First progress report on implementation of the Commission's recommendations
Translating recommendations into action:
November 2011 - June 2012
The strategic workplan to implement the Commission for Information and Accountability for Women’s and Children’s Health recommendations has been in place for just over six months. During this time, the initiative has brought people together, forging partnership between technical health experts, health programme managers, information, communication and technology experts, advocates and politicians. There is renewed energy for women’s and children’s health.
The initial months focused on the development of Country Accountability Frameworks (CAFs), which are the foundation for the priority action that countries undertake to fulfil the Commission’s recommendations. To date there are 39 draft CAFs available, six of which are finalized, costed and ready for funding. By the end of the year all 75 priority countries will have completed draft CAFs, paving the way for country-level implementation towards the Commission’s 10 recommendations. High-level political leadership has been a key convening factor for a broad stakeholder representation as well as decision-making for priority action. In the last six months, three important resolutions related to the Accountability work were passed: First, the World Health Assembly resolution (A65/15) urging Member States to honour their commitments to the Global Strategy and to strengthen efforts to improve women’s and children’s health by implementing the Commission’s 10 recommendations. Second, the Inter-Parliamentary Union unanimously passed a resolution which articulates the role of parliaments in addressing key challenges to improve the health of women and children; and the Human Rights Council passed a resolution on recognizing birth registration as a human right. These resolutions provide a political platform for improvements to women’s and children’s health.
Aside from high-level political leadership, another success has been the gathering of partners representing different disciplines and sectors for the first time to discuss women’s and children’s health – something that served to bring in new ideas and perspectives on how to deliver for women and children’s health. The mix of priority actions included in the CAFs is a reflection of the different disciplines coming together. For example, actions in the innovation area are being used to strengthen civil registration, maternal death surveillance and response and quality of care.
The Accountability Framework proposed by the Commission on Information and Accountability for Women’s and Children’s Health in itself is also an element contributing to success. The fact that there is an accountability framework with time-bound deliverables and targets monitored by the United Nations Secretary-General through an independent and transparent group is keeping up the momentum among partners and is a catalyst for results. The OECD working group members deciding on a method to track financial commitments and disbursements for RMNCAH is an example of how accountability is harmonizing donor funding mechanisms. The Global Vaccine Plan, a new initiative recently endorsed by the World Health Assembly has been asked to use an accountability framework to guide its actions. Similarly, the Commission on Life-Saving Commodities for Women and Children is likely to request an accountability framework for the implementation of its recommendations. Therefore, the accountability framework is increasingly seen as a potential model for strengthening deliverables among partners around new health initiatives.
Of the working group areas, six are on track (or even exceeding targets), and four are “making progress” and one recommendation has mixed progress.1 Much of the work requires systems strengthening and the first six months have been used to lay the foundations for strengthening health systems, an investment that takes time before witnessing tangible returns. The CAFs are now at the phase of implementation. Although countries set ambitious targets and goals, it seems probable many of these plans will produce long-term sustainable results that will improve women’s and children’s health. In order for this to happen, we need sustained inputs from all stakeholders to ensure the commitments are met.
Global leaders and partners are rallying to implement different aspects of the Global Strategy, resulting in new declarations, initiatives and commitments. This is a reflection of the renewed energy for women’s and children’s health and achieving MDGs 4 and 5. Each of the initiatives comes with financial commitments and promises, and in this constrained financial environment it is not yet clear whether the actual funding will match the promises made. This makes harmonization even more important. Moving forward, global partners will need to continue the spirit of collaboration and ensure harmonization across the various processes to ensure efficiencies. At the country level, efforts are required to ensure that the various initiatives link to national processes and do not over burden human or financial resources or other systems. The accountability framework is a catalyst for the required harmonization.