Putting the recommendations into action

Dr Flavia BUSTREO Assistant Director General,

Family, Women’s and Children’s Health Cluster

on behalf of the multi-stakeholder implementation team

24 May, 2012

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The aspiration: to save ~16 million lives

Protect 120 million children from contracting pneumonia

Prevent 88 million children from stunting

Prevent 33 million unwanted pregnancies

Prevent 15 million deaths of children under the age of 5

Prevent 570 thousand deaths of pregnancy related complications

We have the tools and resources and the political will

Progress in the world's 49 poorest countries

if goals are met (2010-15)

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Promises made: Status as of September 2011

More than 200 commitments from a range of constituencies

15 countries attracted more than 10 commitments

7 countries with only one commitment and 1 country with no commitment

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Holding ourselves to account

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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Two interdependent cycles

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From recommendations to action

10 COMMISSION RECOMMENDATIONS May 2011

MULTI-STAKEHOLDER STRATEGIC WORKPLAN & BUDGET November 2011

CONCRETE ACTIONS Specific goals, priorities, activities, roles & responsibilities

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1. Vital events (CRVS) 2. Health indicators & equity

3. Innovation

4. Resource tracking 5. Country Compacts 6. Reaching Women/Children

7. National oversight

8. Transparency

9. Reporting aid for Women/ Children’s health

10. Global Oversight

COMMISSION RECOMMENDATIONS

Country Actions

Global Actions

Birth and death registration

Monitoring of results

Maternal death surveillance & response

Accountability Framework

eHealth & innovation

Monitoring country resources

Advocacy and action

Monitoring results

Tracking resources

Global review (iERG)

The strategic work plan

Concluding compacts

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Key country actions

Development of roadmap to strengthen country accountability framework

Monitoring of results – core indicators, HMIS, surveys, quality

Strengthening civil registration and vital statistics

Quality assessment through maternal and perinatal deaths surveillance and response (MDSR) – Quality of care surveys

Use of e-Health and Innovation in health information systems

Tracking of financial resources – national health expenditure tracking, RMNCH sub-accounts

Concluding compacts between government and all major partners based on a format agreed in each country

Annual review and action – with all relevant stakeholders including human rights bodies

Advocacy – National Countdown conferences, parliamentarians, community participation

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Country Accountability Framework

Achievements

Standard tool developed for assessing country situation and priority actions

Method based on IHP+ common framework building on existing country plans and processes

4 multi-country workshops to orient country teams and facilitate the development of roadmaps

22 Country Accountability Frameworks developed

6 countries developed assessments for CAF

High level national endorsement of roadmaps through national accountability workshops

Challenges

- Ensuring sustained technical support and financing for countries to implement priority actions over next 3 years

Country Accountability Framework

06 March 2012

A tool for assessing and planning implementation of

the country accountability framework for health

with a focus on women's and children's health

Action

Monitor Review

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Progress: Country Accountability Framework

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Achievements

Data quality report card tool developed to strengthen quality of facility data and assess service readiness

10 countries supported to strengthen M&E plans

Preparation of analytical reports for health sector reviews

Strategic partnerships to strengthen country analytical capacity (Africa Population & Health Research Centre, national statistical offices, Statistics Norway)

Challenges

- More partner engagement required to support in scale up at country level

By 2012, the same 11 indicators on reproductive, maternal and child health, disaggregated … being used

Monitoring results

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Achievements

UN Human Rights Council adopted a resolution on birth registration as a human right (April 2012)

Innovative CRVS initiatives underway in 14 countries (i.e. community registration using mobile devices)

16 countries with rapid CRVS assessments completed

Africa Symposium on Statistical Development adopted resolution to strengthen CRVS in all 54 countries in Africa over next 5 years

Asia regional CRVS plan under preparation with targets for country strengthening and high level political engagement

Challenges

- Broad stakeholder engagement slows process

- Death and cause of death reporting consistently weak

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

Civil registration and vital statistics

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Maternal Deaths Surveillance and Response

Countries monitor quality of care provided in health services and take steps to make improvements …

Achievements

Capacity building for MDSR in 10 countries – 19 additional in June 2012

Concept of MDSR and maternal deaths notification well received

Maternal death review used as platform for developing maternal death surveillance and response mechanism

Challenges

- Ensuring maternal death notification within 24 hours

- Capacity for analysis of findings and feedback for action

- Reaching all health facilities and communities

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Achievements

Country assessment based on eHealth Toolkit completed

30 countries for fast-track actions identified

Challenges

- Multiple initiatives and experiences but as yet uncoordinated

- Few countries have a national eHealth strategy

eHealth and Innovation

By 2012, all countries are implementing national e-Health strategies and web-based systems to report data ...

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Total health expenditure by financing source, per capita; and

Total reproductive, maternal, newborn and child health expenditure by financing source, per capita

Achievements

Capacity for expenditure tracking in 30 countries

Data on RMNCH expenditures reported at least once by 18 countries (including data from subaccounts on reproductive and child health)

Challenges

- Country capacity in health accounting is weakened by constant turnover of staff trained

Monitoring Resources in the country

By 2015, all 75 countries are tracking and reporting, at a minimum, two aggregate resource indicators:

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Achievements

Thirty countries have signed up to the International Health Partnership (IHP+)

Sixteen countries have signed compacts/partnership agreement (Benin, Cambodia, DRC, Ethiopia, Kenya, Mali, Mauritania, Mozambique, Nepal, Niger, Nigeria, Rwanda, Sierra Leone, Togo, Uganda, Zambia)

Six countries have partnership agreements in process (Burkina Faso, Burundi, Cote d’Ivoire, Djibouti, Senegal, Sudan)

Compacts

By 2012, in order to facilitate resource tracking, compacts between country governments and all major development partners ...

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National oversight: By 2012, all countries have established accountability mechanisms that are transparent …

Oversight, advocacy and action

In progress

Working with Parliaments

- Inter-Parliamentary Union Resolution on maternal and child health: Access to health as a basic right: the role of Parliaments in addressing key challenges to securing the health of women and children

Annual health sector review meetings involving a broad range of stakeholders including civil society

National Countdown to 2015 events

- Using annual reports and country profiles to convene national conferences with all stakeholders

http://www.who.int/woman_child_accountability/en/

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Progress

Task team of the Working Party on Development Finance Statistics of OECD-DAC convened October 2011 to prepare a technical proposal on tracking RMNCH disbursements and commitments

Two options presented by the Task team to an informal meeting of the Working Party on Statistics February, 2012. Feedback obtained

Three options to be presented in the official annual meeting of the Working Party on Statistics in Paris this June 2012. Technical proposals differ on the precision of the quantification of the amount of ODA to RMNCH

Challenges

- Accuracy of reporting

Tracking resources: global actions

By 2012, development partners request the OECD-DAC to agree on how to improve the Creditor Reporting System …

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Monitoring of results: global actions

More to follow …

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WHO 27%

Partners 21%

Countries 42%

iERG 10%

Funding Gap 60 million

68%

Funds recieved 28 million

29%

Budget Needs Funding Allocation (2012) US$ 25 M

US$ 10 million disbursed to date

Funding

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… and other partners

Mongolian Welfare Association

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Thank you