2014 Partners' Forum
30 JUNE - 1 JULY | Sandton Convention Centre, Johannesburg, South Africa
Session 2A: Better data for better policy making, programming and accountability
A parallel session on better data collecting kicked off the afternoon line up on the first day of the Partners’ Forum and was billed as the perfect segue to the plenary session on Health: an accountability model for Post-2015. Moderator, Ana Langer, Director of the Maternal Health Task Force and Women’s and Health Initiative at the Harvard School of Public health explained the importance of good data to policy making and its critical role in accountability for all stakeholders.
Presentations reviewed advances made by countries, donors, the research community and international agencies working to strengthen accountability for women’s and children’s health and were accompanied by opening remark from Bernadette Daelmanns, Acting Director and Coordinator, Department of Child and Adolescent Health, WHO intervening on behalf of Dr Flavia Bustreo. She highlighted progress achieved on commitments by countries to the Commission on Information and Accountability referred to new information which shows that countries are welcoming accountability and catalytic funding and it has proven to be effective.
Tan Vuoch Chhen, Secretary of State, Ministry of Health, Cambodia in charge of RMNCH nutrition and gender, reported on progress in Cambodia including the establishment of a set of 11 indicators recommended by the COIA, civil registration and vital statistics which has been in place for several years, and the implementation of a digital registration system at district level.
Clara Menéndez, from ISGlobal spoke about establishing the cause of maternal mortality and that millions of people are born and die outside health facilities and without being registered. Many programmes and policies, she explained are designed and implemented on the grounds of estimations of causes of mortality and morbidity. Less than 3% of the almost 7 million of under 5 deaths have been medically certified. Currently we rely on imperfect indirect methods of cause of death determination: verbal autopsies rely on interpretations of clinicians and are subject to misclassification errors; clinical records. When research is done comparing these methods with the gold standard (autopsy) results showcase that major clinical errors were present in more than half of the cases Most of maternal deaths were caused due to infectious diseases and not obstetric causes. “All human life counts, she said, but the reality is that some count more than others- One of the best ways to deliver and to bridge the equity gap is to improve the cause of death determination”.
Khatia Munguambe, from CISM expanded on the socio-cultural barriers for cause of death determination. Coming up with means to estimate the most important cause of death in developing countries is a challenge. The need to understand social and cultural factors, what is acceptable and who should conduct cause of death determination in a feasible and acceptable way was discussed. Some existing determinants are: fear of body determination, no direct benefits, impossibility to obtain consent from the deceased, young age of the deceased or delays in the funeral. Minimal invasive technics like minimally invasive autopsy (MIA) are an alternative to the existing methods. In this context the acceptability and feasibility of conducting MIA is being assessed currently through a multicentered project that intends to capture a variety of cultural backgrounds (Pakistan, Brazil, Gabon, Mali, Mozambique). It will allow to assess the broad concept of “death”.
The session concluded with a general acknowledgement that at all levels (macro, micro), accountability is a complex process to gather and process the information .
The session was chaired by Ana Langer Director of the Maternal Health Task Force and Women’s and Health Initiave at the Harvard School of Public health, and included remarks by Bernadette Daelmanns, Acting Director and Coordinator, Department of Child and Adolescent Health, WHO, Stephen Kebwe Kebwe , Deputy Minister of Health & Social Welfare, Tanzania, Tan Vuoch Chhen, Secretary of State, Ministry of Health, Cambodia, Clara Menéndez, Director Maternal, Infant and Reproductive Health Initiative at the Barcelona Institute for Global Health (ISGlobal) and Khatia Munguambe, Associate Senior Researcher at Manhiça Health Research Centre (CISM) and Lecturer at Eduardo Mondlane University, Maputo, Mozambique.