Accountability for Women’s and Children’s Health

Fifth stakeholder meeting: setting the foundations for post-2015

Moving the agenda beyond 2015

The first plenary session of the day, moderated by Dr Marleen Temmerman, WHO, proceeded to set the scene for what would form the crux of the discussions during the two -day meeting. Panelists, through a round-robin of questions, reviewed the current situation of women’s and children’s health both globally and at the country level and spoke of the positioning of women and children post-2015. Accountability, equity, human rights, health in a broader context, and women and community participation were some of the strongest themes that emerged.

Dr Flavia Bustreo of the World Health Organization opened the session with an overview of the progress made in reducing maternal and child deaths but cautioned that despite the encouraging gains, the MDGs targets have not yet been achieved. She pointed out the changes causes of maternal deaths, now being linked to non-communicable diseases, and underlined the need to adapt health strategies and to start looking at health more broadly, and work across sectors and find solutions that go beyond what the health sector alone can achieve.

To share accountability work happening in countries, H.E. Dr Shirin Sharmin Chaudhury, Speaker of the Parliament of Bangladesh and Dr Pedro Crocco, the Director, of Disease Prevention and Control for the Chilean Ministry of Health shared progress in their respective countries as well as challenges they are still facing.

H.E. Dr Chaudhury explained that her country was able to make improvements and is on track to reducing maternal mortality rates because Bangladesh “identified causes that led to maternal deaths and tried to address them.” She also emphasized the catalytic role of CoIA funding in helping to improve women’s and children’s health and the role of parliamentarians in ensuring that promises made by the government are being implemented. She pointed out that gender equality, social safety net protection and an integrated approach to health continue to be crucial in reducing maternal and child deaths.

Chile’s approach has been showcased as a successful one in improving maternal and child health outcomes - the country went from being at the bottom of the LATAM region in terms of health indicators to one of the best performing ones. Dr Crocco emphasized that universal access to health services is the most important step that countries can take to improve outcomes for mothers and children. He also noted that increased political participation by women makes an enormous difference for women’s and children’s health, and development more broadly. According to Dr Crocco, however, the lack of health workers continues to be a challenge, with public and private health providers in the country competing for limited resources. He highlighted the importance of education, infrastructure, water and sanitation in improving health outcomes in Chile but insisted that a country “cannot have a good health program if you do not involve the community.”

Princess Sarah Zeid put conflicts and other humanitarian emergencies squarely on the agenda, reminding participants that 56% of all maternal deaths take place in fragile states. “This is not unfinished business,” she said, “it is a battle for survival.” She said that across conflict and emergency situations “success is measured in lives saved,” and that support for frontline health workers, birth registration and innovation were imperative in saving lives. She also echoed other participants in urging the audience to move beyond the paradigm of survival to one of “survival and thrival.”

The final speaker was Joy Phumaphi, Co Chair-iERG, who set out the unfinished agenda for women and children naming newborns, stillbirths, sexual and reproductive health and rights, nutrition and health workers as areas that still required focus. Looking ahead to and beyond 2015, she implored the global community to pay more attention to addressing the social determinants of health as well as inequities. In closing, Ms Phumaphi said that we must “go beyond the continuum of care and appreciate that there is no better framework in which to position ourselves than that of human rights.”

Discussions around the scope and content of the renewed Global Strategy looked at how to ensure that the unfinished MDG agenda is central and that there is a vision that takes us to 2030 that is closely aligned with the SDGs, that goes beyond survival, and that is well integrated with other sectors as currently envisaged in the SDG framework. Participants had an opportunity to discuss all these ideas in working groups. The main outcomes and agreement were collected in a presentation (available from the links on the right).

The session on lessons from accountability included representatives from Government of Cambodia, the OECD, the Inter-Parliamentarian Union and the Centre for Economic Governance and AIDS in Africa. The session concluded with the lessons on accountability from the iERG and from the 'Every Woman Every Child' review of accountability mechanisms. Panelists shared important progress in their respective countries and highlighted the need to strengthen the links between global and country accountability processes as accountability work moves forward as a central piece of the efforts to and beyond 2015.

The importance of country leadership was emphasized by Dr Georgina Msemo, Assistant Director of Reproductive and Child Health from Tanzanian Ministry of Health, who showcased how the personal involvement of President Kikwete in the Commission on Information and Accountability has been crucial to prioritizing political and technical support to advance women’s and children’s health in the country.