Using implementation analyses to identify national RMNCH priorities

A multi-stakeholder approach supported by global partnerships

13 August 2013 — A new approach to reviewing progress and challenges in addressing key policy and implementation issues related to reproductive, maternal, newborn and child health (RMNCH) is gaining support from global health and development partners working in the Asia-Pacific and Africa.

In late 2010, four key donors in the field of global health—the Australian Agency for International Development (AusAID), the US Agency for International Development (USAID), the UK Department for International Development (DFID), and the Bill & Melinda Gates Foundation—committed to working together to accelerate progress toward Millennium Development Goals 4 and 5 globally and within 10 focus countries in Africa and Asia. As part of their collaboration in the Alliance for Reproductive, Maternal and Newborn Health (RMNH Alliance), they jointly supported a series of national reviews on current progress and challenges in addressing key policy and implementation issues related to reproductive, maternal, newborn and child health.

In 2012, an initial set of national implementation analyses were conducted in six Asia-Pacific countries — Bangladesh, Nepal, India, Indonesia, Papua New Guinea and the Solomon Islands — and presented at the Asia-Pacific Leadership and Policy Dialogue for Women’s and Children’s Health, which was held in Manila from 7-9 November. These implementation analyses were led by ministries of health and conducted through participatory, multi-stakeholder efforts both at the global and national levels. This experience provides valuable lessons on the value of partnership in developing consensus on policy priorities and providing a platform for joint advocacy and action.

Following the success of the implementation analyses presented at the meeting in Manila, the UNICEF Office of the Pacific Island Countries requested that four more case studies be produced for the following Pacific Island countries: Fiji, Kiribas, Vanuatu and the Federated States of Micronesia. The tools developed for the Asia-Pacific implementation analyses were then adapted and utilized by these four countries and the findings were shared at the 10th Ministerial Meeting of Pacific Island Countries hosted in Samoa from 2-4 July 2013, where delegates from about 20 Pacific Island countries and territories gathered to review their 2015 goals for reproductive, maternal, newborn, child and adolescent health.

Also building on the success in the Asia-Pacific, the RMNH Alliance is currently in conversation with USAID’s Africa Bureau regarding the opportunity to utilize these tools in African countries early next year.

Partnership has been a cornerstone of the joint RMNCH implementation analysis effort from the outset. Working together under the RMNH Alliance, maternal and child health experts from the four donor agencies identified the value of collectively conducting country-specific analyses to ground future collaborative efforts. To facilitate this work, each partner drew on existing mechanisms to provide financial and technical support. AusAID championed the process by earmarking additional funds under their grant to the Partnership for Maternal, Newborn & Child Health (PMNCH). DFID and the Gates Foundation also provided general operating support to PMNCH, and USAID gave support through its flagship Maternal and Child Health Integrated Program (MCHIP). The activity was coordinated by the RMNH Alliance Secretariat, which represented the interests of all four key donors.

The technical team also represented a broad partnership. Representatives from PMNCH, World Health Organization (WHO), MCHIP, USAID and the Alliance actively participated in the process of developing the study protocol; facilitating the work in country; and disseminating the results at the global, regional and national levels. Work at the country-level drew on the comparative advantages of the partners. In conjunction with national governments, MCHIP supported the process in countries where they maintained a presence and WHO supported it in the others. Expert consultants were contracted to support the process in each country. Country representatives from USAID, AusAID, and DFID participated in the country-level planning and consultations and in utilizing the results.

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