict, but since then have made a gradual recovery. Still the access to reliable data on reproductive health remains somewhat limited.Iraqi doctor providing treatment for Iraqi baby

Maternal Mortality Ratio (MMR) remains significantly higher than those for neighboring countries. MMR stands at 84 per 100,000 live births (IFHS 2006/7). Maternal Mortality Ratio during the last 5 years prior to 2006 estimated to be 47 per 100,000 live births.  The reason for high MMR are; poor birth practices, inadequate referral and emergency obstetric care, and a high level of anemia among pregnant women (35%),[1] especially among rural women in the center/south of Iraq. One in four delivering women faces serious complications during pregnancy.[2] About 1 in 15 adult female deaths can be attributed to maternal mortality. The strengthening maternal mortality surveillance is an urgent need.[3] Of all maternal deaths, 80% can be potentially avoided by interventions during pregnancy, childbirth and the postpartum period, that are feasible in most countries.

Currently, Iraqi population pyramid presents a broad-based youthful age composition, with 43% under the age of 15. Marriages at a young age are prevalent in some parts of Iraq though ( before age of 18 years is 2.4.2 % MICS -4,2011 ) though fertility rates have decreased in the past decade. Iraq, with Total Fertility Rate (TFR) of 4.9(MICS-4,2011), remains among the high fertility countries in the world.  To increase access to reproductive health care, these services have been integrated into BHSP at PHCCs.  The care includes; pre-marital testing and counselling, antenatal care post-natal care, family planning, adolescent health, early detection of breast and cervical, cancer, infertility, menopause, etc.  Improvement of woman and family health is a major goal of new PHC package and it calls for the necessary capacity building, development of required facilities, equipment, supplies as well as raising community awareness.

It is reported that 32% of births occur outside health institutions, with 22% of deliveries are at high risk and need advanced medical support. Therefore it is a priority to ensure safe delivery at all levels (community, primary, secondary and tertiary) through strengthening the antenatal care quality services, increasing access to quality basic and emergency obstetric and newborn cares and improving skills of birth attendants. Provision of such cares entail capacity building and upgrading skills, strengthening of

referral system, revision of rules and regulations, provision of supplies and equipments, community awareness (MoH 2009).

Preventing malnutrition is a critical component of achieving the MDG’s[1] by 2015 through Breast Feeding promotion, proper feeding practices, growth monitoring of children under 5 and expansion of Baby Friendly Hospital Initiative. Also, early detection of congenital birth defect is an emerging issue that requires building staff capacities, surveillance system and supplies & equipment in order to cope with it.

Achievements of 2010 -2011

• Review and finalizing the National Maternal, Child and Reproductive health strategy with a plan of action for 2012 – 2015 jointly with UNFPA and UNICEF.
• Launching of the results of the Assessment of Newborn Care Services in 126 Hospitals( Maternity, child and general  hospitals) conducted in 2009
• Implementation of Confidential enquiry into maternal deaths as part of Maternal surveillance system in all governorates.
• Training of trainers (ToT) workshop on best practices and family planning and reproductive health counseling.
• Capacity building of health professionals on the Integrated Management of Pregnancy and Childbirth (IMPAC).
• Adaptation of the WHO guidelines on pregnancy, Childbirth, Postpartum and newborn care (PCPNC) and family planning (adaptation in process)
• Integrated Management of Child Health (IMCI), including both preventive and curative elements for children under 5 years, accurate identification of childhood illnesses, combined treatment of all major illnesses, counseling of caretakers, and speeding up the referral of severely ill children has been implemented as a pilot in 8 governorates
• Expanded programme of Immunization (addition of 2 vaccine in the national EPI Schedule in 2011)
• Implementation of the Infant and Young Child Feeding (IYCF)strategy and Baby Friendly Hospitals Initiativess

 

 Integrated Management of Newborn & Childhood Illness (IMNCI)

• Neonatal mortality ratio: 23 deaths per 100000 live births (IFHS 2006/7)
• Infant mortality rate: 32.9 deaths per 1000 live births (MICS-3/2011)
• Newborn children who are of low birth weight: 14% (MICS-3/2006)
• Under-5 mortality rate: 37.9 deaths per 1000 live births  (MICS-3/2011)
  

Neonatal mortality has been declining worldwide. Despite progress and improvements in many areas, the rates of maternal and child mortality in Iraq are still considerably higher than those seen in neighbouring countries of the region.

Improvement of child health is clearly articulated in the 2009 – 2013 strategic plan of the Ministry of Health of Iraq. In addition, the Iraq National Development Plan 2010-2014 and the Millennium Development Goals (MDGs) enshrine the principle that children have the right to universal access to health services, education, nutrition and shelter.The total number of provinces implementing IMCI is 14 in 55 districts and 360 primary health care centers.

Adolescent Health

• Proportion of youths and adolescents (10-24 years of age) among the general population: more than 20% (2005 Youth Survey)
• Proportion of youths and adolescents (10-24 years of age) who are in the workforce: 16.1% (2005 Youth Survey)

Adolescents (aged 10 to 24 years of age) have specific health and development needs, and many face challenges that hinder their well-being, including poverty, a lack of access to health information and services, and unsafe environments. Interventions that address their needs can save lives and foster a new generation of productive adults who can help their communities progress.