1. Understand context in which the Millennium Development Goals were developed
   1. development has gone for ages
      1. despite all the money going into development, things aren't getting better
         1. health/economics not improving dramatically
            1. culture of dependence
         2. but can't ignore it..
         3. Group of governments got together to discuss what key things needs to be done to CHANGE global health
         4. late 1990s when people were optimistic (no recession) and thought resources and money was readily available
         5. MDG wants the countries themselves to self-assess and improve on their own
         6. downside
            1. what is poverty
            2. not have economic wealth but have wealth in resources and culture
            3. => REJECTED
            4. view that money will solve everything
            5. "LOOK AT SCOTLAND"
            6. poverty = LACK OF MONEY
            7. countries invest a lot in cities but not rural areas
            8. implication for health in different areas
2. 8 Goals
   1. Describe
      1. Goals not linear, interconnected and therefore a circle.
      2. lots of time wasted on trying to roll out the programmes
      3. lots of groups trying to implement these 8 goals
      4. goals not about nursing or medicines
         1. food/water security
         2. women's status in society
         3. education
         4. overlooked in relation to health but actually very important
   2. Their Indicators
   3. Actions taken to deliver them
   4. :
      1. End poverty and hunger
         1. living below $1.25 a day
            1. people can't live on this!
         2. tobacco industry is taking over
            1. offering benefits to poor farmers to increase profit
         3. microfinance
            1. banks that encourage small businesses for women
            2. no deposit
         4. What needs to be done
            1. Establish Safety nets
            2. Enhance food security and reduce trade distortions
      2. Universal Education
         1. Gender inequality
         2. Problems with access
            1. school fees
            2. not enough schools, teachers or resources
            3. quality of education decreased
            4. vicious circle... ( those who have low quality of education teaching low quality of education and etc.)
      3. Improve Maternal mortality
         1. Childbirth
            1. Natural but very dangerous
         2. Africa
         3. We have the capability and should be able to do this without much difficulty
         4. getting enough trained officers who knows what to do
            1. government said it didn't work
         5. STRATEGIES
            1. access to ante-natal care during pregnancy
            2. skilled care during childbirth
            3. care and support in the week's following childbirth
            4. specific interventions
            5. haemorrhage
            6. eclampsia
            7. obstructed labour
            8. unsafe abortion
            9. often where abortion is illegal
            10. not very difficult to do, primary/secondary healthcare
            11. need to provide access to reproductive healthcare
            12. protect poor families from unaffordable maternity care
            13. trap for poverty
            14. postpone first pregnancy
            15. tackle non-medical barriers
            16. such as transport, culture
            17. quite a lot of care before childbirth for mothers but not enough after because child became priority and mother ignored.
3. Reasons why goals will not be met in many countries
   1. DELAYS
      1. in making decision to seek care
         1. women not often having permission from family (man) to seek healthcare
         2. not enough education
      2. in reaching an appropriate obstetric facility
         1. lack of TRANSPORT
      3. in receiving appropriate care once at the facility guided this project
         1. staff might not be there, lacking in resources
4. Etc
   1. HIV/AIDS
      1. huge investment into reducing HIV
         1. so much that other healthcare was not much cared for
      2. next HIV infection spread
         1. eastern European
         2. China
         3. don't have the system in place to deal with this
   2. Malaria
   3. Other diseases that are not infectious
      1. becoming bigger in those countries that may not be able to deal with it
      2. chronic disease are increasing in where there is no system for...