putting the recommendations into action · by 2015, all countries have ... convene national...
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Putting the recommendations into action
Dr Flavia BUSTREO Assistant Director General,
Family, Women’s and Children’s Health Cluster
on behalf of the multi-stakeholder implementation team
24 May, 2012
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The aspiration: to save ~16 million lives
Protect 120 million children from contracting pneumonia
Prevent 88 million children from stunting
Prevent 33 million unwanted pregnancies
Prevent 15 million deaths of children under the age of 5
Prevent 570 thousand deaths of pregnancy related complications
We have the tools and resources and the political will
Progress in the world's 49 poorest countries
if goals are met (2010-15)
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Promises made: Status as of September 2011
More than 200 commitments from a range of constituencies
15 countries attracted more than 10 commitments
7 countries with only one commitment and 1 country with no commitment
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Holding ourselves to account
Recommendations 1-3: Better information for better results
Recommendations 4-6: Better tracking of resources for women's and children's health
Recommendations 7-10: Better oversight of results and resources: nationally and globally
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Two interdependent cycles
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From recommendations to action
10 COMMISSION RECOMMENDATIONS May 2011
MULTI-STAKEHOLDER STRATEGIC WORKPLAN & BUDGET November 2011
CONCRETE ACTIONS Specific goals, priorities, activities, roles & responsibilities
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1. Vital events (CRVS) 2. Health indicators & equity
3. Innovation
4. Resource tracking 5. Country Compacts 6. Reaching Women/Children
7. National oversight
8. Transparency
9. Reporting aid for Women/ Children’s health
10. Global Oversight
COMMISSION RECOMMENDATIONS
Country Actions
Global Actions
Birth and death registration
Monitoring of results
Maternal death surveillance & response
Accountability Framework
eHealth & innovation
Monitoring country resources
Advocacy and action
Monitoring results
Tracking resources
Global review (iERG)
The strategic work plan
Concluding compacts
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Key country actions
Development of roadmap to strengthen country accountability framework
Monitoring of results – core indicators, HMIS, surveys, quality
Strengthening civil registration and vital statistics
Quality assessment through maternal and perinatal deaths surveillance and response (MDSR) – Quality of care surveys
Use of e-Health and Innovation in health information systems
Tracking of financial resources – national health expenditure tracking, RMNCH sub-accounts
Concluding compacts between government and all major partners based on a format agreed in each country
Annual review and action – with all relevant stakeholders including human rights bodies
Advocacy – National Countdown conferences, parliamentarians, community participation
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Country Accountability Framework
Achievements
Standard tool developed for assessing country situation and priority actions
Method based on IHP+ common framework building on existing country plans and processes
4 multi-country workshops to orient country teams and facilitate the development of roadmaps
22 Country Accountability Frameworks developed
6 countries developed assessments for CAF
High level national endorsement of roadmaps through national accountability workshops
Challenges
- Ensuring sustained technical support and financing for countries to implement priority actions over next 3 years
Country Accountability Framework
06 March 2012
A tool for assessing and planning implementation of
the country accountability framework for health
with a focus on women's and children's health
Action
Monitor Review
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Progress: Country Accountability Framework
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Achievements
Data quality report card tool developed to strengthen quality of facility data and assess service readiness
10 countries supported to strengthen M&E plans
Preparation of analytical reports for health sector reviews
Strategic partnerships to strengthen country analytical capacity (Africa Population & Health Research Centre, national statistical offices, Statistics Norway)
Challenges
- More partner engagement required to support in scale up at country level
By 2012, the same 11 indicators on reproductive, maternal and child health, disaggregated … being used
Monitoring results
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Achievements
UN Human Rights Council adopted a resolution on birth registration as a human right (April 2012)
Innovative CRVS initiatives underway in 14 countries (i.e. community registration using mobile devices)
16 countries with rapid CRVS assessments completed
Africa Symposium on Statistical Development adopted resolution to strengthen CRVS in all 54 countries in Africa over next 5 years
Asia regional CRVS plan under preparation with targets for country strengthening and high level political engagement
Challenges
- Broad stakeholder engagement slows process
- Death and cause of death reporting consistently weak
By 2015, all countries have taken significant steps to establish a system for registration of births, deaths and causes …
Civil registration and vital statistics
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Maternal Deaths Surveillance and Response
Countries monitor quality of care provided in health services and take steps to make improvements …
Achievements
Capacity building for MDSR in 10 countries – 19 additional in June 2012
Concept of MDSR and maternal deaths notification well received
Maternal death review used as platform for developing maternal death surveillance and response mechanism
Challenges
- Ensuring maternal death notification within 24 hours
- Capacity for analysis of findings and feedback for action
- Reaching all health facilities and communities
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Achievements
Country assessment based on eHealth Toolkit completed
30 countries for fast-track actions identified
Challenges
- Multiple initiatives and experiences but as yet uncoordinated
- Few countries have a national eHealth strategy
eHealth and Innovation
By 2012, all countries are implementing national e-Health strategies and web-based systems to report data ...
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Total health expenditure by financing source, per capita; and
Total reproductive, maternal, newborn and child health expenditure by financing source, per capita
Achievements
Capacity for expenditure tracking in 30 countries
Data on RMNCH expenditures reported at least once by 18 countries (including data from subaccounts on reproductive and child health)
Challenges
- Country capacity in health accounting is weakened by constant turnover of staff trained
Monitoring Resources in the country
By 2015, all 75 countries are tracking and reporting, at a minimum, two aggregate resource indicators:
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Achievements
Thirty countries have signed up to the International Health Partnership (IHP+)
Sixteen countries have signed compacts/partnership agreement (Benin, Cambodia, DRC, Ethiopia, Kenya, Mali, Mauritania, Mozambique, Nepal, Niger, Nigeria, Rwanda, Sierra Leone, Togo, Uganda, Zambia)
Six countries have partnership agreements in process (Burkina Faso, Burundi, Cote d’Ivoire, Djibouti, Senegal, Sudan)
Compacts
By 2012, in order to facilitate resource tracking, compacts between country governments and all major development partners ...
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National oversight: By 2012, all countries have established accountability mechanisms that are transparent …
Oversight, advocacy and action
In progress
Working with Parliaments
- Inter-Parliamentary Union Resolution on maternal and child health: Access to health as a basic right: the role of Parliaments in addressing key challenges to securing the health of women and children
Annual health sector review meetings involving a broad range of stakeholders including civil society
National Countdown to 2015 events
- Using annual reports and country profiles to convene national conferences with all stakeholders
http://www.who.int/woman_child_accountability/en/
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Progress
Task team of the Working Party on Development Finance Statistics of OECD-DAC convened October 2011 to prepare a technical proposal on tracking RMNCH disbursements and commitments
Two options presented by the Task team to an informal meeting of the Working Party on Statistics February, 2012. Feedback obtained
Three options to be presented in the official annual meeting of the Working Party on Statistics in Paris this June 2012. Technical proposals differ on the precision of the quantification of the amount of ODA to RMNCH
Challenges
- Accuracy of reporting
Tracking resources: global actions
By 2012, development partners request the OECD-DAC to agree on how to improve the Creditor Reporting System …
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Monitoring of results: global actions
More to follow …
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WHO 27%
Partners 21%
Countries 42%
iERG 10%
Funding Gap 60 million
68%
Funds recieved 28 million
29%
Budget Needs Funding Allocation (2012) US$ 25 M
US$ 10 million disbursed to date
Funding
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… and other partners
Mongolian Welfare Association
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Thank you