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© United Nations Development Programme

MDG Acceleration Framework (MAF) in the Philippines: Reducing Maternal Mortality

21 June 2012

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OVERVIEW

The global context for the MAF

What is the MAF? Where it has been applied?

The case of the Philippines on Maternal Mortality

Following through: value addition and implementation

|© United Nations Development Programme

▪ The 2010 MDG Summit – Provides the evidence from the ground on what works and what

doesn’t: countries know what needs to be done to achieve the MDGs, but progress in implementation is lacking or has slowed in many

– Outcome document calls for an acceleration agenda for the MDGs

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THE MAF: GLOBAL CONTEXT

▪ MAF formally endorsed in 2010 by UNDG– UN Secretary-General Ban Ki-moon and UNDG Chair Helen Clark

introduce it at the 2010 Summit– UNDP corporate priority– UNDG guidance to UNCTs

▪ MAF developed and tested over 2009-2010– 14 countries and six MDGs– In 2011-2012: MAF being rolled-out in 20 countries

▪ Unlocking Progress: MDG Acceleration on the road to 2015– Summarize and synthesize main lessons learned from the pilot

phase– Growing body of country reports and experiences

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20002001200220032004200520062007200820092010201120122013201420152016201720180%

20%

40%

60%

80%

100%

High Trajectory (solution has immediate impact)

Low Trajectory (solution has low impact)

Target

Starting point

Achievement of intermediate targets

Historical trend

WHAT IS ACCELERATION?

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WHAT IS THE MDG ACCELERATION FRAMEWORK?

Drawing upon country experiences and ongoing processes toidentify and prioritize bottlenecks

interfering with the implementation of key MDG interventions

Using knowledge-based good practices to determineobjective and feasible solutions for accelerating

MDG progress

Creating a partnership with identified roles for all relevantstakeholders to jointly achieve MDG progress

Responding to national/local political determination to tackle identified off-track MDGs

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Identify, codify the interventions required to meet the MDG targets

Help identify and prioritize MDG bottlenecks

Identify solutions to form an MDG Country Action Plan that aligns and focuses stakeholders and resources on accelerating MDG progress

Implement and Monitor the MDG Country Action Plan to ensure required impact

MAF SYSTEMATIC STEPS

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KEY OBJECTIVE

DELIVERABLES

▪ Identify and prioritize the package of interventions critical to accelerating progress toward priority MDG targets by 2015

▪ Justification for acceleration efforts to achieve the MDGs in the next years

▪ Status and trend analysis of MDGs in the country

▪ List of MDG-critical interventions

▪ Intervention profiles with data on impact

▪ Identify and prioritize bottlenecks that impede implementation of the priority interventions identified in Step 1

▪ Detailed map of bottlenecks

▪ Bottleneck specific profiles with data on impact and available solutions

▪ Prioritized list of bottlenecks to be removed/mitigated for each priority intervention

▪ Identify and sequence near-term solutions to remove/mitigate intervention bottlenecks identified in Step 2

▪ Defined list of solutions for each bottleneck

▪ Solution profiles with data on the impact and feasibility

▪ Finalized list of bottleneck solutions that the country will pursue

▪ Develop an MAF Action Plan with solutions and accountability matrix to deliver on the solutions of Step 3

▪ MDG Action Plan for the country and development partners

▪ Project roadmap with implementation steps and deliverables

▪ Resource plan and cost assessment for each solution

X weeks X weeks X weeks

Step 1: Intervention identification and prioritization

Step 2: Bottleneck identification and prioritization

Step 4: Develop MDG Compact and an implementation and monitoring plan

Step 3: Solution identification and sequencing

Ongoing

PROCESSNEEDS TO BUILD PARTNERSHIPS

▪ Validate bottleneck analysis findings with relevant key stakeholders

▪ Engage key partners that may be involved involved in the implementation

▪ Put in place a participatory process to arrive at an Action Plan

▪ Involve critical partners in the identification of key interventions

APPLYING THE MAF: THE PROCESS

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MAF ROLLOUTS TO DATE

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Prioritizing within current investment plans

Motivating cross-ministerial collaboration

Highlighting local solutions

Bringing together different partners and stand-alone activities

Helping implement laws, roadmaps and policies

Indicating how best to adapt existing tools

Addressing inequalities

Attracting partner interest

Government ownership and coordination

Expert MAF team – national and external – for quality and coherence

Cross-sectoral and cross-ministerial engagement:

UNCT involvement: UNDG endorsement

Anchoring in existing plans

Participation of local governments, CSOs and NGOs

Learning – but not duplicating – across countries

Using available data

MAF LESSONS ADDED VALUE

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MATERNAL HEALTH IN THE PHILIPPINES

• From 1990 to 2006, maternal deaths per 100,000 live births decreased from 209 to 162.

• But in 2010, it increased to 221• According to the DOH, maternal mortality

was caused by three “delays”: (a) delay in deciding to seek medical care; (b) delay in reaching appropriate care; and (c) delay in receiving care at health facilities.

2015 target is from 221 to 52---least likely to be achieved

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1990 1991 1992 1993 1994 1995 1998 2006 2010 20150

50

100

150

200

250

209203

197 191186 180

172162

221

52

MDG 5

Year

No.

of M

ater

nal

Deat

hs b

y 10

0,00

0 liv

e bi

rths

MATERNAL HEALTH IN THE PHILIPPINES

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MATERNAL HEALTH IN THE PHILIPPINESProgress in reducing maternal mortality

Source: Staff calculations based on the United Nations MDG Database.

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MATERNAL HEALTH IN THE PHILIPPINES Rate of progress needed for off-track countries to meet the maternal mortality target

Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

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MATERNAL HEALTH IN THE PHILIPPINES

Rate of progress needed for off-track countries to meet the skilled birth attendance target

Source: Staff calculations based on the United Nations MDG Database and World Population Prospects 2010.

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THE MAF VALUE ADDED FOR MATERNAL HEALTH

Changing the prevailing political thinking: maternal health is more than a health issue, it’s a development challenge (provide evidence to show the strong linkages between MDG 5 and other MDGs).

Economic feasibility: investment returns are high – productivity implications.

Identifying most effective actions in sectors (including non-health sectors) that could contribute to accelerating maternal health.

Engage sectors on how to implement these actions within their mandate.

Identify and provide incremental funding for these actions when needed.

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Relevant tool to develop a focused Action Plan

to accelerate maternal health

The MAF can support theoperationalization of the

existing health policies and strategies

Brings together fragmentedefforts of various partners

Address inequalities

Emphasizes local and innovative solutions.

Focus on demand side interventions to address bottlenecks related to

service use.

Helps to break the silos across different sectors, facilitating cross-sectoral

and cross-ministerial collaboration

MAF POTENTIAL VALUE ADDED FOR THE PHILIPPINES

Supports the prioritization of existing solutions

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MAF PROCESS GUIDE

Identify MDG target(s) needing

accelerated efforts

Verify domestic political

commitment

Secure Government ownership

Bring together UNCT, national, academic and other partners

Ensure high quality technical participation and

expert facilitation

Motivate on-going multi-stakeholder engagement

Promote consensus

around MAF action plan

Link to global/regional

acceleration efforts

Lead advocacy at highest levels

with donors and Government for

implementation

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Thank You