(d) National Perinatal Programme

2. Perinatal and pre school developmental programmes

Certain conditions originating in the perinatal period

(a) The antenatal, perinatal and post natal periods.

306. The National Perinatal Programme introduced in 1990 has four components

(1) National Commission to Combat Maternal and Perinatal Mortality (Executive Decree No. 116 2000)

The neonatal or perinatal mortality rate is 30 per cent higher for boys than for girls.

In 2001, the incidence of infant deaths caused by perinatal problems increased for the first time since 1995.

Deaths from arteriosclerosis as a simple condition and from certain conditions originating in the perinatal period have decreased.

In addition, perinatal (pre delivery) diagnostics and preventive measures for hereditary and congenital diseases in children are to be improved.

425. The heterosexualization of HIV AIDS propagation in Peru is also reflected in a slow but steady trend towards perinatal transmission.

AIDS cases occur in girls aged less than five chiefly as a result of perinatal transmission and transmission through the bloodstream.

Primary prevention approaches include public awareness campaigns, perinatal and pre school developmental interventions, in school education, youth programmes and drug testing.

Primary prevention approaches include public awareness campaigns, perinatal and pre school developmental interventions, in school education, youth programmes and drug testing.

Care during pregnancy, confinement and the post natal period by traditional trained midwives. In order to continue to improve the quality of antenatal care in rural areas and reduce maternal mortality, the training of traditional midwives is continuing. During 1995, trained midwives provided perinatal care in 279,335 cases. Perinatal health

In this context, it is especially gratified to note the exceptionally low infant and perinatal mortality rates attained by the Czech Republic.

In addition, hospital care is provided to pregnant women by 34 maternity centres, 11 perinatal centres, and 156 maternity departments in central rayon hospitals.

They included a) conditions that originated during the perinatal period b) acute respiratory infections (ARI) c) acute diarrhoeal diseases (ADD) and d) nutritional deficiencies.

Perinatal programmes involve interventions focused upon pregnant women and neonates that are designed to reduce illicit drug use among the children concerned many years later.

The Ministry of Health is implementing a plan of action to reduce maternal and perinatal mortality and a plan to promote the comprehensive health of women.

The leading causes of infant deaths are perinatal disorders, low birth weight, birth asphyxia birth trauma, diseases of the respiratory system, parasitic diseases and intestinal infections.

Perinatal and pre school programmes designed to target specific risk factors have recently been promoted as a means of reducing illicit demand among children later in life.

Diarrhoea is now a major cause of child mortality, and perinatal mortality in women has increased as a result of malnutrition and the collapse of health care.

Such programmes seldom empower women to prevent perinatal transmission by pre natal prevention education and an available choice of health services and overlook the care needs of women.

Both in the structure of morbidity and the structure of mortality for children, the main causes are infectious parasitic diseases, respiratory illnesses and conditions arising in the perinatal period.

At present the Ministry of Health, with international assistance, is implementing an action plan to reduce maternal and perinatal mortality and a plan to promote the comprehensive health of women.

286. There is currently a National Committee for the Study of Maternal and Perinatal Mortality, as well as equivalent committees in each federal entity, which provide epidemiological and operative care.

308. The Programme seeks to reduce maternal and perinatal mortality and morbidity and prevent children from being born with disabilities as a result of an ailment occurring during pregnancy, confinement or post partum.

The Shared Paths project is forming technical advisory committees in four priority areas identified by the members of the working group mental health and addictions, perinatal and infant health, chronic disease, and oral health.

For some programmes, such as the ones on AIDS, rabies, diarrhoea among children, perinatal services, etc., a specific education strategy is implemented in close collaboration with the health partners and using a multiplier approach.

In 2001, 41.5 of infant mortalities were caused by perinatal pathologies, 34.5 by inborn anomalies, 5.1 by injuries, poisoning and other external factors, 2.3 by infectious and parasitic diseases, and 3.2 by respiratory system diseases.

138. It has programmes aimed at maternal and child health (perinatal and maternal and child health) family planning programmes development programmes on women, health and development and programmes on the health of schoolchildren and adolescents.

Aboriginal and Torres Strait Islander women are 1.4 times more likely than non indigenous women to visit hospital for pregnancy and childbirth related issues, experiencing higher rates of perinatal mortality and adverse maternal outcomes, including death.

It should be pointed out in this same paragraph, which states that the perinatal death rate is still high, that this is the case mainly in rural areas and on the fringes of the big towns.

When we compare these indicators to data from 2000, we find that the proportion of deaths caused by perinatal pathologies continues to decline, while infant deaths from inborn anomalies, infectious and parasitic diseases and respiratory problems has increased.

210. Conditions originating in the perinatal period are responsible for 50 per cent of child deaths and are the leading cause of death not only in the first year of life, but up to the age of 10.

States parties are urged to take all possible measures to improve perinatal care for mothers and babies, reduce infant and child mortality, and create conditions that promote the well being of all young children during this critical phase of their lives.

If the purpose of testing pregnant women is not only to prevent perinatal HIV transmission but also to enable women to care for their own health, all women should be offered voluntary counselling and testing (VCT), preferably before they become pregnant.

Services should include the following high quality options antenatal, perinatal and post natal care, when requested, both for woman and baby post abortion care and measures to ensure women's access to safe, legal abortions when requested and safe sterilization, again only when requested.

While improvements in perinatal services and pre school education may be meritorious, the mechanism through which illicit drug use in adolescence or later is prevented is weak because of the influence of a vast array of mediating variables in the intervening years.

Women should be provided with accurate information about the risk of perinatal transmission to support them in making voluntary, informed choices about reproduction. The chance of a woman living with HIV giving birth to an HIV positive baby is approximately 1 in 3.

Ms. Coker Appiah expressed fear that the provision of early detection cervical and uterine cancer services under the Maternal and Perinatal Care subprogramme might exclude women beyond childbearing years or women who had no children (CEDAW PSWG 2004 II CRP.2 Add.1, response to question 29).

Lastly, the mortality rates are higher for children with low birth weight (falling from 65 for small babies to 24 for average sized or big ones) and for mothers receiving no perinatal or delivery care (falling from 54 to 22 for mothers who do receive such care).

The rate of infantile mortality is still high, that's 135 deaths per 1000 living births, and the index of perinatal mortality, that is delayed loss of pregnancy, stillbirths or deaths in the first week of birth, reaches 70 per 100 births, or approximately 01 woman out of 13.

(a) An integrated approach would include interventions that impact indirectly on parents' ability to promote the best interests of children (e.g. taxation and benefits, adequate housing, working hours) as well as those that have more immediate consequences (e.g. perinatal health services for mother and baby, parent education, home visitors)