They have to depend on scientists. And many of them gave advice and made decisions that benefited the pharmaceutical industry," says Wodarg. Over the years, similar trends in relationships between the WHO, the UN and specific businesses and organisations have emerged; some in the most unlikely and critical situations, including the Chernobyl disaster.
As the WHO allegedly played down the number of deaths as caused directly by and due to the aftereffects of the nuclear explosion, it had become clear that organisation was working closely with the International Atomic Energy Agency IAEA. And while the two organisations have, ultimately, two very different endeavours - once concerning global health and the other, the 'safe' use of atomic energy - not only Chernobyl, but also Fukushima were undersold in their levels of devastation.
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Humanitarian crises , South Sudan , Africa. Meet the man on a mission to take down Cambodia's timber tycoons and expose a rampant illegal cross-border trade. Asia Pacific , Interactive , Cambodia. In addition to the common problems that all WHO regions face there are a number of issues that are specific to particular regions. These problems, like those which all WHO regions face are rooted in a complicated web of economic capacity, health, culture and politics. One well-known example of a maternal health issue that exists almost entirely at a regional level is obstetric fistula in Africa .
Each WHO regional office believes that if the maternal health situation is to improve they must work to overcome these difficulties at a regional level.
This strategy was developed in response to requests from some of the 53 European Members States based on their needs . Consensus amongst the major stakeholders at African regional level to support countries over the next eleven years using this Road Map is a breakthrough in maternal and newborn mortality reduction efforts .
It is clear to see that the regional level of WHO plays a significant role in improving maternal health and in achieving MDG 5 not only because WHO regional offices are equipped to deal with problems that are specific to particular regions but also because they play an important role in coordinating international policy.
WHO regional offices are not merely concerned with issues that affect their own regions, they are also deeply involved with attempting to tailor regional solutions to global problems in the area of maternal health. WHO produces a range of literature designed to fulfil this normative function.
Some of it is technical in nature, designed largely as a teaching aid to those working in the field. An example of this type of literature is Care in Normal Birth: a practical guide which is a detailed and systematic guide to care providing information on such matters as diagnosing when labour has started, how to monitor the progress of labour, how to prevent prolonged labour etc .
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Other literature is directed at policymakers. An example of this form of literature is Standards for Maternal and Neonatal Care. This document discusses standards for maternal and newborn care. Each standard is presented in a uniform manner  and details the evidence and rationale used in developing the standard . WHO states that the purpose of this document is to help policymakers develop and implement policy at national, sub-national and facility levels for providing effective maternal and newborn health services and improve to the uptake of these services by communities .
Other documents are a combination of technical and policy considerations.
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The role WHO plays as an actor in maternal health is a complex one. Now that some insight as to how WHO functions in relation to maternal health has been gained it is possible to assess how effective it has been. Assessing the effectiveness of WHO in the area of maternal health is not as easy as it may first appear. This is the case for a number of reasons.
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First is the question of exactly how to measure the effectiveness of WHO. Second is the question of which level any assessment should focus on. These frameworks will both focus on WHO at an international level. The reason for this is simple, as a scholar of international relations the international level is the most relevant. These two approaches whilst by no means exhaustive serve to illustrate the difficulties in accurately assessing the performance of an organization as multidimensional as WHO. Put bluntly WHO will fail to achieve these targets. Data published in indicates that few low and middle income countries will achieve the 75 percent reduction in the maternal mortality ratio that the first target of MDG 5 demands .
Worse still, the African region has gone backwards with the maternal mortality ratio widening from deaths per , live births in to 1, deaths per , live births in . However there is still cause for cautious optimism. Though, at a regional level, none of the regions have achieved the yearly percentage decline in the maternal mortality ratio required to achieve the 75 percent target, some, most notably East Asia are close to doing so .
Moreover the global maternal mortality ratio is slowly declining . Another point of progress is the increase in number of births attended by a skilled assistant with the percentage of births attended worldwide increasing by 14 percent in the 16 year period from to Data related to the second MDG target of achieving universal reproductive health and its indicators is far more difficult to come by which in itself suggests that it is unlikely that this target will be met.
The available data indicates that some progress has been made particularly in the area of access to and use of contraception however this progress is patchy at both the international level and within states . Progress in this area, especially within states is tightly linked to socio-economic status and other markers of development .
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As noted above it is difficult, if not impossible to assess progress towards the achievement of any one of the eight MDGs in isolation. Progress or lack thereof in achieving any one of the eight goals has effects on progression towards achieving the others.
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This is especially true of MDG 5. Perhaps more than any of the other goals the achievement of MDG 5 will require progress towards achieving at least some of the targets and indicators of almost every other MDG. This is because the improvement of maternal health is so closely interlinked with other aspects of development. Improved education and gender equality will result in fewer pregnancies in the very young and fewer unwanted pregnancies among women of all ages . The boundaries of public health action have become blurred, extending into other sectors that influence health opportunities and outcomes.
WHO responds to these challenges using a six-point agenda. The six points address two health objectives, two strategic needs, and two operational approaches. The overall performance of WHO will be measured by the impact of its work on women's health and health in Africa. Promoting development 2. Fostering health security 3. Strengthening health systems 4. Harnessing research, information and evidence 5.
Enhancing partnerships 6. Improving performance The role of WHO in public health WHO fulfils its objectives through its core functions: providing leadership on matters critical to health and engaging in partnerships where joint action is needed; shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge; setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options; providing technical support, catalysing change, and building sustainable institutional capacity; and monitoring the health situation and assessing health trends.
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