By: Madeline Taskier, Partnership Coordinator for Women Deliver
Last week during the MDG Summit, the H4+ group gathered to present country successes in maternal health and to announce its next steps for MDG5. The H4+ official side event at the Unicef House, “Accelerating progress in achieving MDG5: Trends and Lessons from countries,” brought together mission representatives and delegates from countries, development partners, donors, foundations, and non-governmental organizations. The H4+ group including Unicef, WHO, UNFPA, the World Bank, and UNAIDS currently supports maternal health programming in 26 priority countries.
Dr. Sudha Sharma, Secretary of Health from Nepal; Professor Issifou Takpara, Minister of Health from Benin; Dr. K.C.S. Malefho, Permanent Secretary of Health from Botswana; and Dr. Kessetebrehan Admasu, Director General of the Federal Ministry of Health in Ethiopia presented examples of in-country programmatic successes in maternal health.
These countries are burdened by some of the worst maternal mortality rates, yet they are making progressive strides forward. Botswana has expanded PMTCT programs by layering ARV treatment onto existing antenatal care. Ethiopia has trained young, female skilled health workers from villages and equipped them with attractive government salary incentive program. Nepal has rolled out a Safe Motherhood Inventive program that has increased institutional births up to 40%. Benin is reshaping how to train non-physician clinicians. Despite all of these innovations, every country presenter appealed to audience members and the H4+ representatives for “fresh money” – funds that will let them rest easy at night and effectively implement maternal health programs.
Where will this new money come from? With the global economic recession, international aid wells seem to be drying up leaving priority countries wondering how they will continue to grow their maternal health programs and accelerate their progress on the MDGs. Margaret Chan, Director-General of the WHO, and Tamar Manuelya Atinc, Vice President of the World Bank, gave us some answers.
According to Margaret Chan, not only does the international community need to understand and wake up to the challenge of collaboration; we need to understand that the best way to make change is to learn from those individuals in-country who offer locally-based results. She asked the international community to refrain from arrogance. “We have not walked our talk. We need to change this time because we don’t have much time until 2015.”
And in order to make this change, the WHO will support mutual accountability programs to improve health systems and reach the MDGs. This framework requires heavy measurement of health indictors and country ownership of programs. And more funding. Donors have indeed been talking about new money and Ms. Chan urged everyone to join the Secretary General to keep to their financial promises, of any kind.
Tamar Manuelyan Atinc expressed the importance of payment systems from donor agencies to country recipients. If we adopt a results-based model where health care providers are financially rewarded with conditional payments after they reach predetermined health results, we are sure to accelerate progress toward achieving MDG5. Ms. Manuelyan Atinc also announced the World Bank’s expansion of “fresh money” for results-based financing projects -- $600 million over the next five years to 35 of the poorest countries in Africa and Asia.
To close the event, Purnima Mane, Deputy Executive Director of UNFPA, revealed the H4+ group’s expansion, which now will fund 49 priority countries. These are promising commitments and strategies that bring energy to the MDG Summit and align well with the Secretary General’s Global Strategy.