Backgrounder

From the Prime Minister's Web Site (http://www.pm.gc.ca/)

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PM endorses greater global accountability to save lives of mothers and children

May 20, 2011
Ottawa, Ontario

The Commission on Information and Accountability for Women's and Children's Health was launched on December 16, 2010, by United Nations Secretary-General Ban Ki-moon.

The mandate of the Commission was to develop recommendations for greater accountability by donor countries, multilateral organizations, private foundations and developing countries in the delivery of resources that save the lives of mothers and children. The overall goal was to ensure that the funding commitments made in the UN Global Strategy for Women's and Children's Health – $40 billion over five years to save 16 million lives in the world's 49 poorest countries – were kept.

The Global Strategy was put in place in response to the realization that progress toward the two Millennium Development Goals (MDGs) dealing specifically with the health of women and children, MDGs 4 and 5, are the farthest from being achieved by 2015. The 2010 G8 Muskoka Maternal, Newborn and Child Health initiative, led by Prime Minister Stephen Harper, is part of the Global Strategy and represents Canada's and other G-8 countries' determination to do more in developing countries to save the lives of mothers and children.

The Commission was made up of two co-chairs: Prime Minister Harper and Tanzanian President Jakaya Kikwete; two vice-chairs: Dr. Margaret Chan, Executive-Director of the World Health Organization and Dr. Hamadoun Touré; and, 26 Commissioners representing a cross-section of stakeholders, including developing country and donor governments, multilateral organizations, civil society and the private sector. The first meeting of the Commission was held January 26, 2011, in Geneva and established a tight timeline of delivering a Final Report in May, 2011. That report, Keeping Promises, Measuring Results, was released on May 19.

Keeping Promises, Measuring Results

The report makes 10 recommendations that call for an unprecedented level of accountability to track commitments for resources aimed at saving the lives of women and children in developing countries. These recommendations build on existing mechanisms so that simple and clear results can be put in place quickly and work for the benefit of all stakeholders:

1. Vital events: By 2015, ensure all countries take significant steps to establish a system for registering births, deaths and causes of death, and have well-functioning health information systems;
   
2. Health indicators: By 2012, ensure indicators on reproductive, maternal and child health are being used to monitor progress towards the goals of the Global Strategy;
   
3. Innovation: By 2015, ensure all countries integrate the use of Information and Communication Technologies in their national health information systems and health infrastructure;
   
4. Resource tracking: By 2015, ensure all 74 countries where 98% of maternal and child deaths take place are tracking and reporting the total health and reproductive, maternal, newborn and child health by financing source, per capita;
   
5. Country compacts: By 2012, install "compacts" (agreements) between country governments and all major development partners to facilitate resource tracking;
   
6. Reaching women and children: By 2015, ensure all governments have the capacity to regularly review health spending and to relate spending to commitments, human rights, gender and other equity goals and results;
   
7. National oversight: By 2012, ensure all countries have established national accountability mechanisms that are transparent, that are inclusive of all stakeholders, and that recommend remedial action;
   
8. Transparency: By 2013, ensure all stakeholders are publicly sharing information on commitments, resources provided and results achieved annually, at both national and international levels;
   
9. Reporting aid for women's and children's health: By 2012, development partners will request the OECD-DAC to agree on how to improve the Creditor Reporting System so that it can capture, in a timely manner, all reproductive, maternal, newborn and child health spending by development partners. In the interim, development partners and the OECD will implement a simple method for reporting such expenditures; and
   
10. Global oversight: Starting in 2012 and ending in 2015, ensure an independent "Expert Review Group" reports regularly to the United Nations Secretary-General on the results and resources related to the Global Strategy and on progress in implementing this Commission's recommendations.

Canada's Response

Canada made a commitment to developing countries at the Muskoka G-8 Summit in 2010 that G-8 leaders would be accountable and transparent in showing where the Muskoka Initiative funding was being spent and the results that it was achieving. According to World Health Organization and World Bank estimates, the Muskoka Initiative will assist developing countries to prevent 1.3 million deaths of children under five years of age, and prevent 64,000 maternal deaths.

Canada committed $2.85 billion in new and ongoing funding from 2010 to 2015 as its contribution to global efforts to reduce preventable maternal and early childhood deaths in developing countries, delivering results in three key areas: strengthening health systems; reducing childhood illness and disease; and improving nutrition. Canada's goal in its work on the UN Commission was to improve the health of women and children around the world, improve how vital information is registered, collected and shared, and find the best ways of tracking resources and investments at the global and national levels.

Canada, through the Canadian International Development Agency (CIDA), is delivering programs under the Muskoka Initiative in 10 partner countries with high maternal and child mortality. Those countries are Ethiopia, Malawi, Mali, Mozambique, Nigeria, Sudan, Tanzania, Bangladesh, Haiti and Afghanistan. Complementing these bilateral investments, CIDA is working with multilateral agencies and with its Canadian civil society partners to develop and support projects in the world's poorest countries that contribute to the Initiative's life-saving and health improvement goals.

Canada has endorsed the recommendations of the Keeping Promises, Measuring Results report. There is strong alignment between the work of the UN Commission and Canada's implementation of the Muskoka Initiative.

Canada will incorporate the 11 core health indicators that the Commission has recommended into its performance framework:

Monitoring the status of women's and children's health

• Maternal mortality ratio (deaths per 100 000 live births);
  
• Under-five child mortality, with the proportion of newborn deaths (deaths per 1000 live births); and
  
• Children under five who are stunted (percentage of children under five years of age whose height-for-age is below minus two standard deviations from the median of the WHO Child Growth Standards).

Monitoring a tracer set of coverage indicators

• Met need for contraception;
  
• Antenatal care coverage;
  
• Antiretroviral prophylaxis among HIV-positive pregnant women to prevent vertical transmission of HIV, and antiretroviral therapy for women who are treatment-eligible;
  
• Skilled attendant at birth;
  
• Postnatal care for mothers and babies;
  
• Exclusive breastfeeding for six months;
  
• Three doses of the combined diphtheria, pertussis and tetanus vaccine; and
  
• Antibiotic treatment for pneumonia.

CIDA will also measure and report on the results achieved through Canada's contribution to the Muskoka Initiative. In addition, CIDA is exploring with its country partners and other donors opportunities to improve accountability by increasing the capacity of developing countries to collect and use health information including the registration of births, deaths and causes of death.

These measures will advance the Commission's objectives in each country, and will reinforce Canada's ongoing work by ensuring that systems are in place to measure results achieved.

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The Prime Minister's Office - Communications
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