Analysing the Commitments to Advance the Global Strategy for Women's and Children's Health
Of the specific commitments, 70 percent focused on the 49 low-income countries that received Global Strategy priority.
Nearly 100 of the 127 stakeholders making commitments promised to strengthen health systems and improve the delivery of care. For example, CARE committed to expand its maternal health programs into at least 10 additional countries—a 50 percent increase—and by scaling-up programs in countries where it currently operates, CARE aims to assist more than 30 million women of reproductive age by the 2015 Millennium Development Goals deadline.
One hundred and six of the 127 committed to increasing coverage for essential components of reproductive, maternal and newborn and child health, such as improving the reach and quality of antenatal care, care at birth and immunization. For example, The Reproductive Health Supplies Coalition committed, through its launch of the HAND to HAND Campaign, to reach 100 million new modern contraceptive users by 2015 thereby fulfilling the family planning needs of 80 percent of women in low- and middle-income countries.
Other commitments focused on addressing the socio-cultural and legal barriers that impede progress in improving women’s and children’s health. For example, Bangladesh, Burkina Faso, Niger, and Laos pledged to increase the minimum age for marriage, prevent female genital mutilation, and/or reduce domestic violence. Yemen promised a safe motherhood law.
Many commitments targeted specific needs identified by the Global Strategy. For example, 33 pledged to increase skilled attendance at birth, 31 to expanding family planning services, 66 to expand and/or strengthen the health care workforce, and 23 to reduce or eliminate financial barriers, such as high costs and user fees, to reproductive, maternal and child health care.
However, the report also revealed certain gaps. Relatively few commitments referenced key needs such as postnatal care for mothers, insecticide-treated bednets for children, and nutrition. Under-nutrition is an underlying cause of stillbirths as well as one-third of child deaths, while maternal nutritional status is increasingly recognized as an underlying determinant of not just newborn health but subsequent adult health as well. Going forward, other challenges include strengthening the engagement of players from outside the traditional health sector, such as those engaged in education, nutrition, water and sanitation, trade, agriculture and infrastructure. Only 5% of the current set of commitments were made by those from outside the health arena.
There were also relatively few commitments from middle-income countries (4%) and the business community (11%), although these will increase significantly this year. Notable commitments in 2010 included Johnson & Johnson, which pledged $200 million over five years for a package of commitments that included providing more than 15 million expectant and new mothers with free mobile phone messages about prenatal health. Also in 2010, Merck committed $840 million over five years to HIV prevention and treatment, childhood asthma programs, and donation of HPV vaccine to prevent cervical cancer. This year, Merck is enhancing its commitment significantly, with its new “Merck for Mothers” initiative, pledging $500 million over 10 years to reduce maternal mortality.
“The Global Strategy underlines the need for greater innovation to catalyze progress,” says Carole Presern, Ph.D, a midwife and the Director of PMNCH. “New ways of working, such as the use of information and communications technology, is critical in accelerating implementation and improving efficiency.”