Keeping promises, Measuring results:

The Global Strategy and Accountability for

Women's and Children's Health

Bernadette Daelmans Family, Women and Children's Health Cluster

World Health Organization

The Global Strategy (2010)

By 2015:

• Saving 16 million lives of women and children

• Preventing 33 million unwanted pregnancies

• Protecting 88 million children from stunting

• Protecting 120 million children from pneumonia

Commitments made

Graphs of commitments:http://www.who.int/pmnch/topics/part_publications/2011_pmnch_report/en/index4.html

93 commitments made in 2010 amounting to

over US$ 40 billion 39 Low-income countries; 21 NGOs; 15 high income countries;

14 foundations; 14 business community

Many new commitments were announced at

the Every Woman Every Child first –year

anniversary. 29 Low-income countries; 4 high income countries; 12 UN and

partnerships; 2 philanthropic institutions; 40 NGOs & civil

society; 15 business community; 11 HCW and academic

institutions

Commission on Information and Accountability

• Called at the request of the UN Secretary-General as an integral part of the UN Global Strategy for Women's and Children's Health

• Commission's Report (advanced) released during the World Health Assembly, May 2011

• Recommendations discussed in high level meetings – World Health Assembly - resolution WHA 64.12– G8 meeting

• Agreement to focus follow-up on 74 countries - 49 lowest income countries (Global Strategy) + 25 additional high burden countries (Countdown)

• Commission's report officially released by Dr Ban Ki-Moon, September 20, 2011

• Independent expert group announced – Carmen Barroso, Zulfikar Bhutta, Richard Horton, Dean Jamison, Joy Phumaphi, Marleen Temmerman, Miriam Were

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Key principles

• National leadership and ownership of results

• Strengthen countries’ capacity to monitor and evaluate

• Reduce the reporting burden by aligning efforts with the systems countries use to monitor and evaluate their national health strategies

• Strengthen and harmonize existing international mechanisms to track progress on all commitments made

• Founded on the fundamental human right of every woman and child to the highest attainable standard of health, and on achieving equity in health

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10 Recommendations

Holding all stakeholders accountable

• Recommendations 1-3: Better information for better results

• Recommendations 4-6: Better tracking of resources for women's and children's health

• Recommendations 7-10: Better oversight of results and resources: nationally and globally

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Measuring results

• Vital events: By 2015, all countries have taken significant steps to establish a system for registration of births, deaths and causes …

• Health indicators: By 2012, the same 11 indicators across the continuum of care: reproductive, maternal, newborn and child health, including HIV …

• Innovation: By 2015, all countries have integrated the use of Information and Communication Technologies …

Indicators for results

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Eleven indicators• Three tracer indicators:

– maternal mortality ratio– under-5 child mortality (with the proportion of newborn deaths)– children under 5 who are stunted

• Eight coverage indicators:– met need for contraception– antenatal care coverage– antiretroviral prophylaxis among HIV positive pregnant women to

prevent mother-to-child transmission of HIV– skilled attendant at birth– postnatal care (within 48 hours of childbirth) for mother and child– breastfeeding exclusively for 6 months– three doses of the combined diphtheria, pertussis and tetanus vaccine– children with suspected pneumonia receiving antibiotics.

• Resource tracking: By 2015, all 74 countries where 98% of maternal and child deaths take place are tracking and reporting, at a minimum, two aggregate resource indicators

- total health expenditure by financing source, per capita; and - total reproductive, maternal, newborn and child health expenditure by

financing source, per capita.

• Country Compacts: By 2012, in order to facilitate resource tracking, “compacts” between country governments and all major development partners …

• Reaching women and children: By 2015, all governments have the capacity to regularly review health spending …

Tracking resources

• National oversight: By 2012, all countries have established national accountability mechanisms that are transparent, that are inclusive of all stakeholders, and that recommend remedial action, as required.

• Transparency: By 2013, all stakeholders are publicly sharing information on commitments, resources provided and results achieved annually, at both national and international levels.

Better oversight

Key steps in follow-up at country level

• Development of national plan to augment information and accountability

• Monitoring 11 core results indicators – HMIS, surveys, use of ICT

• Strengthening registration of births and deaths

• Quality assessments – maternal and perinatal deaths reviews, quality of care surveys

• Tracking financial resources – domestic and external commitments, expenditures

• Development of a national digital health strategy

• Annual review and action – with all relevant stakeholders incl. human rights bodies

• Advocacy – National Countdown conferences, parliamentarians, community participation

Putting recommendations into action

• Multi-stakeholder work plan developed through consultative process with all interested partiesCosts: US$ 88 million

• Roles and responsibilities for many partners: H4+, global health partnerships (PMNCH, HMN, GAVI, others), IPU, civil society organizations, academics and researchers, country representatives, private sector

• Funding commitments for implementation made by Norway, Canada and United Kingdom

• Hosting the ERG secretariat

• Facilitating the implementation of the workplan and mobilizing resources

• Coordinating technical support to each of the recommendations – roll out in countries

• Building partnership and capitalizing on partner' strengths

• Promoting and supporting innovation

Role of WHO and UN partners

Action can be taken now

• Strengthen health systems and improve quality of health services

• Improve measurement and use of data

• Use innovation and technology to disseminate and share information