Financial and political commitments to improve health of women and children

March 19, 2016

To prevent mother-to-child transmission of HIV/AIDS, Burundi pledges to increase coverage from 25 to 85 percent; Chad plans to increase coverage from 7 to 80 percent; Myanmar to reach 80 percent, and Vietnam from 20 to 50 percent.

Other examples:

Afghanistan pledges to increase the use of contraception from 15 to 60 percentngo, Madagascar, Papua New Guinea and Zimbabwe will introduce maternal death audits.Burundi, Lao, and Papua New Guinea plan to increase skilled birth attendance. Papua New Guinea also promises to add 23 more obstetricians as well.

Many commitments involve some type of financial reform. For instance, 23 countries committed to abolishing user fees or providing new income protection for the poorest and most vulnerable groups, especially women and children.

Kyrgyzstan promises free medical care to pregnant women and children under 5; Malawi will partner with private institutions to provide free care; Nepal will provide free maternal health services for hard to reach populations, encourage public-private partnerships to increase use of family planning services, and provide cash incentives to pregnant and lactating women to improve maternal nutrition; Chad will provide free emergency care for women and children and provide free HIV testing and anti-retroviral drugs. Yemen pledges to enforce a ministerial decree to provide free deliveries and free contraceptives to all women of reproductive age.

Some commitments aimed to improve health facilities and drug supplies. For example, Rwanda pledges to provide water and electric services to all health facilities.

China will provide free breast and cervical cancer screening, subsidies for hospital deliveries, free folic acid supplements and hepatitis B vaccines for children under 15, and will reimburse 90 percent of medical expenses for rural children with leukemia or congenital heart disease.

Support for specific countries

The assessment also looked at countries that received commitments for specific help. India, which accounts for 20 percent of all maternal and young child deaths, received the most specific commitments for support, even though India is not one of the world's poorest countries.

Other countries that received specific commitments were Nigeria, Kenya, Ethiopia, Bangladesh, Tanzania, Uganda, Pakistan, Zambia, Mali, South Africa, Afghanistan, Burkina Faso, Democratic Republic of Congo, Congo, Haiti, Malawi, and Nepal.

The reports authors suggest some special assistance may be needed in the following areas:

Several of the world's poorest nations-- Democratic People's Republic of North Korea, Sao Tome and Principe, the Solomon Islands, and Yemen-- received no special pledges French-speaking African countries-Burundi, Djibouti, Equatorial Guinea, Central African Republic, Gabon, Madagascar, and Togo-received little specific support; Indonesia, the world's fourth most populous country, and the Philippines received very little pledged support.

Financing barrier to meeting commitments

The one-year assessment identifies a shortage of financing as a significant obstacle faced by low-income countries in implementing Global Strategy commitments. Also, the PMNCH team that conducted the assessment through a series of questionnaires and interviews found it difficult to assign a monetary value to some commitments, such as those for improved service delivery or changes in laws and policies, and indeed is not necessarily important to do so.

The assessment shows it is too soon after commitments were made to report on concrete steps to honour them. A majority of those who responded asked for a regular reporting process to keep track of progress and a system for measuring results and assessing their impact, according to the report.

The PMNCH report is intended to support the recommendations of the Commission for Information and Accountability, which was tasked by UN Secretary-General Ban Ki-moon to develop an accountability framework to track resources and results related to women's and children's health worldwide. A multi-stakeholder independent Expert Review Group will help take forward the Commission's recommendations. Members of this group will be announced at the September 20th event.

"We must not forget that women and children, their families and communities are at the heart of the Global Strategy, and we are ultimately accountable to them," says Dr Carole Presern of PMNCH. "The success of the Global Strategy will be determined by whether the action it mobilized was able to save 16 million lives in the world's poorest countries by 2015. PMNCH will continue to act as a platform for joint action and accountability to support this goal."

Source: Partnership for Maternal, Newborn & Child Health

Financial reform commitments