Key highlights from 2013 report on health accountability
There are lots of useful information in the report for member states to digest and for the media and civil society to apply and engage in advocacy and sensitization as we match towards 2015 when a final review of the attainment of the Millennium Development Goals (MDGs) will be done.The background of the report dated […]
There are lots of useful information in the report for member states to digest and for the media and civil society to apply and engage in advocacy and sensitization as we match towards 2015 when a final review of the attainment of the Millennium Development Goals (MDGs) will be done.
The background of the report dated three years precisely from September 2010 when the United Nations Secretary-General launched the Global Strategy for Women’s and Children’s Health – aiming to save 16 million lives by 2015 in the 75 countries where more than 95% of all maternal and child deaths take place. The Global Strategy called for a process to determine the best arrangements for global reporting, oversight and accountability for women’s and children’s health (Millennium Development Goals 4 and 5). This led to the formation of the Commission on Information and Accountability for Women’s and Children’s Health (CoIA), convened by President Kikwete of the United Republic of Tanzania and Prime Minister Harper of Canada.
The report observed that:
In countries, it is clear that the accountability framework has gained traction as a guide to implementing the 10 CoIA recommendations. To date, 58 of the 75 target countries have completed accountability frameworks or are in the process of completion. The Country Accountability Framework (CAF) process has been instrumental in bringing together donors and country stakeholders and strengthening International Health Partnership (IHP+) processes. The CAF process has also generated high levels of demand from counties for resources and technical support to implement their country accountability frameworks. (Nigeria is reported to be among the 58 countries.)
By May 2013, 36 countries had received catalytic funds to create accountability frameworks. Countries are requested to submit progress reports twice each year on the implementation of framework activities. Virtually all other countries are in the process of raising awareness about the accountability framework in-country and finalizing their country accountability frameworks. (Nigeria is reported to have gotten the catalytic funds from W.H.O)
Countries are taking steps to strengthen their health information systems, including systems for annual routine reporting on health facilities. More than 20 countries are now using District Health Information Software (DHIS 2.0). This is an integrated approach that includes a web-based element that improves collection, transfer and analysis of facility data. Eleven countries have started to implement data quality mechanisms as part of efforts to improve transparency of data. They have conducted facility assessments to measure and monitor scale up of essential interventions and services for women and children. This includes monitoring the 13 essential life-saving commodities identified by the United Nations Commission on Life-Saving Commodities for Women and Children. (Nigeria is reported not to start monitoring the 13 commodities.)
Twenty-one countries are now tracking resources for women’s and children’s health, and an additional 23 are expected to have started work on health accounts by the end of 2013. This harmonized approach is based on the System of Health Accounts methodology (SHA 2011), with additional catalytic funding for this activity coming from the Global Fund. Continued technical assistance to institutionalize the approach is required. (Nigeria is reported not to have a robust and functional Health Account but in the process of making it).
To date, 40 countries report having signed a compact or equivalent agreement with development partners, and an additional six countries are in the process of developing such agreements. The accountability framework is an integral part of the Country Compact. With the renewed global momentum around IHP+, there is further opportunity and need to coordinate partner investments in, and work on, accountability processes at country level. (Nigeria is reported not to be among the 40 countries to have signed a compact).
Fifty-three countries have reported they are conducting annual health sector reviews, to build a clearer picture of the gaps in their health-care provision and as the basis for national accountability mechanisms. Broader participation of stakeholders in this process has increased transparency. However, much more needs to be done to engage the active participation of civil society and nongovernmental organizations (NGOs). Improvements in the quality of the analytical inputs would strengthen the evidence base for decision-making, policy dialogue and resource allocation. (Nigeria is among the countries reported to be conducting annual health sector reviews)
Transparency is enhanced by better monitoring of results and tracking of resources, as described above. The benefits include better data on the 11 health indicators and better data and analyses to inform reviews of progress and performance. Dissemination of information is improved by the introduction of DHIS 2.0 and the launch of regional initiatives such as the African Health Observatory. Parliamentarians, civil society organizations (CSOs) and the media are all contributing to gradual improvements in review processes. Work with the Inter-Parliamentary Union (IPU) has already led to greater involvement of parliamentarians in women’s and children’s health issues. However, many countries lack strong CSOs and media that can play a role in regular reviews and accountability processes, which should lead to greater transparency and effective action. (Nigeria is reported to be among the countries with weak CSOs and media for regular reviews and accountability processes).
With this report at our disposal, it is duty bound upon us to review the entire report and situate our countries by flagging a scorecard to score the level of implementations of all the 10 recommendations by the Commission on Information and Accountability Recommendations (CoIA).
All comments to Dr Aminu Magashi at [email protected]