Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 1 |
The Global Context
Overview of the Commission on Information and Accountability Recommendations
and Opportunities for Strengthening Accountability
MULTI-COUNTRY WORKSHOP TO STRENGTHEN RESULTS AND ACCOUNTABILITY FOR WOMEN'S AND CHILDREN'S HEALTH AND
THE HEALTH SECTOR AS A WHOLE Harare, Zimbabwe, 1-3 October 2012
Dr. Thierry Lambrechts
Maternal Newborn Child and Adolescent Health Department (WHO/MCA)
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 2 |
Global Context
Goal: Accelerate progress towards MDGs 4 and 5 in the world's poorer countries
Multiple partners and country commitments estimated at US$ 40 billions. These commitments need to be honored, efforts harmonized, and progress tracked.
In September 2010, the Secretary-General of the United Nations launched the
Global Strategy for Women's and Children's Health
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 3 |
• In November 2010, establishment of the Commission on Information and Accountability
- objective: to develop framework for accountability for women's and children's health
• Recommendations discussed in high level meetings including
- World Health Assembly - resolution WHA 64.12: May 2011
- G8 meeting: July 2011
• Report officially released by Dr Ban Ki-Moon,
September 20, 2011 - Recommendations - Priority areas for actions at country and global levels
Global Context
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 4 |
• Vital events: By 2015, all countries have taken significant steps to establish a system for registration of births, deaths and causes of deaths and have well-functioning health information systems that combine data from facilities, administrative sources and surveys.
• Health indicators: By 2012, the same 11 indicators across the continuum of care: reproductive, maternal, newborn and child health, disaggregated for gender and other equity considerations, are being used …
Commission' Recommendations on Monitoring Results
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 5 |
Health indicators: By 2012, the same 11 indicators across the continuum of care: reproductive, maternal, newborn and child health …
Three tracer indicators:
– maternal mortality ratio
– under-5 child mortality (with the proportion of newborn deaths)
– children under 5 who are stunted
Eight coverage indicators:
– met need for contraception
– antenatal care coverage
– antiretroviral prophylaxis among HIV positive pregnant women to prevent mother-to-child transmission of HIV
– skilled attendant at birth
– postnatal care (within 48 hours of childbirth) for mother and child
– breastfeeding exclusively for 6 months
– three doses of the combined diphtheria, pertussis and tetanus vaccine
– children with suspected pneumonia receiving antibiotics.
Commission' Recommendations on Monitoring Results (details on indicators)
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 6 |
• Vital events: By 2015, all countries have taken significant steps to establish a system for registration of births, deaths and causes of deaths, and have well functioning health information systems that combine data from facilities, administrative sources and surveys
• Health indicators: By 2012, the same 11 indicators across the continuum of care: reproductive, maternal, newborn and child health, including HIV …
• Innovation: By 2015, all countries have integrated the use of Information and Communication Technologies in their national health information systems and health infrastructure
Commission' Recommendations on Monitoring Results
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 7 |
● Resource tracking: By 2015, all 75 countries where 98% of maternal and child deaths take place are tracking and reporting, at a minimum, two aggregate resource indicators
• total health expenditure by financing source, per capita; and
• total reproductive, maternal, newborn and child health expenditure by financing source, per capita.
● Country Compacts: By 2012, in order to facilitate resource tracking, “compacts” between country governments and all major development partners are in place and include reporting on externally funded expenditures and predictable commitments
Reaching women and children: By 2015, all governments have the capacity to regularly review health spending (including on RMNCH) and to relate spending to commitments, human rights, gender and other equity considerations
Commission' Recommendations on Tracking Resources
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 8 |
National oversight: By 2012, all countries have established national accountability mechanisms that are transparent, that are inclusive of all stakeholders, and that recommend remedial action, as required.
Transparency: By 2013, all stakeholders are publicly sharing information on commitments, resources provided and results achieved annually, at both national and international levels.
Reporting international aid on women's and children's health: development partners and the OECD will develop mechanisms to capture and report all reproductive, maternal, newborn and child health spending by development partners
Global oversight: international Expert Review Group will report regularly to the UN Secretary-General (first report available)
Commission' Recommendations on Better Oversight
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 9 |
Monitor
Action
Review
National
Review
Mechanisms
What do we mean by accountability?
Key principles: - focus on national leadership and ownership of results; - strengthening countries’ capacity to monitor and evaluate; - aligning efforts with the systems countries use to monitor and evaluate their national health strategies and specific health programmes; - harmonizing existing international mechanisms to track progress on all commitments made. for better results
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 10 |
Health system performance monitoring
Malaria
Inputs Outputs Outcome Impact
RMNCH
HIV/AIDS
Tuberculosis
NCD & injuries
HSS
Nutrition
- aligning efforts with the systems countries use to monitor and evaluate their national health strategies and specific health programmes;
What do we mean by accountability?
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 11 |
Accountability Framework Summary
1. Vital Events—System for birth, death registration including cause of death; Health information system (HIS) combining administrative data, surveys by 2015
2. Health indicators–-Monitor Global Strategy using 11 RMCH indicators disaggregated by gender, other equity considerations by 2012
3. Innovation—Integrated information and communication technologies into country HIS by 2015
4. Resource tracking— Monitor per capita 1) total health expenditure by financing source 2) total RMCH expenditure by financing source by 2015
5. Country compacts between countries and major development partners for resource tracking
6. Reaching women and children—Systems to review health spending and relate to commitments, human rights and results by 2015
7. National oversight—Country level accountability mechanisms with remedial action by 2012
8. Transparency all stakeholders report commitments, resources and results by 2013
9. Reporting aid systems for women’s and children’s health by 2012
10.Global oversight expert review group report on implementation of these recommendations
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 12 |
July 2011: Multi partner consultation on the strategic workplan for implementing the recommendations, Geneva, Switzerland
Multi-stakeholder work-plan developed though consultative process (est. USD 88 m)
WHO coordination
Focus on country actions (49 countries in Global Strategy + additional 25 Countdown countries)
Roles and responsibilities for many partners (Bilateral donors global initiatives, CSOs, PMNCH, HMN, Countdown 2015, H4+, OECD)
From Recommendations to Actions
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 13 |
COMMISSION 10
RECOMMENDATIONS Birth and death registration
Monitoring of results
Maternal death surveillance & response & QoC
Tracking expenditures (NHA & RMNCH sub-accounts)
ehealth & innovation
Country review processes
Advocacy and action
Monitoring results
Tracking resources
Global review (iERG)
Country level
Global level
From Recommendations to Actions
Strategic workplan with priority actions
Accountability assessment &
Roadmap
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 14 |
• Conduct self-assessment using the country accountability framework tool
• Develop the first draft of a roadmap with priority activities for implementation of the country accountability framework
• National workshop with broader stakeholder group:
Requirements: information/orientation of key stakeholders prior to national workshop and mapping of activities and commitments
Objectives: finalize assessment, complete roadmap with priorities and budget (CoIA catalytic budget and other sources) and align with M&E plans for national health strategy
• Transparency: making data and information publicly available
• Monitor implementation
This workshop
From Recommendations to Actions: Process
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 15 |
Transparency: making information available
http://www.who.int/ woman_child_accountability/en/
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 16 |
Global (countries, partners, UN organizations) and multisectoral (government and several ministries, parliamentarians, partners in the country, civil society) initiative.
Focus on maternal, newborn, and child health but aligning on national health policy and monitoring and evaluation plans and building on existing country activities and accountability mechanisms.
Accountability is a fundamental component of a rights based approach to health
Regional workshops are only the first step in national processes to improve health results and accountability mechanisms
Accountability agenda provides opportunities to strengthen M&E and review mechanisms at country level
Translating the CoIA Recommendations into Actions: Conclusions
Multi-country Workshop to Develop Accountability Frameworks in the AFR
Harare, Zimbabwe 1-3 October 2012 17 |
Thank You!
Monitor
Action
Review