Strengthening National Advocacy Coalitions for Improved Women’s and Children’s Health

Publisher: The Partnership for Maternal, Newborn and Child Health
Date of publication: 2013
Language: English
Number of pages: 30

Introduction

In recent years civil society organizations have grown in number and prominence in many countries where women’s and children’s health demands greater priority and accountability. However, given the range of interests and actors, such organizations have not always received adequate support to come together to speak with one voice and be heard effectively in forums where decisions are made.

The Partnership for Maternal, Newborn & Child Health (PMNCH) represents over 500 members across seven constituencies, including government, multilaterals, donors, the private sector, health professional organizations, non-governmental organizations (NGOs) and academia. Of this, nearly 400 PMNCH members are NGOs. This represents a significant opportunity for PMNCH to support national coalitions of civil society actors to come together with common positions, strategies and messages, acting together through joint efforts to demand greater accountability and action.

These joint efforts can support the implementation of commitments made through national processes, as well as those pledged through regional efforts such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA), or through global efforts, such as Every Woman Every Child, supporting the Global Strategy for Women’s and Children’s Health, launched by UN Secretary-General Ban Ki-moon in 2010.

This document, Strengthening National Advocacy Coalitions for Improved Women’s and Children’s Health, reports on the work of national CSO coalitions in 10 countries, supported by PMNCH over the past 18 months to intensify joint action to enhance accountability relating to women’s and children’s health.

Responding directly to the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health (CoIA), PMNCH began in late 2011 to provide catalytic financial and technical support for the development or strengthening of national civil society alliances for Reproductive, Maternal, Newborn and Child Health (RMNCH) advocacy in key countries in Africa and Asia where the mortality burden is high and where clear pledges for action have been made. These CSO coalitions are now present in 10 countries: Bangladesh, Burkina Faso, Ethiopia, Ghana, India, Indonesia, Kenya, Nigeria, Uganda and Tanzania.

The coalitions are anchored by two focal points per country: one nationally headquartered NGO and one internationally headquartered NGO, ensuring a deliberate link between national action and regional and global political processes and interests. In the case of the Africa-based coalitions, PMNCH partners with the Africa MNCH Coalition to build capacity among the coalitions to facilitate the implementation of the African Union’s Integrated RMNCH Advocacy Strategy, which seeks to reconcile existing African commitments and platforms with the Global Strategy.

A total of US$ 35 000 in catalytic funds was provided to each country by PMNCH in 2012. These funds were to be used to:

  • Conduct a rapid mapping of CSOs intervening in women’s and children’s health in each country
  • Organize a national advocacy stakeholder meeting to discuss and agree on common priorities, needs and workplans
  • Develop a sustainable coalition with resource mobilization capacity
  • Support a limited number of specific joint activities emerging from the joint workplans, including possible support for national Countdown to 2015 products and events

During this time, national coalitions were encouraged to align priorities and activities in view of existing national plans and processes. As such, varying models have developed.

  • For instance: some countries, like Tanzania, Burkina Faso and Kenya, recognized the lack of space for discussion and alignment of CSOs across the RMNCH continuum of care, and decided to prioritize efforts on creating and expanding RMNCH-focused CSO coalitions;
  • Other countries, like India and Ethiopia, identified the key challenge as the opportunity for CSOs to participate in broad-based RMNCH policy and planning, and focused on securing CSO participation within multistakeholder RMNCH alliances, including government, donors, and the UN;
  • Within both models, some alliances restricted membership to stakeholders involved in RMNCH advocacy, while others, such as Nigeria and Uganda, also included those working on social and environmental determinants of health.

As the country profiles in this report suggest, participants have taken full advantage from the creation of these collaborative spaces. In most of the 10 countries, these are the first CSO coalitions to cover the entire continuum from pre-conception to child and adolescent health. In countries where these coalitions were pre-existing – such as in Ethiopia or Bangladesh– membership was expanded and the remit of the group was re-focused on evidence-based advocacy. In all cases, these coalitions have built on pre-existing efforts and are focusing specifically on aligning advocacy efforts.

These partnerships have resulted in the implementation of innovative approaches, such as:

  • The creation of a joint advocacy toolkit in Tanzania to increase the enrolment of youth in midwifery training
  • The creation of voluntary contribution schemes in Indonesia, Ghana and Uganda to cover the cost of alliance activities
  • Strengthening the role of media in accountability in Ghana, Indonesia, Nigeria and Tanzania
  • Collaboration with parliamentarians on policy and budget support for health plans in nearly all countries
  • Capacity building of CSOs to develop and implement locally relevant advocacy strategies in Ghana
  • Monitoring by the coalitions of implementation of workplan commitments by CSOs in Burkina Faso and Uganda

Countries remain at varying stages in building their CSO coalitions. However, in producing the country reports that make up this document, the coalition leads indicate their belief in the value-added of these joint efforts. In Uganda, for example, the national CSO coalition led by ACHEST and World Vision Uganda worked with legislators to delay the budget approval process by two weeks, until the allocation to health was increased. The Ugandan Coalition has also been instrumental in advocating for the leadership of the Ministry in undertaking a national Countdown process. The Coalition is also supporting the implementation of Uganda’s national accountability roadmap funded by the CoIA workplan, and is lending its advocacy capacity to the East African Community Open Health Initiative to Improve Maternal and Child Health in East African Partner States -- a south-south collaborative initiative building on the exchange of information and capacity to improve health outcomes. The Coalition has developed a three-year costed strategic plan to guide its activities.

In Kenya and Burkina Faso, the CSO coalitions are leading in the proposal of country Countdown to 2015 processes. In Burkina Faso this advocacy has resulted in the Minister of Health making Countdown to 2015 a national health advocacy priority and allocating resources for its implementation. The RMNCH CSO network is now also in consultation with the global Countdown committee and the national government to advise on the implementation of the Burkina Faso Countdown to 2015 advocacy strategy.

In India, the reproductive, maternal, newborn, child and adolescent health (RMNCH+A) Coalition, led by Save the Children India under the auspices of the Government of India, as authority to provide direction and advocate for RMNCH+A policy and programming. The first of its kind, the coalition which includes central and state government agencies, academia, research and training institutes, health care professional associations, local bodies (Panchayats and Nagarpalikas), nongovernmental organizations, CSOs, faith-based organizations (FBOs), media, corporate organizations, bilateral and multilateral donors and United Nations agencies, aims to work more effectively with stakeholders to enhance joint action and accountability, and to support the implementation of national commitments and policies.

During the past 18 months, PMNCH has supported two technical meetings to develop this programme: In March 2012, alongside the Women Deliver Africa regional consultation meeting, and in Washington, DC, in June 2012, alongside the Promise Renewed for Child Survival event, linked with the launch of the Countdown to 2015 report.

During this process, support has been received from Norad, the Bill and Melinda Gates Foundation, and the Commission on Information and Accountability for Women’s and Children’s Health to strengthen this programme of national advocacy.

Future efforts will include support for an Africa regional budgettracking capacity building workshop with civil society, parliamentarians and the media, to be held this year with the support of CSO coalitions from Uganda, Tanzania, Kenya, as well as the Inter-Parliamentary Union, the Open Health Initiative, Evidence for Action (E4A), Save the Children, the White Ribbon Alliance, and World Vision.

PMNCH looks forward to continued support to its NGO constituency and these country coalitions to ensure that civil society is enabled to maximize its voice and impact in advocating for greater results for women and children.

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