PMNCH release: A review of global accountability mechanisms for women’s and children’s health

Mothers and babies - Photo credit: © UNICEF/NYHQ2005-1566/Pirozzi
Photo credit: © UNICEF/NYHQ2005-1566/Pirozzi

21 FEBRUARY 2011 | GENEVA - PMNCH has just released a new discussion paper - A review of global accountability mechanisms for women’s and children’s health - as part of its accountability work on the United Nations’ Global Strategy for Women’s and Children’s Health and in support of The Commission on Information and Accountability for Women’s and Children’s Health. The review concludes that there are significant gaps in accountability mechanisms for monitoring, review and remedy or action, particularly as relates to vital registration and health information systems in countries, and to the activities of the range of non-state stakeholders who made commitments to the Global Strategy - including multilateral organizations, non-governmental organizations, donors, foundations, healthcare professional associations, academic institutions and the private sector - working in the area of women’s and children’s health. There is an urgent need for monitoring and independent review mechanisms that inform remedial actions for all stakeholders in order to achieve results for women’s and children’s health.

Background

In November 2010, the Partners’ Forum of PMNCH marked the culmination of a landmark year for women’s and children’s health. In response to the United Nations Secretary-General's (UNSG) Global Strategy for Women's and Children's Health (the Global Strategy), world leaders and other stakeholders made pledges at the G8, African Union and United Nations General Assembly. To transform these pledges into action, PMNCH partners adopted the Delhi Declaration 2010, in which they agreed to: “shared principles for advocacy, action and accountability.”

In the Global Strategy, the UNSG requested WHO to chair a process to determine the most effective international institutional arrangements for global reporting, oversight and accountability on women's and children's health” — a process which began with the first meeting of the Commission on Information and Accountability for Women’s and Children’s Health held 26 January 2011 in Geneva.

PMNCH constituencies will develop a 2011 progress report on the Global Strategy to be presented at the UN Assembly in September which will analyze how far all stakeholders have progressed with their commitments. As part of the process, PMNCH commissioned the landscape review to look at existing global accountability mechanisms for women’s and children’s health.

Purpose of the review

The Review examines accountability mechanisms encompassing: monitoring; review (which may be independent or non-independent); and remedy or action (e.g. recommendations that specific policies and programmes be revised). It confirms that while monitoring is central to accountability, it is not the same thing.

The Review looks at existing global accountability mechanisms that apply to different stakeholders with respect to commitments made to the Global Strategy. Since there are some gaps in arrangements for global accountability specifically for women’s and children’s health, the Review also looks at accountability arrangements more generally in the fields of global health, development and human rights. The Review does not provide a comprehensive summary of arrangements for reporting, oversight and accountability for women’s and children’s health, or for international health, development or human rights. The Review does provide illustrative examples, highlighting good practices where possible.

Key findings include:

  • Monitoring: Currently, a large amount of data on states and women’s and children’s health is collected and evaluated. However, there are significant data gaps. Vital registration and health information systems need to be strengthened in many countries. Data are very limited on activities of non-state stakeholders - including multilateral organizations, non-governmental organizations, donors, foundations, healthcare professional associations, academic institutions and the private sector - working in the area of women’s and children’s health. Arrangements are urgently needed to develop monitoring for general and specific commitments of all stakeholders under the Global Strategy.
  • Review: Few global review processes focus on accountability for women’s and children’s health, and none is well placed to provide accountability for specific commitments made by a range of different stakeholders to the Global Strategy. A new independent review body is needed urgently that: considers an agreed core set of quantitative and qualitative data from all stakeholders; commends good practices; signals where there is room for improvement; and makes constructive, practical, remedial recommendations.
  • Remedy or action: The review body’s observations and recommendations should then be considered by a body or bodies representing the different stakeholders, so they can take the required remedial actions. These include the United Nations General Assembly and other bodies such as non-governmental organization coalitions, healthcare professional associations and private sector forums. Technical and financial assistance will be required to strengthen health information systems and to help implement and monitor the activities of the multiple stakeholders that made financial, policy and service delivery commitments to the Global Strategy.

In short, monitoring, independent review and remedial or action mechanisms should feed into a cyclical process that facilitates stakeholders’ individual and mutual accountability to achieve results at all levels for women’s and children’s health.

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