Full document: Global Strategy for Women's and Children's health
Holding ourselves accountable
Accountability is essential. It ensures that all partners deliver on their commitments, demonstrates how actions and investment translate into tangible results and better long-term outcomes, and tells us what works, what needs to be improved and what requires more attention. Key principles include:
- A focus on national leadership and ownership of results
- Strengthening countries’ capacity to monitor and evaluate
- Reducing the reporting burden by aligning efforts with the systems countries use to monitor and evaluate their national health strategies
- Strengthening and harmonizing existing international mechanisms to track progress on all commitments made.
Figure 3: Approach to tracking progress
National leadership and ownership are the foundation of accountability. Most monitoring, evaluating and reporting takes place, or at least starts, at the country level, and partners at all levels should strive to make countries accountable for the success of their national health strategies. Strong community-based efforts should hold governments and other organizations accountable for delivering on their commitments and ensure all money is used in a transparent manner. India’s National Rural Health Mission, for example, has a communitybased performance-monitoring mechanism to ensure that services reach their targets and that communities participate in delivery.
Strengthening national capacities also requires harmonized investment in monitoring and evaluation systems, to improve the availability and quality of data. This must support countries’ efforts to strengthen their health information systems in line with the “Call for Action on Health Information”.36 Priority investments will vary from country to country, and might include filling gaps in essential data (on births, maternal and child deaths, health status and intervention coverage), tracking resources and expenditure more effectively, and enhancing the analysis of data quality. The availability of essential data is critical so that health workers are equipped with the information they need to make decisions.
Existing global mechanisms must also be used to support accountability efforts at the national and global levels. For example, a key objective of The Partnership for Maternal, Newborn & Child Health (PMNCH) is to track progress and commitments on MDGs 4 and 5. Several mechanisms are being explored to track donors’ financial commitments and disbursements, such as the OECD-DAC’s peerreviewed assessments of aid policies and implementation, and the Countdown to 2015 Report. Further mechanisms are being explored to report on the work of civil society organizations, and to contribute to country-level initiatives, such as promotion of National Health Accounts to track health expenditures, and the United Nations initiative to develop a “unified costing tool”.
Reducing the reporting burden on countries will contribute to more timely, effective and efficient monitoring, evaluation and reporting. It is important to accelerate efforts to develop an agreed set of core health indicators, reducing the overall number of indicators countries report on while ensuring that key information, such as on efforts to address gender equality and deliver services to vulnerable communities, is collected. This will also encourage regular and accurate national reports, which will assess and track performance and progress. These should result in fewer requests by donors and multilateral institutions for separate reports.
To ensure that stakeholders are held accountable for their commitment and progress is sustained, the implementation of commitments made as part of this global strategy should be tracked every two years, in line with standard international practice. This will build upon the principles outlined in this document while ensuring existing country-level and global monitoring and reporting initiatives are coordinated and complement the development of high-quality, comparable reporting.
Current initiatives and mechanisms – such as the MDG reports, Countdown to 2015, the International Health Partnership + initiative, analysis and research conducted by academic and international institutions, and other related processes – will inform the development of the biennial report. The UN Secretary-General requests that the World Health Organization chair a process to determine the most effective international institutional arrangements for global reporting, oversight and accountability on women’s and children’s health, including through the UN system.