Partners' Forum, Dar es Salaam, Tanzania
19 April 2004
Achieving MDGs 4 & 5
The morning meetings opened with an interactive question and answer session moderated by Lynn Freedman. The following key themes were discussed between the audience and a diverse panel of Partner members (Bertha Pooley, Save the Children, USA; Aparjita Gogoi, White Ribbon Alliance, India; Doyin Oluwole, Africa’s Health in 2010, AED; and Francis Omaswa, Global Health Workforce Alliance).
Changing the vision for how we think about health and health systems
Everyone in attendance agreed that this process includes moving forward from thinking about health as a medical, moral, and ethical issue to understanding its political and social dimensions. The panel members all agreed that political leaders must be convinced via high impact and readily understandable messages that maternal, newborn, and child health is a political issue and should be prioritized. They also stressed that bottom-up approaches that integrate NGOs and other grass roots movements into the design and selection of maternal, newborn, and child health interventions are critical for women’s empowerment and the achievement of MDGs 4 & 5.
Capacity building with an emphasis on human resources
Dr Francis Omaswa argued that greater attention must be directed not only at training more health care workers and building better infrastructure, but also at creating financial and other incentive mechanisms resulting in higher health care worker retention rates. Dr Songane suggested that providing non-medically trained health care workers with life saving skills, enabling them to provide critical care in under-served regions, is a measure that could be immediately implemented.
The apparent paradox about the funding situation for health care programs in the developing world was debated. Responding to anecdotes about countries with poor maternal and newborn health statistics returning allocated money, panel members noted that these situations typically occur in countries that lack sufficient infrastructure and coordinated programs so that funding can not be properly directed.
Reminding us that many developing countries are facing funding shortages, Lynn Freedman stated: “We must realize that current levels of funding will never get us to MDGs 4 & 5.” In response, Dr Oluwole asserted that, “we must start applying lessons learned from other public health initiatives that have successfully addressed funding crises so that we are better able to increase funding for maternal, newborn, and child health.”
Both Dr Bertha Pooley (Bolivia) and Dr Aparjita Gogoi (India) commented that awareness-generating campaigns-- to convince communities that access to quality health care services is a human right-- must be seen as the first step in fostering greater demand for maternal, newborn and child health care services. However, they also stressed that in order for these efforts to be successful increases in the availability and acceptability of health care services must occur simultaneously.
Moving towards the Global Business Plan (GBP)
Dr Flavia Bustreo and Dr Tore Godal, the Prime Minister’s office, Norway presented fundamental elements of the GBP, a plan initiated by the Prime Minister of Norway, the Hon. Jens Stottenberg. Members had the opportunity to comment on these elements in an open discussion session co-moderated by Prof. David Mwakyusa, Hon. Minister of Health and Social Welfare and Dr Aletty Pinel, UNFPA.
Dr Godal explained that the mission of the GBP is to provide political impetus at the highest level to facilitate country-led action directed towards attaining MDG 4 and 5. “The Prime Minister himself started this initiative following the Millennium Summit, with a strong personal commitment to saving lives. He feels we all have a moral imperative as individuals and society--to respect, protect and fulfill the rights of women and their newborns and children.”
The Partnership Board approved involvement with the GBP in December 2006, with the role of The Partnership focusing on advocacy and communication. "The function is to open up the process, to allow participation of all stakeholders which are involved in The Partnership, especially countries with the highest burden," said Partnership Deputy Director, Dr Flavia Bustreo. Dr Bustreo also said that the GBP will not transform into a finance mechanism for The Partnership.
Country level scale up
The two afternoon sessions were dedicated to the presentation of selected country case studies where effective work is being done in the scaling up of MNCH. The first session included presentations from four separate countries (Shaheen Masud, Representative of the Ministry of Health, Pakistan; Tesfanesh Belay, Representative of the Ministry of Health, Ethiopia; Bun Sreng, Representative of the Ministry of Health, Cambodia, and; Ruth Calderon, Ministry of Health, Bolivia) followed by a round-table discussion co-moderated by Elizabeth Mason, WHO and Cesar Vitora, Brazil.
They discussed next-steps for each country in its efforts to attain MDGs 4&5:
- Additional resources for programmed implementation;
- Severe funding challenges in relation to population size and Gross Domestic Product(GDP);
- Ensuring high and equitable service coverage;
- The strong participation of NGOs and other community-based organizations;
- Investment in capacity building, including human resources.