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The views expressed in this presentation are the views of the author and do not necessarily reflect the

views or policies of the Asian


Development Bank Institute (ADBI), the Asian Development Bank (ADB), its Board of Directors, or the governments they represent. ADBI
does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequences of their use. Terminology
used may not necessarily be consistent with ADB official terms.

Gender Dimension in Health &


Sustainable Development Goals
in Lao PDR
25-26 March 2019
Ewha Women’s University Republic of Korea
Founkham Rattanavong, DDG, Department of Planning & Cooperation,
MOH, Lao PDR
Outlines

 Country Profile and Health


Situation
 Health Related to Women’s Sexual
and Reproductive Health
 Challenges/Problem & Innovative
Strategies
Country Profile & Indicators, 2018
- Population: 6.5 million
- Areas: 236.800 km2
- Provinces: 18
- Districts: 148
- Villages: 8.500
- Central Hosp.: 5
- Provincial Hosp.: 17
- District Hosp.: 131
- Health Centre: 1.060
- Underweight: 21.1%
- Stunting: 33%
- M M R: 206/100.000
- I M R (<1): 40/1.000
- I M R (<5): 46/1000
- S B A: 64.4%
- Immunization Rate: 85%
- Clean Water Utilization: 83.9%
- Latrine Utilization Rate: 73.8%
- Health Insurance Coverage:75%
Nutrition Status Comparison
Infant Mortality Status
Family Planning on Reproductive
ANC - 4 or More Visits to any Provider
(%) by Wealth Quintile
(%)
100
90
90
83 83
2011/12
80
68
70 2017 62
60 57
54
50
41
40 37
32
30
19
20
9
10

0
Poorest Second Middle Fourth Richest Average
Skilled Birth Attendance Rate (%)
by Wealth Quintile
(%)
100 97
91
90 87
2011/12
80
72
70 2017 64 64
60
51
50 45
42
40
33
30 24
20
11
10

0
Poorest Second Middle Fourth Richest Average
Skilled Birth Attendance Rate (%)
by Mother’s Education
(%)
100
90 91 93 98
90 86 87
80 2011/12 75
70 64 64
60 2017 57
50
42
40 36 35
30

20 16
10

0
None Primary Lower Upper Post Higher Average
secondary secondary secondary
non tertiary
Skilled Birth Attendance Rate (%)
by Ethnicity
(%)
100
90
2011/12
80
78
2017
70
59
60 53
50
48 46 43
40
30
21 18 18
20
10
0
Lao-Thai Mon-Khmer Hmong-Mien Chinese-Tibetan Other, DK, Missing
Skilled Birth Attendance Rate (%)
by Residence
(%)
100
90
90 2011/12
80 Breakdown
80
2017 with/without road
70
59
60 55
50

40 34
31 33
30

20
12
10

0
Urban Rural Rural with road Rural without
road
Challenges/Problems, Innovative Strategy in Health to
Achieve Gender Equality & Empower all Women & Girls

1. Health network is covered but high MCH mortality and malnutrition are
linked to quality of services, poverty, culture, parents or mother
education, etc.
2. Health accessibility and affordability are still facing especially in
remote and ethnic group areas
3. Culture barrier including gender inequality, behavior, adolescent
married and languages (IEC)
4. Free delivery and <5 treatment policy implementation to increase
health accessibility and affordability (HSR)
5. National Strategy and Action Plan for Integrated Services on
Reproductive, Maternal, Newborn and Child Health (2016-2025) to
reduce MMR/IMR and malnutrition
6. Gender Equality on Mother and Child Health Services Strategy (2019-
2025) to increase opportunity for empowerment and promotion with at
least 1 female at health center (GAP)
Fewer Female on high Qualification & Positions

Qualificati Position
No. Total Female % No. Total Female %
on levels levels

1 Ph.D level 102 32 31% Minister


1 3 0 0%
level

Master
2 1012 415 41%
level
Departmen
2 90 17 19.5%
t level
Diploma
3 3.754 2.138 57%
level

4 High level 2.905 1.750 60% Division


3 1.352 460 34%
level

Mid &
5 Basic 12.427 8.747 70%
4 Unit level 2.734 1.624 59%
levels
MCH Services At Facility Levels
Neo-Natal Mortality in ASEAN

No. Country Neo-Natal Mortality

1 Brunei 4.4
2 Cambodia 16.2
3 Indonesia 13.7
4 Lao PDR 28.7
5 Malaysia 4.4
6 Myanmar 24.5
7 Philippines 12.6
8 Singapore 1.1
9 Thailand 7.3
10 Timor-Leste 21.6
11 Vietnam 11.5
Source: WHO, World Health Statistics 2018, Monitoring Health For the SDGs
Maternal Mortality Ratio
1200
Cambodia
China
1000 1020
Lao PDR
905
Papua New Guinea
800
730 Philippines
695 Solomon Islands
600 546 Viet Nam

470 484
400 418
364 377
342 315
273 277 294 215 206*
214 238
200 197
139
152 122 164 136 161
124 127 129
107 81 114
97 61 58
72 58 48 35 27
0

Data source: Trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA,
The World Bank and the UN Population Division, WHO 2015 *Census 2015: MMR 206 as the baseline for the future
Main Causes & Factors to Maternal Mortality

Haemorrage,
Other 25%
Indirect, 20%

ANC?

Other Direct,
8% Sepsis,
14%

Abortion,
13%

Eclampsia,
Obstructed
13%
Labor, 7%
Females on Health Programs
Health is wealth, no gender maybe no health and sustainability!

Thank you very much for your attention!