Commitments in Support of the Global Strategy, September 2012


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The commitments outlined in this document represent the global community's promise to do more for women's and children's health, in line with the Every Woman Every Child movement spearheaded by UN Secretary-General Ban Ki-moon.

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Commitments in Support of the Global Strategy, September 2012

  3. 3. Every Woman Every Child was launched in September 2010 with the goal of improving women’s and children’s health around the world. In the two years since its launch, the Every Woman Every Child movement has seen remarkable progress, with ambitious commitments; new partners coming on board; increased funding; improved policies; and services on the ground strengthened and expanded. This work is paying off. Deaths of young children have continued to decrease, dropping from 7.6 million deaths in 2010 to 6.9 million at present. Women dying of pregnancy-related causes have fallen from nearly 360,000 in 2008 to 287,000 in 2010, with major gains made in some of the world’s largest countries. Today, far fewer children are being infected with HIV. The percentage of children that are exclusively breastfed until six months has risen over the past decade in many countries, particularly in Africa and Asia, providing a sound nutritional start to life and ensuring critical protection against water-borne diseases and diarrhea – a major cause of death. As of September 2012, an impressive group of more than 250 organizations from a wide range of sectors made commitments in support of Every Woman Every Child. Together, these partners are taking a major step towards filling the gap between the investment needed and what is currently provided for women’s and children’s health. Political support to meet the health-related MDGs has increased at the highest levels. Some of the most neglected causes of women’s and children’s mortality have seen new attention and investment. This year, we saw tangible results of leadership, producing “more money for health and more health for the money”. • April saw the launch of the UN Commission on Life-Saving Commodities for Women and Children, chaired by President Goodluck Jonathan of Nigeria and Prime Minister of Norway Jens Stoltenberg. Their recommendations and a corresponding implementation plan seeks to reduce barriers and increase access to life-saving medicines and health supplies for the world’s most vulnerable women and children; • Thirty new and expanded commitments proposing actions towards the prevention and care of preterm birth were announced in May at the launch of the Born Too Soon report on preterm birth; • Since the June 2012, Committing to Child Survival: A Promise Renewed, has mobilized 114 governments, 174 civil society organizations and more than 250 leaders from faith based groups to renew their commitment to child survival; and • At the London Family Planning Summit in July, more than 150 partners announced commitments to ensure that an additional 120 million women and girls can access voluntary family planning by 2020. More than 20 developing countries made bold commitments to address the barriers to women accessing contraceptive information, services and supplies. Donors made new financial commitments to support these plans amounting to $2.6 billion – exceeding the Summit’s financial goal.GOVERNMENT 4
  4. 4. • The Secretary-General has continued to prioritize women’s and children’s health in his own travels. Last year in Nigeria, Ethiopia, Bangladesh, Thailand and Indonesia the Secretary-General’s visits, along with other UN leaders, encouraged coordinated action and helped showcase progress and innovative approaches to advance the Global Strategy that these countries are driving forward. Further detailing the movement’s progress and implementation of commitments, two reports will be released during the week of the 2012 United Nations General Assembly meeting in New York. The independent Expert Review Group (iERG) will submit its first annual review of the results and resources to advance the Global Strategy and the implementation of the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health. The PMNCH 2012 report will review the progress made towards implementing the commitments by all stakeholders to advance the Global Strategy. As we assess progress in 2012, we must also recognize how far we are from the finish line. To achieve the health-related MDGs and reach our global target to prevent the deaths of 16 million women and children and improve the lives of many more, we need to accelerate the rate of progress through 2015 and beyond. The commitments outlined in the rest of this document represent the global community’s commitment to achieving the health MDGs to 2015 and beyond: an ongoing promise to do more for women’s and children’s health. The nearly 275 entries include individual organizations and partnerships, illustrating the growing collaborative spirit of the effort. Commitments are organized alphabetically, by sector. All new and enhanced commitments made between 2010 and September 2012 are listed, with text indicating when commitments were announced as part of key pledging events and advocacy moments throughout the year. With these commitments, partners are re-doubling their efforts to ensure predictable funding, the promotion and scaling up of innovations, and improved access to voluntary family planning and health commodities for some of the world’s most vulnerable women and children. Please visit for the electronic version of this document and to learn more about this exciting movement. If you have not done so yet, join us!GOVERNMENT 5
  5. 5. 74 GOVERNMENTSPhoto Courtesy of United Nations Foundation/David Evans
  6. 6. AFGHANISTAN (2010) Afghanistan will increase public spending on health from $10.92 to at least $15 per capita by 2020. Afghanistan will increase the proportion of deliveries assisted by a skilled professional from 24% to 75% through strategies such as increasing the number of midwives from 2400 to 4556 and increasing the proportion of women with access to emergency obstetric care to 80%. Afghanistan will also improve access to health services - strengthening outreach, home visits, mobile health teams, and local health facilities. Afghanistan will increase the use of contraception from 15% to 60%, the coverage of childhood immunization programs to 95%, and universalize Integrated Management of Childhood Illness. AUSTRALIA (2010 & 2012) 2010 Australia supports the UN Secretary-General’s Global Strategy for Women’s and Children’s Health as a firm platform for putting the health needs of women and children back into the centre of the development agenda. Recognising the need for increased effort on women’s and children’s health, Australia will invest around US$1.5 billion (A$1.6 billion) over the five years to 2015 on interventions evidence shows will improve maternal and child health outcomes. These will include expanding access to family planning and vaccination services, and funding skilled health workers (including midwives), health facilities and supplies. Financial support committed in 2010 includes an additional US$79.5 million ($85 million) for the Pacific and Papua New Guinea and US$131 million (A$140 million) for Eastern Africa. Australia’s strong focus on Indonesia, South Asia and effectively performing international organizations will also continue. [on current projections subject to annual budget processes] 2012—Born Too Soon Australia will spend $1.6 billion over five years to 2015 under the Global Strategy for Women’s and Children’s Health to help give poor women and their babies the best chance of survival. A strong health system, available 24 hours a day, 365 days a year is needed to ensure women have healthy pregnancies, safe deliveries and access to services for their newborn babies. Working in partnership with national governments, Australia helps to strengthen health systems by improving service delivery and access to health clinics, training skilled health workers and ensuring reliable supplies of essential medicines, educating women on nutrition, prenatal and postnatal care, and providing quality emergency care if a delivery becomes complicated. Australia also supports efforts to prevent preterm births and improve the health of preterm babies through substantial core contributions to WHO, UNFPA, UNICEF; global initiatives such as the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria; and civil society organisations. 2012—London Family Planning Summit Australia commits to spending an additional AUD 58 million over five years on family planning, doubling annual contributions to AUD 53 million by 2016. This commitment will form a part of Australia’s broader investments in maternal, reproductive and child health (at least AUD 1.6 billion over five years to 2015). This commitment is subject to annual budget processes.GOVERNMENT 9
  7. 7. BANGLADESH (2010 & 2012) 2010 Bangladesh commits to: doubling the percentage of births attended by a skilled health worker by 2015 (from the current level of 24.4%) through training an additional 3000 midwives, staffing all 427 sub-district health centres to provide round-the-clock midwifery services, and upgrading all 59 district hospitals and 70 Mother and Child Welfare Centres as centres of excellence for emergency obstetric care services. Bangladesh will also reduce the rate of adolescent pregnancies through social mobilization, implementation of the minimum legal age for marriage, and upgrading one third of MNCH centres to provide adolescent friendly sexual and reproductive health services. Bangladesh will halve unmet need for family planning (from the current level of 18%) by 2015; and ensure universal implementation of the Integrated Management of Childhood Illness Programme. 2012—London Family Planning Summit Bangladesh will increase access and use for poor people in urban and rural areas, improving choice and availability of Long Acting and Permanent Methods (LaPMs), including for men, and post-partum and post- abortion services. The government will work with the private sector and non-governmental organizations (NGOs) to: address the needs of young people, especially young couples; reduce regional disparities, working with leaders and communities to delay early marriage and child birth; and increase male involvement. One-third of Maternal Newborn and Child Health (MNCH) centers will provide adolescent Sexual and Reproductive Health and Rights (SRHR) services. Monitoring to ensure quality of care will be strengthened, including informed consent and choice, and to support women to continue use of family planning. BENIN (2010) Benin will increase the national budget dedicated to health to 10% by 2015 with a particular focus on women, children, adolescents and HIV; introduce a policy to ensure universal free access to emergency obstetric care; ensure access to the full package of reproductive health interventions by 2018; and increase the use of contraception from 6.2% to 15%. Benin will also step up efforts to address HIV/AIDS through providing ARVs to 90% of HIV+ pregnant women; ensuring that 90% of health centres offer PMTCT services; and enacting measures against stigma and discrimination. Benin will develop new policies on adolescent sexual health; pass a law against the trafficking of children, and implement new legislation on gender equality. BURKINA FASO (2010 & 2012) 2010 Burkina Faso has met the 15% target for health spending, and commits to maintain spending at this level. Burkina Faso will also develop and implement a plan for human resources for health and construct a new public and private school for midwives by 2015. This is in addition to other initiatives being pursued which will also impact on women’s and children’s health, including free schooling for all primary school girls by 2015, and measures to enforce the laws against early and forced marriage, and female genital mutilation. 2012—London Family Planning Summit Burkina Faso, through the leadership and advocacy of the First Lady, pledges to take action in terms of policy, funding and programming. The aim will be to maintain family planning as a central priority of development policies, effectively enforcing existing legal instruments on reproductive health and reducing the cost ofGOVERNMENT 10
  8. 8. contraceptive commodities. Burkina Faso will work toward increasing the resources allocated to family planning in state budgets. It will also seek to boost partnerships with the private sector and civil society organizations for service provision, to define and develop strategies for engaging men, and to establish regular and active monitoring of the availability of contraceptive commodities at all levels. BURUNDI (2011) Burundi commits to increase the allocation to health sector from 8% in 2011 to 15% in 2015, with a focus on women and children’s health; increase the number of midwives from 39 in 2010 to 250, and the number of training schools for midwives from 1 in 2011 to 4 in 2015; increase the percentage of births attended by a skilled birth attendant from 60% in 2010 to 85% in 2015. Burundi also commits to increase contraception prevalence from 18.9% in 2010 to 30%; PMTCT service coverage from 15% in 2010 to 85% with a focus on integration with reproductive health; and reduce percentage of underweight children under-five from 29% to 21% by 2015. CAMBODIA (2010) Cambodia will ensure that 95% of the poor are covered by health equity funds by 2015, and develop a new policy to ensure availability of emergency obstetric care at the district level. Cambodia will improve reproductive health by increasing the proportion of deliveries assisted by a skilled birth attendant to 70%; increase the proportion of couples using modern contraception to 60%; and increase the number of health facilities offering safe abortion/post abortion services. Cambodia will further seek to increase attendance at ante-natal clinics to 90% and attendance at post-natal clinics to 50%. CAMEROON (2011) Cameroon commits to implement and expand the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), re-establish midwifery training to train 200 midwives a year, and pilot a performance-based financing and a voucher system in order to promote access to maternal and child care services. Cameroon further commits to increase the contraception prevalence from 14% to 38%; the proportion of HIV+ pregnant women access to antiretrovirals from 57% to 75%; and the vaccine coverage from 84% to 93%. Cameroon will increase to 60% the proportion of health facilities offering integrated services; increase to 50% the proportion of women with access to Emergency Obstetric Care (EmOC) services; offer free malaria care to children under 5; ensure free availability of mosquito-treated nets to every family; increase funding to paediatric HIV/AIDS; strengthen health information systems management and integrated disease surveillance. CANADA (2010) As Chair of the G8, Canada made maternal, newborn and child health a priority for the G8 Muskoka Summit in June 2010. At the Muskoka Summit, Prime Minister Stephen Harper committed C$1.1billion in new and additional funding for women’s and children’s health as part of the Muskoka Initiative. Prime Minister Harper also confirmed renewal of existing resources of C$1.75 billion, meaning Canada will provide C$2.85 billion for MNCH by 2015. Canada will focus its efforts on improving the services and care needed to ensure healthy pregnancies and safe delivery, and placing a particular emphasis on meeting the nutritional needs of pregnant women, mothers, newborns and young children. Canada will work to increase access to the high-impact, cost- effective interventions that address the leading killers of children under the age of five. Canada will also commitGOVERNMENT 11
  9. 9. an additional $540 million over three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This is in addition to a total of $978.4 million that Canada has committed and disbursed to the Global Fund since 2002. CENTRAL AFRICAN REPUBLIC (2011) Central African Republic commits to increase health sector spending from 9.7% to 15%, with 30% of the health budget focused on women and children’s health; ensure emergency obstetric care and prevention of PMTCT in at least 50% of health facilities; and ensure the number of births assisted by skilled personnel increase from 44% to 85% by 2015. CAR will also create at least 500 village centers for family planning to contribute towards a target of increase contraception prevalence from 8.6% to 15%; increase vaccination coverage to 90%; and ensure integration of childhood illnesses including pediatric HIV/AIDS in 75% of the health facilities. CHAD (2011) Chad commits to increase health sector spending to 15%; provide free emergency care for women and children; provide free HIV testing and ARVs; allocate of US$10million per year for implementation of the national roadmap for accelerating reduction in MNC mortality; strengthen human resources for health by training 40 midwives a year for the next 4 years, including creating a school of midwifery and constructing a national referral hospital for women and children with 250 beds; and deploying health workers at health centres to ensure delivery of a minimum package of services. Chad also commits to pass a national human resources for health policy; increase contraception prevalence to 15%; ensure 50% of the births are assisted by a skilled birth attendant; and increase coverage of PMTCT from 7% to 80%, and pediatric HIV coverage from 9% to 80%. CHINA (2010) China will continue to increase its domestic investment in women and children’s health, through new policies and measures, and additional financing. New reforms now being implemented will provide basic health care insurance for all. There are also new measures which especially benefit rural women, including free breast and cervical cancer screening, hospital birth-delivery subsidies, and free folic acid supplements. Additional measures include free hepatitis B vaccination for all children under 15 years old, a national immunization program covering all children, and free services to prevent mother-to-child transmission of the HIV virus for all pregnant women. The government will also reimburse 90% of medical expenses for rural children who have congenital heart disease or leukaemia. COMOROS (2011) Comoros commits to increase health sector spending to 14% of budget by 2014; ensure universal coverage for PMTCT by 2015; reduce underweight children from 25% to 10%; increase contraception prevalence rate from 13% to 20%; and the births that take place in health facilities from 75% to 85%. Comoros will also accelerate the implementation existing national policies including the national plan for reproductive health commodity security, the strategic plan for human resources for health, and the roadmap for accelerating reduction of maternal and neonatal mortality. CONGO (2010) Congo commits to reducing maternal mortality and morbidity by 20% by 2015 including obstetric fistula, by introducing free obstetric care, including free access to caesarean sections. Congo will also establish a newGOVERNMENT 12
  10. 10. observatory to investigate deaths linked to pregnancy; and will support women’s empowerment by passing a law to ensure equal representation of Congolese women in political, elected and administrative positions. CÔTE D’IVOIRE (2011) Côte d’Ivoire commits to ensure the provision of free health services for all pregnant women during delivery, including free caesarian-sections, for women affected by obstetric fistula and for children under 5. Côte d’Ivoire also commits to rehabilitate maternity centres, provide insecticide-treated mosquito nets for women and children under 5; to strengthen the integrated management of childhood illnesses programmes; and to integrate HIV and Sexual and Reproductive Health, and community involvement in health management, including training health workers to ensure the provision of family planning at the community level. DEMOCRATIC REPUBLIC OF CONGO (DRC) (2010) The Democratic Republic of Congo (DRC) will develop a national health policy aimed to strengthen health systems, and will allocate more funds from the Highly Indebted Poor Country program to the health sector. DRC will increase the proportion of deliveries assisted by a skilled birth attendant to 80%, and increase emergency obstetric care and the use of contraception. The government will increase to 70% the number of children under 12 months who are fully immunized; ensure that up to 80% of children under 5 and pregnant women use ITNs; and provide AVRs to 20,000 more people living with HIV/AIDS. DENMARK (2012) 2012—London Family Planning Summit Denmark commits an additional US $13 million over eight years. DJIBOUTI (2011) Djibouti commits to increase the health budget from 14% to 15%. In terms of service delivery, the Government will ensure that all pregnant women will have access to skilled personnel during childbirth. For this purpose, the Government will increase the number of trained midwives and nurses and will increase access to emergency obstetric care services nationally to 80%. A package of integrated emergency obstetric and newborn care and reproductive health will also be delivered in health services. This will be achieved by ensuring that all health centers are upgraded to deliver a package of emergency obstetric and newborn care and reproductive health services by upgrading them and ensuring that appropriate staff are posted and maintained in those centers. Contraceptive prevalence will be increased to 70%. The mobile health services will be extended to cover all areas of the country and will adopt a mix of outreach services, home visits and community based interventions. The government commits to implement Integrated Management of Childhood Illnesses in all health centers. Vaccine coverage will be 100%. Malnutrition will be addressed through a comprehensive multi-sectoral package in order to reduce the prevalence of stunting to 20% and that of wasting to 10%. Djibouti commits to decrease the HIV/AIDS prevalence to 1.8% in 2015 and to ensure that all pregnant HIV-positive women receive antiretrovirals.GOVERNMENT 13
  11. 11. ETHIOPIA (2010 & 2012) 2010 Ethiopia will increase the number of midwives from 2050 to 8635; increase the proportion of births attended by a skilled professional from 18% to 60%; and provide emergency obstetric care to all women at all health centres and hospitals. Ethiopia will also increase the proportion of children immunized against measles to 90%, and provide access to prevention, care and support and treatment for HIV/AIDS for all those who need it, by 2015. As a result, the government expects a decrease in the maternal mortality ratio from 590 to 267, and under-five morality from 101 to 68 (per 100,000) by 2015. 2012—London Family Planning Summit Contraceptive use has doubled in Ethiopia since 2005. The government will further increase its funding to uphold the rights of all people to access and choose voluntary family planning through the strong network of primary health care providers. In particular, the needs of married and unmarried adolescent girls will be met through partnerships with non-government and private providers, as well as expanding youth-friendly services. The government will also improve access for isolated pastoralist communities. FRANCE (2010, 2011 & 2012) 2010 France announced 500 million euros for the period 2011-2015 to support the Muskoka initiative. Furthermore, France announced an increase by 20 % of its contribution to the Global Fund to fight AIDS, TB and Malaria over the period 2011-2013 (1.080 billion euros as compared to 900 million euros for the previous triennium). 2011 France made a substantial commitment to the Global Strategy for Women’s and Children’s Health in 2010, and during 2011 it was greatly strengthened. France has allocated EUR 19 million per year to the World Health Organisation, UNFPA, UNICEF and UN Women in support of their joint initiatives on women’s and children’s health. In addition, the increase of the French contribution to the GAVI Alliance for the period 2011-2015 amounts to EUR 100 million, and the increase of its contribution to UNAIDS amounts to EUR 60 million per year. 100% of the contribution to GAVI and 46% of the contribution to UNAIDS - a total of EUR 47 million per year - directly supports MDG4 and MDG5. Finally, France, through its international development agency, will allocate EUR 48 million per year towards national and multi-country projects to improve the development of health systems. 2012—London Family Planning Summit In 2011, France pledged to spend an additional €100m on family planning within the context of reproductive health through to 2015, in nine countries in francophone Africa. GAMBIA (2011) The Gambia commits to increase the health budget to 15% of the national budget by the year 2015; and to implement its existing free maternal and child health care policy, ensuring universal coverage of high quality emergency maternal, neonatal and child health services. Special attention will be accorded to rural and hard- to-reach areas. Efforts will be intensified to increase the proportion of births attended by skilled professionalsGOVERNMENT 14
  12. 12. to 64.5%, ensure reproductive health commodities security, scale up free Prevention of Mother-to-Child Transmission (PMTCT) services to all reproductive health clinics and ensure universal access to HIV prevention, treatment, care and support services, including social protection for women, orphans and vulnerable children. Furthermore, The Gambia will continue to maintain the high immunization coverage for all antigens at 80% and above at regional levels, and 90% and above at national levels, while seeking to increase access of all children, particularly in the most vulnerable communities, to high impact and cost-effective interventions that address the main killers of children under five. GERMANY (2010 & 2012) 2010 Germany is developing a new initiative on Voluntary Family Planning with resources to be made available for family planning and reproductive health and rights as part of Germany’s ongoing annual commitment in the area of mother and child health of 300m euros per year and Germany’s commitment made in June at Muskoka of an additional 400m euros over the next five years. 2012—London Family Planning Summit Germany commits €400 million (US $491.6 million) to reproductive health and family planning over four years, of which 25% (€100 million or US $122.29 million) is likely to be dedicated directly to family planning, depending on partner countries’ priorities. GHANA (2010 & 2012) 2010 Ghana will increase its funding for health to at least 15% of the national budget by 2015. Ghana will also strengthen its free maternal health care policy, ensure 95% of pregnant women are reached with comprehensive PMTCT service and ensure security for family planning commodities. Ghana will further improve child health by increasing the proportion of fully immunized children to 85% and the proportion of children under-five and pregnant women sleeping under insecticide-treated nets to 85%. 2012—London Family Planning Summit Ghana is committed to making family planning free in the public sector and supporting the private sector to provide services. Services will be available for sexually active young people through youth promoters and adolescent friendly services. Improved counseling and customer care will be prioritized. Contraceptive choices are being expanded to include a wider range of long acting and permanent methods along with including task shifting options and improvement of post-partum and post-abortion family planning services. The government has put in place a comprehensive multi-sectorial program to increase demand for family planning as a priority intervention in the MDG 5 Acceleration Framework, including advocacy and communications to improve male involvement, such as the “Real Man” campaign. GUINEA (2011) Guinea commits to establish a budget line for reproductive health commodities; ensure access to free prenatal and obstetric care, both basic and emergency; ensure provision of newborn care in 2 national hospitals, 7GOVERNMENT 15
  13. 13. regional hospitals, 26 district hospitals, and 5 municipality medical centres; and introduce curriculum on integrated prevention and care of new born and childhood illnesses in health training institutes. Guinea also commits to secure 10 life-saving essential medications in at least 36 facilities providing basic obstetric care and 9 structures with comprehensive obstetric care by 2012; ensure at least three contraception methods in all the 406 centres of health in the public sector by December 2012; and include PMTCT in 150 health facilities. GUINEA-BISSAU (2011) Guinea-Bissau commits to increase financial spending from 10% to 14% by 2015 and to implement the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA); to ensure accessible comprehensive emergency obstetric and neonatal care in all regions, and to provide around-the-clock referrals. Guinea-Bissau also commits to ensure that each health center has access to basic Emergency Obstetric Care (EmOC), including strengthening the technical capacity of 95% of the EmOC facilities; increasing the proportion of women giving birth in health facilities from 35% to 60%; ensuring that 75% of the pregnant women are covered by health mutual funds, and that 90% of the most vulnerable are covered by state funds. In addition, Guinea-Bissau also commits to reduce the unmet need for family planning to 10% and to increase contraceptive prevalence from 10% to 20%; to increase pre-natal consultations to 70%, postnatal consultations to 30%, and to reduce the proportion of underweight children from 24% to 10%; and to integrate Prevention of Mother-to- Child Transmission in 90% of the maternity care centers. GUYANA (2011) Guyana commits to improve the contraceptive prevalence rate from 34.5% to above 60% by increasing the method-mix at national and regional levels, including by promoting long-term methods and emergency contraceptives; and further integrating family planning in community-based activities, as well as gender-based violence and teen mothers initiatives. Guyana also commits to increase Emergency Obstetric and Newborn Care (EmONC) to 100%, including by strengthening referral and transportation in Basic EmONC facilities and improving the interconnectedness of maternal health facilities to ensure access to EmONC. HAITI (2010) Haiti will create a financial mechanism to ensure free maternal, newborn and child health services, and develop a plan for human resources in health by 2015. Haiti will also provide emergency obstetric care in 108 health institutions constructing, rehabilitating or equipping facilities as necessary. Haiti will further reduce unmet need for family planning from 38% to 10% by improving commodity security and making services more youth-friendly. INDIA (2010 & 2012) 2010 India is spending over US $ 3.5 billion each year on health services, with substantial expenditure on services aimed towards women’s and children’s health. Currently, India is focusing on strengthening its efforts in the 264 districts that account for nearly 70% of all infant and maternal deaths. Between now and 2015, India will provide technical assistance to other countries and share its experience, and will support the creation of a platform for global knowledge management to oversee the dissemination of best practices.GOVERNMENT 16
  14. 14. 2012—London Family Planning Summit India will include family planning as a central element of its efforts to achieve Universal Health Coverage. Through the largest public health programme in the world, the National Rural Health Mission and the upcoming National Urban Health Mission, addressing equity, ensuring quality, including adolescents and integration into the continuum of care are slated to be the cornerstones of the new strategy. The centre-piece of its strategy on family planning will be a shift from limiting to spacing methods, and an expansion of choice of methods, especially IUDs (Intrauterine devices). To enable women to delay and space their births, India will distribute contraceptives at the community level through 860,000 community health workers, train 200,000 health workers to provide IUDs, and shall substantially augment counselling services for women after childbirth. Expenditure on Family Planning alone out of the total Reproductive, Maternal, Newborn and Child Health and Adolescent Health (RMNCH+A) bouquet is expected to cross 2 billion dollars from 2012 to 2020. This will ensure free services and commodities through public health facilities for 200 million couples of reproductive age group and adolescents seeking contraceptive services. INDONESIA (2010 & 2012) 2010 Indonesia will ensure all deliveries will be performed by skilled birth attendants by 2015. This universal access intervention is aimed at reducing the maternal mortality ratio from 228 per 100.000 live births in 2007 to 102 per 100.000 live births in 2015. In 2011, at least one and a half (1.5) million deliveries by poor women will be fully funded by the government. Central Government funding for health in 2011 will increase by USD 556 million compared to 2010. This fund will be available to support professional health personnel and to achieve quality health care and services in 552 hospitals, 8,898 health centres and 52,000 village health posts throughout Indonesia. 2012—London Family Planning Summit Over half of Indonesia’s women of reproductive age are using contraception to plan their families, with strong political leadership and a national movement for reproductive health and family planning. This has helped improve economic growth and reduce poverty through the resulting demographic dividend. Key factors have been support from religious leaders, participation of the private sector and quality of care, and communications campaigns. The government right now provides free services to 7 of 33 provinces since 2010; but will include family planning freely throughout the country in the Universal Health-care Coverage program in 2014; and will broaden access and choice especially in poorer regions, through the strengthening of all public and private clinic services and provision of preferable long-acting and permanent methods. Indonesia is investing in South-South exchange to share experiences. The government commits to maintaining its investment in finances for family planning programs, which has increased from US $65.9 million in 2006 to US $263.7 million in 2012 ISRAEL (2011) Israel supports the Global Strategy for Women’s and Children’s Health by placing women’s and children’s health issues at the heart of its international development agenda. In 2011, in line with its ongoing partnership with the Ghanaian authorities in Kumasi, Israel built a cane water supply system at the Komfo Anokye hospital valued at USD $50,000, in addition to supporting the training of health professionals working at the Mother and Baby units previously established by Israel, a training program valued at USD $70,000. In spring 2011, Israel completed the construction of an emergency and trauma unit and provided the operational medical equipment and specialized training for health professionals at the Hospital Justinien in Cap-Haitiën, Haiti, aGOVERNMENT 17
  15. 15. project valued at USD $720,000. Over the course of this year and next, in an effort to provide quality diagnostic and emergency services for women and children, Israel will supply equipment for diagnostic services in Freetown, Sierra Leone; an emergency trauma unit in Kampala, Uganda; three mobile medical emergency units in Guatemala; and a diagnostic center in Vinice, Ukraine, for a total value of USD $1.3 million. Finally, this year Israel announced a USD $100,000 contribution to UNAIDS to conduct a qualitative assessment to better understand the gender-related socio-cultural factors which amplify the barriers faced by pregnant women with HIV. JAPAN (2010 & 2012) 2010 At the Plenary of the MDG Summit Japan’s Prime Minister will launch its new Global Health Policy, which places a special focus on maternal, newborn and child health and will commit to provide $ 5 billion in five years from 2011. Under this new Policy, Japan will support the Global Strategy by implementing and advocating a package model by the name of “EMBRACE”, which intends to ensure the continuum of care from pregnancy to post natal stage. Japan also reaffirms its financial commitment made at the G8 Muskoka Summit to provide up to an additional $500 million for maternal, newborn and child health in five years from 2011 will be fulfilled as part of today’s $5 billion commitment. 2012—Born Too Soon The Japan International Cooperation Agency (JICA) commits to support the Global Strategy for Women’s and Children’s Health through the capacity development of partner countries in enhancing their health service delivery for maternal, newborn and child health care. JICA will contribute to achieving the goals expressed in Japan’s Global Health Policy 2011-2015, which commits to saving approximately 11.3 million children’s lives and 430,000 maternal lives in cooperation with other donors. JICA will support partner countries in building and strengthening systems that provide a comprehensive “Continuum of Care for Maternal and Child Health”. Every year, JICA implements technical cooperation and grant aid projects for MNCH at the level of 3 billion and 3-16 billion Japanese yen respectively, and will initiate concessional loans to help support partner countries to achieve MNCH-related MDGs. JICA will endeavor to make a change on MNCH through the integrated management of the three modalities of assistance. KENYA (2010 & 2012) 2010 Kenya will recruit and deploy an additional 20,000 primary care health workers; establish and operationalize 210 primary health facility centres of excellence to provide maternal and child health services to an additional 1.5 million women and 1.5 million children; and will expand community health care, and decentralize resources. 2012—London Family Planning Summit Kenya has enshrined the individual’s rights to quality reproductive health care, including family planning information, services and supplies, in the Constitution. The government’s budgetary allocation to family planning has grown from US $2.5 million in 2005/2006 to US $6.6 million in 2012/2013. The government is workingGOVERNMENT 18
  16. 16. closely with development partners to secure increased finance for family planning commodities and services. As part of the efforts to address family planning needs for the poor and hard-to-reach segments of the population, the government will scale up its Voucher System which provides reproductive health services, including family planning, in five rural and urban districts in Kenya. The government has already established over 70 Youth Empowerment Centres. The target is to have one in each constituency to provide a one-stop-shop for youth friendly information, including family planning. The target is to increase the contraceptive prevalence rate from 46% to 56% by 2015. KOREA, REPUBLIC OF (2012) 2012—London Family Planning Summit Korea commits to more than double its support for maternal and child health, including family planning, from US $5.4 million in 2010 to at least US $10.8 million a year beginning in 2013. Maternal and child health, including family planning, will continue as a priority area in Korea’s official development assistance (ODA) policy. Korea will expand its overall ODA program from .12% of its GNI in 2010 to .25% by 2015. KYRGYZSTAN (2011) The Government of Kyrgyzstan commits to ensure that 100% of the population of reproductive age have choice and access to modern contraception with at least 3 modern methods of family planning ; 100% free medical care for pregnant women and under-fives; ensure at least 80% of births take place at a health facilities and 90% of health facilities have access to centralized water supply system. Kyrgyzstan will ensure that 95% of health facilities with antenatal services provide both HIV testing PMTCT; 35% family medicine centers provide the standard package of youth-friendly health services; and that70% of children receive evidence-based services within integrated management of childhood illness. LAO PEOPLE’S DEMOCRATIC REPUBLIC (2011) The Lao People’s Democratic Republic commits to provide free deliveries in order to ensure access to the most vulnerable; produce 1500 new midwives by 2015 by upgrading existing staff and training and recruiting new staff; and increase immunization from 67% to 90% by 2015. Lao PDR will also increase the proportion of couples with access to modern contraception and the proportion of births attended by a skilled attendant. LESOTHO (2011) The Government of Lesotho is committed to meeting the Abuja Declaration Target of 15% expenditure for health, compared to the current 14% expenditure. The Government abolished user fees for all the health services at Health Centre level, while it has standardized user fees at hospital-level. The country has developed the National Health Sector Policy and its Strategic Plan which puts women and children at the centre. The National Reproductive Health Policy and its Strategic Plan also focus on women and children. These documents have been disseminated and their implementation is closely monitored. The Reproductive Health Commodity Security Strategy is in place and ensures that 90% of the women and men in the reproductive age group have access to commodities. The Lesotho Expanded Programme on Immunization Policy has been disseminated in 2010, focusing on under-five children. The Infant and Young Child Feeding Policy focuses on nutrition of children.GOVERNMENT 19
  17. 17. LIBERIA (2010) Liberia will increase health spending from 4% to 10% of the national budget and will ensure that by 2015 there are double the numbers of midwives trained and deployed than were in the health sector in 2006. Liberia will provide free universal access to health services including family planning and increasing the proportion of health care clinics providing emergency obstetric care services from 33% to 50%. Liberia will increase the proportion of immunized children to 80%, and address social determinants of ill-health through increasing girl’s education, and the mainstreaming of gender issues in national development. MADAGASCAR (2011) By 2015, Madagascar commits to increase health spending to at least 12%; ensure universal coverage for emergency obstetric care in all public health facilities; increase births assisted by skilled attendants from 44% to 75%; and double from 35% the percentage of births in health facilities. Madagascar will also address teenage pregnancy by making 50% of primary health care facilities youth-friendly; reduce from 19% to 9.5% the unmet need of contraception by strengthening commodity security; increase tetanus vaccination for pregnant women from 57% to 80%; and institute maternal death audits. MALAWI (2010 & 2012) 2010 Malawi will strengthen human resources for health, including accelerating training and recruitment of health professionals to fill all available positions in the health sector; expand infrastructures for maternal, newborn and child health; increase basic emergency obstetric and neonatal care coverage to reach World Health Organization standards; and provide free care through partnerships with private institutions. 2012—London Family Planning Summit With the goal of “no parenthood before adulthood,” Malawi commits to raising the country’s contraceptive prevalence rate to 60% by 2020 with a focused increase in those aged 15 to 24. Malawi will create a family planning budget line in the main drug budget by 2013/2014 and will raise the age of marriage to 18 by 2014. In addition, Malawi will develop a comprehensive sexual and reproductive health program to meet the needs of its young people and will work to strengthen effective policy leadership for family planning. It will also demonstrate accountability in the utilization of available resources and improve financial allocation for health systems supporting family planning. Malawi will increase coverage of services through the expansion of public/private partnerships, increase community access to family planning methods and strengthen forecasting and data management for effective supply chain operation. MALI (2010) Mali commits to create a free medical assistance fund by 2015 and to reinforce existing solidarity and mutual funds for health, and extend the coverage of a minimum package of health interventions. Mali will implement a national strategic plan for improving the reproductive health of adolescents; and will strengthen emergency obstetric care, introducing free caesarean and fistula services, also by 2015. Mali will promote improvements in child health through free vitamin A supplements, and increased screening for and management of malnutrition, and through the extension of the Integrated Management of Childhood Illness Programme. Mali will also distribute free insecticide-treated bed-nets to women making second ante-natal visits, and remove taxes on other ITNs.GOVERNMENT 20
  18. 18. MAURITANIA (2011) Mauritania commits to increasing expenditure on health to 15% by 2015, and including a budget line on reproductive health commodities with a focus on contraceptives; to increase contraception prevalence from 9% to 15%, constructing 3 more schools of public health, increasing access to Emergency Obstetric and Newborn Care in all regional and national hospitals; to increase the proportion of births assisted by skilled personnel from 61% to 75%; and increasing the proportion of health centers offering PMTCT services to 75%. Mauritania further commits to increase proportion of vaccinated children, institute in all districts a program of integrated management of childhood illnesses, and improve the management of human resources including providing incentives for staff to work in isolated areas. MONGOLIA (2011) Mongolia commits to implement a policy on increasing salaries of obstetricians, gynecologists and pediatricians by 50%; increase financial allocation to national immunization program; improve provision of micronutrients to children under 5; ensure reproductive health commodity security; and increase the number of health facilities for women and children, including the construction of a new Women’s and Children’s Health Centre in Ulaanbaatar. MOZAMBIQUE (2010 & 2012) 2010 Mozambique commits to increase the percentage of children immunized aged under 1, from 69 to 90 percent by 2012 and to increase the number of HIV+ children receiving ARTs from 11, 900 to 31,000 by 2012. Mozambique will also increase contraceptive prevalence from 24 to 34 % by 2015 and will increase institutional deliveries from a level of 49% to 66% by 2015. Mozambique also commits to establish a centre for the treatment of obstetric fistula in each province by 2015. 2012—London Family Planning Summit Mozambique is committed to continuing to provide free integrated sexual reproductive health services and commodities in all health facilities, and to cover 5% (2012), 10% (2015) and 15% (2020) of contraceptives needs. Family planning information and services for the youth will be revitalized. Access to long acting and permanent methods will be increased from about 1% to 5% of women by 2015. Post-partum and post-abortion counseling on family planning and contraception will be expanded by training at least 500 health providers throughout the country by 2015. A public-private partnership to strengthen the distribution of contraceptives will increase the number of health facilities with at least three contraceptive methods from one-third to 50% by 2015. MYANMAR (2011) Myanmar commits to ensure 80% ante-natal care coverage; 80% of births attended by a skilled attendant; 70% access to emergency obstetric care; and 80% coverage for PMTCT as well as its integration with MCH. Myanmar will also ensure universal coverage for the expanded immunization; increase the proportion of newborn who receive essential newborn care at least two times within first week of life by 80%; increase contraception prevalence to 50%; reduce unmet need for contraception to under 10%; improve ratio of midwife to population from 1/5000 to 1/4000; and develop a new human resources for health plan for 2012-2015.GOVERNMENT 21
  19. 19. NEPAL (2010) Nepal commits to recruit, train and deploy 10,000 additional skilled birth attendants; fund free maternal health services among hard-to-reach populations; and will ensure at least 70% of primary health care centres offer emergency obstetric care. Nepal will also double coverage of PMTCT; reduce unmet need for family planning to 18%, including by making family planning services more adolescent friendly and encouraging public-private partnerships to raise awareness and increase access and utilization. Nepal will work to improve child health and nutrition through rolling out the Community Based Integrated Management of Childhood Illnesses Programme from 27 districts to all 75 districts in the country; maintaining de-worming and micro-nutrient supplementation coverage at over 90%; and implementing effective nutrition interventions (using innovative programs such as cash transfers to pregnant and lactating women and other community based interventions). NETHERLANDS (2011 & 2012) 2011 The Netherlands endorses the Global Strategy for Women’s and Children’s Health, as the effort to ensure that women’s and children’s health issues have the priority they deserve in the 21st century. In 2011 the Netherlands’ Parliament approved development policies focusing on sexual and reproductive health and rights including HIV/AIDS, food security, water and security and governance issues. The Netherlands directly supports efforts to improve the health of women and children through our substantial core contributions to UNICEF, UNFPA and UNAIDS. In addition, the Netherlands has allocated EUR 29 million in 2011 to the Global Programme to enhance Reproductive Health Commodities Security and the Maternal Health Thematic Fund; EUR 55 million to the Global Fund to fight AIDS Tuberculosis and Malaria; and will maintain its ongoing support to the GAVI Alliance for the period 2011-2015. 2012—London Family Planning Summit The Netherlands commits €370 million in 2012 for sexual and reproductive health and rights, including HIV and health, and intends to extend this amount from €381 million in 2013 to €413 million in 2015. Within this, the Netherlands intends to increase its focus on sexual reproductive health and rights, including family planning. This commitment is dependent on continued political support from a new government that will be elected next September. NIGER (2010 & 2012) 2010 Niger commits to increase health spending from 8.1% to 15% by 2015, with free care for maternal and child heath, including obstetric complications management and family planning. Niger will train 1000 providers on handling adolescent reproductive health issues, and to address domestic violence and female genital mutilation (FGM). Niger will reduce the fertility rate from 3.3% to 2.5% through training 1500 providers of family planning, and creating 2120 new contraception distribution sites. Niger will further equip 2700 health centres to support reproductive health and HIV/AIDS education, and ensure that at least 60% of births are attended by a skilled professional. Niger will additionally introduce new policies that support the health of women and children, including legislation to make the legal age of marriage 18 years and to improve female literacy from 28.9% in 2002 to 88% in 2013.GOVERNMENT 22
  20. 20. 2012—London Family Planning Summit Niger has a high level of political engagement. It will quadruple its family planning budget for 2013, as well as increasing its overall health and reproductive health budgets. There will be policy change to include injectable contraceptives in the method mix provided by community health workers; a focus on new strategies for reaching disadvantaged groups, including through ‘Friends of Youth’ centers; and new mobile clinic services for isolated communities. Niger will scale up its effective network of Ecole Des Maris (Schools for Husbands), to involve and increase acceptance among men, work with faith based networks, and integrate family planning in the school health curriculum. NIGERIA (2010 & 2012) 2010 Nigeria endorses the Secretary General’s Global Strategy for Women’s and Children’s Health, and affirms that the initiatives is in full alignment to our existing country-led efforts through the National Health Plan and strategies targeted for implementation for the period 2010 – 2015, with a focus on the MDGs in the first instance and the national Vision 20 – 2020. In this regard, Nigeria is committed to fully funding its health program at $31.63 per capita through increasing budgetary allocation to as much as 15% from an average of 5% by the Federal, States and Local Government Areas by 2015. This will include financing from the proposed 2% of the Consolidated Federal Revenue Capital to be provided in the National Health Bill targeted at pro-poor women’s and children’s health services. Nigeria will work towards the integration of services for maternal, newborn and child Health, HIV/AIDS, Tuberculosis and Malaria as well as strengthening Health Management Information Systems. To reinforce the 2488 Midwives recently deployed to local health facilities nationwide, Nigeria will introduce a policy to increase the number of core services providers including Community Health Extension Workers and midwives, with a focus on deploying more skilled health staff in rural areas. 2012—London Family Planning Summit Nigeria commits to achieving the goal of a contraceptive prevalence rate of 36% by 2018. This will enhance maternal and child survival, thereby contributing to the government of Nigeria’s initiative to save one million lives by 2015. In addition to Nigeria’s current annual commitment of US $3 million for the procurement of reproductive health commodities, Nigeria commits to provide an additional US $8.35 million annually over the next four years. This increases Nigeria’s total commitment for the next four years from US $12 million to US $45.4 million, an increase of almost 300%. The federal government will work with the state and local governments to secure complementary budgets for family planning and reproductive health service delivery. Nigeria’s commitments include training frontline health workers to deliver a range of contraceptives and action to improve equity and access to family planning for the poorest. The government of Nigeria will partner with the private sector, civil society, traditional and religious institutions and development partners. NORWAY (2010 & 2012) 2010 Norway will increase its contribution to the Global Fund for AIDS, Tuberculosis and Malaria by 20% for the next 3 years, making a total contribution in 2011-13 of USD 225 million. This is in addition to the commitment made in June as part of the Muskoka initiative of USD $500 million for the period 2011-2020, partly subject to the annual budgetary process.GOVERNMENT 23
  21. 21. 2012 Norway commits to doubling its annual contribution to GAVI between 2010-2015, from NOK 500 million in 2010 to NOK 1000 million in 2015. This amounts to an increase of NOK 100 million in 2012. 2012—London Family Planning Summit Norway intends to more than double our support over the next eight year for family planning and to provide an additional 200 million USD over the period 2013 through 2020. This contribution is in support of DFID (UK) and Bill and Melinda Gates Foundation Family Planning Summit and the UN Commission on Life-Saving Commodities for Women and Children, and will contribute to fill the financing gap of 4 billion USD that will provide family planning services and devices to 120 million people in the poorest countries. 2012—Saving Mothers, Giving Life Norway intends to provide an allocation of up to 500 million NOK (app equivalent to 80 million dollars) over five years to the Saving Mothers, Giving Life partnership (Norway, US government, Merck, American College of Obstetricians and Gynecologists, Every Mother Counts). In the Partnership Norway will provide co-leadership globally, including by mobilizing international support through partnerships with African leaders and with other donor governments. The partnership will be drawing on related global and regional initiatives such as the UN Secretary-General’s Every Woman Every Child. The Government of Norway will – as a Founding Participant in the Saving Mothers, Giving Life partnership – support program implementation with a particular focus on promoting sustainability. PAKISTAN (2012) 2012—London Family Planning Summit Pakistan commits to working toward achieving universal access to reproductive health and raising the contraceptive prevalence rate to 55% by 2020. Pakistan will take forward its 2011 commitment with the Provinces for all public and private health facilities to offer birth spacing services. The amount spent on family planning, estimated at US $151 million in 2012/13 will be increased to nearly US $200 million in 2012/13, and further in future years. The federal government assesses the contraceptive requirement as US $186 million over the period 2013 to 2020, which will need to be provided for. Contraceptive services will be included in the essential service package of two provinces in 2012, with the others following in 2013. Supply chain management, training and communication campaigns will be strengthened. Family planning will be a priority for over 100,000 lady health workers, who cover 70% of rural areas. Public-private partnerships and contracting out mechanisms will help scale up access, and work with religious leaders and men to promote the benefit of birth spacing will continue. PAPUA NEW GUINEA (2011) Papua New Guinea commits to improve midwifery education and register 500 new midwives by 2015; increase number of obstetricians from 17 in 2011 to 40 in 2020; improve access to drugs and equipment necessary for maternal newborn and child health; introduce maternal health audits in all districts; and develop comprehensive plans to improve existing health services in all four regions of the country by 2015.GOVERNMENT 24
  22. 22. PHILIPPINES (2012) 2012—London Family Planning Summit The Philippines has long believed that access to family planning information, services and supplies is a fundamental and essential right that is key to inclusive growth and sustainable development. The government is working to establish a national policy on reproductive health and population development, and to allocate funds to implement this vital policy. The Philippines will commit $15 million in 2012 for the purchase of family planning commodities for poor women with an unmet need. Family planning services will be provided to poor families with zero co-payment. In addition, the government will be upgrading public health facilities and increasing the number of health service providers who can provide reproductive health information. We are also intensifying efforts with partners who can help give women the information and counseling they need. RWANDA (2010 & 2012) 2010 Rwanda commits to increasing heath sector spending from 10.9% to 15% by 2012; reducing maternal mortality from 750 per 100,000 live births to 268 per 100,000 live births by 2015 and to halve neonatal mortality among women who deliver in a health facility by training five times more midwives (increasing the ratio from 1/100,000 to 1/20,000). Rwanda will reduce the proportion of children with chronic malnutrition (stunting) from 45% to 24.5% through promoting good nutrition practices, and will increase the proportion of health facilities with electricity and water to 100%. 2012—London Family Planning Summit Rwanda commits to ensuring the availability of family planning services in each of the 14,841 Rwanda administrative villages (Imidugudu) through delivery by the 45,000 community health workers already in service. Rwanda will expand existing information and dissemination programs about family planning to the general public and will increase awareness of the various choices available. Focusing on convenience and reducing the frequency of visits to health providers, the government of Rwanda will introduce long-lasting contraceptive methods, including permanent ones, and high quality integrated family planning services in every hospital and health center. Sao Tome and Principe (2011) Sao Tome and Principe commits to increase the percentage of the general budget for health from 10% to 15% in 2012; increase the ratio of births attended by a qualified health personnel from 87.5% to 95%; reduce the percentage of inadequate family planning service delivery from 37% to 15%; increase the geographic coverage of PMTCT services from 23% to 95%; increase the percentage of pregnant women receiving ARVs from prenatal centres from 29% to 95%; and increase the prevalence of contraception from 33.7% to 50%. SENEGAL (2011 & 2012) 2011 Senegal commits to increasing its national health spending from 10% of the budget currently to 15% by 2015. It also proposes to increase the budget allocated to MNCH by 50% by 2015. The country commits to improving coordination of MNCH initiatives by creating a national Directorate for MNCH, reinstating the national committeeGOVERNMENT 25
  23. 23. in charge of the implementation of the multi-sectoral roadmap for the reduction of maternal and child mortality and to accelerate the dissemination and implementation of national strategies targeting a reduction of maternal mortality. Through these efforts the government hopes to offer a full range of high impact MNCH interventions in 90% of health centers, increase the proportion of assisted deliveries from 51% to 80% by increasing recruitment of state midwives and nurses and increasing contraceptive prevalence rate from 10% to 45%, among others. 2012—London Family Planning Summit Senegal commits to making family planning a national top priority, increasing the commodity budget from the government by 200% and doubling the overall budget for the management of the family planning program. Senegal’s vision is for women to have equal access to high quality and affordable maternal, newborn and child health services, including family planning. Senegal’s action plan builds on six fundamental pillars: 1) generate demand especially through mass media communication and community mobilization with targeted messages for women and to increase involvement of men and young people; 2) leverage networks of religious leaders and national and local champions to advocate for family planning; 3) improve the supply chain and reduce stock outs to zero especially through the Informed Push Model; 4) improve the quality of care and services; 5) expand mobile outreach, social marketing and franchising to ensure access in peri-urban and rural areas; and 6) generalize community-based distribution to bring family planning to the most vulnerable and remote areas. Senegal will continue its commitment to introducing innovative approaches to family planning, such as the acceptability study of Depo Provera subQ, a new self-injectable contraceptive that should highly facilitate access for women. SIERRA LEONE (2010) Sierra Leone will increase access to health facilities by pregnant women, newborns and children under five by 40% through the removal of user fees, effective from April 27 2010. Sierra Leone will also develop a Health Compact to align development partners around a single country-led national health strategy and will ensure that all teachers engage in continuous professional development in health. SOLOMON ISLANDS (2012) 2012—London Family Planning Summit Solomon Islands recognizes family planning as a very important component of reproductive and child health, and as an important consideration for development plans. Solomon Islands is recommitting to supporting programs that will help stop preventable deaths of women and babies, including making family planning a priority under the reproductive health program part of the government’s National Health Strategic Plans for 2006-2015. Solomon Islands is also committing to making men partners in all reproductive health issues, including voluntary family planning. SOUTH AFRICA (2012) 2012—London Family Planning Summit South Africa is prioritizing the need to strengthen family planning services while emphasizing dual protection. The government has recently revised its contraception and fertility policy which will be launched publically with a campaign around family planning during August 2012. This policy addresses the full range of issues relating toGOVERNMENT 26
  24. 24. contraception within a human rights context and also requires that the full range of family planning methods is available at public health facilities. In order to strengthen implementation, South Africa is developing standard operating procedures for community health workers who are part of outreach teams, for nurses in clinics, as well as for midwives in maternity units. It wants community health workers to be able to promote family planning during their visits to homes, and health professionals to use every encounter with a user of its services to also promote family planning. South Africa recognizes the need to target teenagers in particular given its relatively high rates of teenage pregnancies. SOUTH SUDAN (2011) The Republic of South Sudan commits to increase the percentage of government budget allocation to the Ministry of Health from 4.2% to 10% by 2015; to increase the proportion of women delivering with skilled birth attendants from 10%- 45%, through the construction of 160 Basic Emergency Obstetric Care facilities by 2015 and training of 1,000 enrolled/registered midwives by 2015; and to establish 6 accredited midwifery schools or training institutions/colleges; increase the contraceptive prevalence rate from 3.7% to 20%, and increase the percentage of health facilities without stock-out of essential drugs from 40% to 100%. South Sudan also commits to reduce the prevalence of underweight among children under five from 30% to 20%; increase the percentage of fully-immunized children from 1.8% to 50%; and increase the percentage of under- fives sleeping under bed nets from 25% to 70%. Finally, South Sudan will develop and implement a range of national policies that will strengthen its response to women and children’s health, including policies on national family planning, on provision of free reproductive health services, especially Emergency Obstetric care services, on decentralization of budgeting, planning, management of health services, and on adolescent sexual and reproductive health and rights. SRI LANKA (2011) Sri Lanka will empower the health sector through capacity building and leadership in information and communication technology. More specifically, the Government will provide education, training, and assessment to 100,000 members of the work force using a royalty-free open source based technology platform developed by Intel. Sri Lanka will provide training and will certify the 100,000 members of the workforce on information and communication technology by 2015 and also implement a basic electronic health record for children in 5,000 schools that would enable the health sector planners to launch prioritized health programmes by 2015. SUDAN (2011) Sudan commits to increase the total health sector expenditure from 6.2% in 2008 to 15% by 2015. Sudan commits to guarantee immediately free universal access to Maternal and Child Health (MCH) services including Immunization, Integrated Management of Neonatal and Childhood Illnesses (IMNCI), Nutrition, Antenatal Care (ANC), delivery care, post-natal care, and child spacing services to target all women and children. Sudan also commits to train and employ at least 4,600 midwives focusing on states with the highest maternal mortality ratios and the lowest proportion of births attended by trained personnel. This will increase the percentage of births attended by trained personnel from 72.5% to 90%, increase quality universal access to Comprehensive Emergency Obstetric and Neonatal Care, and advocate for the elimination of harmful traditional practices like early marriage and Female Genital Mutilation/Cutting.GOVERNMENT 27
  25. 25. SWEDEN (2010, 2011 & 2012) 2010 Sweden’s strong commitment to Women’s and Children’s health is clearly reflected in Sweden’s policy for global development, in Sweden’s international policy on Sexual and Reproductive Health and Rights (SRHR) and in the Policy for Gender Equality and the Rights and Role of Women. In the bilateral development cooperation support is primarily given to the strengthening of national health and education systems with a focus on a broad SRHR approach. A range of funding and other mechanisms is used. Policy dialogue and strategic partnerships are essential to raise awareness and build capacity with regard to phenomena related to maternal and child health including controversial issues such as access to safe abortions. Globally Sweden supports the UN system (UNFPA including the UNFPA/ICM program to strengthen midwifery, UNICEF, UNESCO), global initiatives (GAVI, Education for all Fast Track Initiative, GFATM) and civil society (IPAS, IPPF, Men Engage network). To further strengthen the commitment a special effort on MDG5 has been developed. The ambition is to raise awareness and build capacity to improve maternal health at all levels of development cooperation. Sweden also endorses the G8 Muskoka Initiative for Maternal, Newborn and Child Health, and has made a substantial allocation in the budget bill proposed to parliament for 2011 to further strengthen work to improve child health. 2011 Sweden has enhanced its commitment to the Global Strategy for Women’s and Children’s Health during 2011. Contributing to the achievement of the MDGs, especially MDGs 4 and 5, is one of the core focuses of Swedish development aid, which amounts to approximately 1% of its annual Gross Domestic Income. In 2011, Sweden has committed to allocate 500 million Swedish kroner to combat child mortality and maternal mortality and promote health, education and youth entrepreneurship. In addition the Swedish Minister for International Development Cooperation has announced that Swedish development aid has the ambition of helping save the lives of 250,000 children, as well as 50,000 women who otherwise would lose their lives due to complications arising from pregnancy or childbirth. Sweden will support, through bilateral development cooperation, efforts to strengthen national health and education systems, in order to generate better access to sexual and reproductive health. A range of different funding mechanisms are utilized and policy dialogues and external partnerships are essential to Sweden’s assistance. Sweden will continue its support to UNFPA, UNICEF and UNESCO; global initiatives such as the GAVI Alliance (with $201 million for the period 2011-2015), the GFATM; and civil society (Ipas, IPPF, MenEngage Alliance). Sweden endorses the G8 Muskoka Initiative on Maternal, Newborn and Child Health. 2012—Born Too Soon This report puts important attention to an area within the continuum of maternal and newborn health care. Knowledge and interventions to prevent prematurity is a neglected area in many countries of the world; especially in low income countries. For Sweden and Sida the reduction of newborn morbidity and mortality remains a high priority. We are committed to reducing the incidence of prematurity and to do so mainly through support to capacity building of a competent midwifery workforce. An educated and professional midwife provides a number of important prerequisites for preventing pre-term births as well as identifying and caring for the pre- term baby. As part of the global movement to reduce MNC mortality Sida will work to increase awareness of the role midwives can play and improve education and working conditions to allow midwives to play a significant role in the prevention of premature birth and competent care for the pre-term baby. 2012—London Family Planning Summit Sweden’s priority is to work in the most effective way for the rights and improved health of women and girlsGOVERNMENT 28
  26. 26. in the most vulnerable countries in Africa. The Swedish government will continue to be a major player, both financially and politically, in the issue of family planning. Sweden will increase spending on contraceptives from its 2010 level of US $32 million per year to US $40 million per year, totaling an additional US $40 million between 2011 and 2015. Sweden also commits to ensuring that support of family planning utilizes existing structures for financing and support, and is contributing to the broader agenda of Millennium Development Goal’s (MDG) 4 and 5. The government plans to increase its contribution to MDG 4 and 5 from its current amount of US $450 million per year. TAJIKISTAN (2011) Tajikistan commits to ensure that by 2015, 85% of midwives are trained in provision of emergency obstetric care; at least 85% of maternity facilities apply the clinical protocols approved by the ministry of health; youth friendly health services are expanded from pilot to nationwide implementation; and 50% of the needs of women of reproductive age in modern contraceptives are covered from the budget. Tajikistan will also develop an accreditation policy for maternity institutions and ensure that 90% of maternity hospitals are certified. TANZANIA (2010) Tanzania will increase health sector spending from 12% to 15% of the national budget by 2015. Tanzania will increase the annual enrollment in health training institutions from 5000 to 10,000, and the graduate output from health training institutions from 3,000 to 7,000; simultaneously improving recruitment, deployment and retention through new and innovative schemes for performance related pay focusing on maternal and child health services. Tanzania will reinforce the implementation of the policy for provision of free reproductive health services and expand pre-payment schemes, increase the contraceptive prevalence rate from 28% to 60%; expand coverage of health facilities; and provide basic and comprehensive Emergency Obstetric and Newborn care. Tanzania will improve referral and communication systems, including radio call communications and mobile technology and will introduce new, innovative, low cost ambulances. Tanzania will increase the proportion of Children fully immunized from 86% to 95%, extend PMTCT to all RMNCH services; and secure 80% coverage of long lasting insecticide treated nets for children under five and pregnant women. Tanzania will aim to increase the proportion of children who are exclusively breast fed from 41% to 80%. THAILAND (2012) Thailand endorses the United Nations Secretary-General’s Global Strategy for Women’s and Children’s Health through the Every Woman Every Child project for strengthening the maternal and child health service system. Thailand will increase the quality of antenatal care service countrywide to reduce maternal and child mortality. The country commits to improving the breastfeeding rate from 26% to 60% and reducing the percentage of low birth weight babies from 8.7% to less than 7% of total births by 2015 through the Family Love Bonding Project (Sai-Yai-Rak Hang Krob Krua Project) under the Patronage of His Royal Highness the Crown Prince of Thailand. Thailand will also support highly active antiretroviral therapy (HAART) for all pregnant women with HIV to reduce the mother-to-child transmission rate from 3.5% to 1.5% by the year 2015. The country will develop and implement a range of national policies that will strengthen its response to women’s and children’s health, including policies on national family planning and reproductive health services to reduce teenage pregnancy.GOVERNMENT 29
  27. 27. TOGO (2011) Togo commits to ensure 95% coverage of vaccination for children under 5, and to implement the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA). UGANDA (2011 & 2012) 2011 Uganda commits to ensure that comprehensive Emergency Obstetric and Newborn Care (EmONC) services in hospitals increase from 70% to 100% and in health centers from 17% to 50%; and to ensure that basic EmONC services are available in all health centers; and will ensure that skilled providers are available in hard to reach/hard to serve areas. Uganda also commits to reduce the unmet need for family planning from 40% to 20%; increase focused Antenatal Care from 42% to 75%, with special emphasis on Prevention of Mother- to-Child Transmission (PMTCT) and treatment of HIV; and ensure that at least 80% of under 5 children with diarrhea, pneumonia or malaria have access to treatment; to access to oral rehydration salts and Zinc within 24 hours, to improve immunization coverage to 85%, and to introduce pneumococcal and human papilloma virus (HPV) vaccines. 2012—London Family Planning Summit Uganda commits to universal access to family planning and to reduce unmet need for family planning from 40% to 10% in 2022. It will increase the annual government allocation for family planning supplies from US $3.3 million to US $5 million for the next five years and improve accountability for procurement and distribution. It will develop and implement a campaign for integration of family planning into other services, including partnerships with the private sector, by supporting the alternative distribution channel for the private sector and scaling up of innovative approaches, such as the community-based distribution, outreaches, social marketing, social franchising and youth friendly service provision. Uganda will strengthen institutional capacity of the public and community-based service delivery points to increase choice and quality of care at all levels (through staff recruitment, training, motivation and equipment). UNITED KINGDOM (2010 & 2012) 2010 The UK is currently re-orienting its aid programme to put women at the heart of its development efforts and is focusing rigorously on results, including a review of all bilateral and multilateral aid programmes to maximise impact on mothers and babies. The UK’s new Business Plan for Reproductive Maternal and Newborn Health will set out how the UK aims to increase efforts up to 2015 ‘to double the number of maternal, newborn and children’s lives saved.’ It is anticipated that UK aid will save the lives of at least 50,000 women in pregnancy and childbirth, a quarter of a million newborn babies and enable 10 million couples to access modern methods of family planning over the next five years. To achieve this ambitious goal, the UK will double its annual support for Maternal, Newborn and Child Health by 2012, and sustain that level to 2015. The UK will provide an annual average of £740 million (US$1.1 billion) for Maternal, Newborn and Child Health from 2010 to 2015. This means that over this period the UK will spend an additional £2.1bn on Maternal, Newborn and Child Health. This commitment adds an additional £1.6bn to the commitment of £490m the UK made for 2010 and 2011 at the Muskoka Summit.GOVERNMENT 30
  28. 28. 2012—Born Too Soon The UK welcomes the publication of Born Too Soon: The Global Action Report for Preterm Birth, highlighting the impact of pre-term birth on newborn and under-five mortality. We agree there is an urgent need for more action to prevent and manage pre-term births. We urge all our partners to increase their efforts to achieve the aims of the UN Secretary-General’s Global Strategy for Women’s and Children’s Health. The UK has set out clear plans to help improve the health of women and young children in many of the poorest countries. We will help save the lives of at least 250,000 newborn babies and 50,000 women during pregnancy and childbirth by 2015. All the UK’s commitments to improve the lives of women and children can be found in “UK AID: Changing lives, delivering results”, at 2012—London Family Planning Summit The UK is committing £516 million (US $800 million) over eight years towards the Summit goal of enabling an additional 120 million women and girls in the world’s poorest countries to be using modern methods of family planning by 2020. This commitment is part of the UK’s broader commitment to double efforts on family planning, increasing investments from £90 million per year (average spend over 2010/11 and 2011/12) to £180 million per year over the eight years from 2012/13 to 2019/20. The UK has put girls and women front and center of its aid program and being able to plan the size of her family is a fundamental right that the UK believes all women and girls should have. Between now and 2020, UK support to the Family Planning Summit Goal will enable an additional 24 million girls and women in the world’s poorest countries, who wish to avoid an unintended pregnancy, to use voluntary family planning information, services and supplies, so that they are able to decide, freely and for themselves, whether, when and how many children to have. Meeting this need will prevent over 20 million unintended pregnancies and in doing so avert the deaths of 42,000 girls and women for whom an unintended pregnancy carries the risk of fatal consequences. British support will contribute to ensuring that governments and partners are enabling access to a wide range of affordable, high quality contraceptive methods. It will also support partners including governments, civil society and faith-based organizations to tackle the social and cultural barriers to using contraception through education, counseling, information campaigns, and working with partners and communities, and to ensure safeguards against coercion and discrimination. UNITED STATES (2010 & 2012) 2010 The commitments detailed in this document build on important recent efforts, notably President Obama’s Global Health Initiative (GHI), a $63 billion initiative to help partner countries save lives and achieve sustainable health outcomes. Through the GHI, the United States will scale up efforts and achieve significant results in maternal and child health and family planning. The GHI sets out ambitious targets for improving maternal and child health to inspire an intensive effort, and will: reduce maternal mortality by 30 percent across assisted countries; reduce mortality rates for children under 5 by 35 percent across assisted countries; reduce child under-nutrition by 30 percent across assisted food insecure countries, in conjunction with the President’s Feed the Future Initiative; double the number of at-risk babies born HIV-free, from a baseline of 240,000 babies of HIV-positive mothers born HIV-negative during the first five years of PEPFAR; and reach a modern contraceptive prevalence rate of 35 percent across assisted countries.GOVERNMENT 31
  29. 29. 2012 USAID continues to focus its MCH resources on reducing maternal and child mortality in 24 countries, which represent more than 70% of the mortality. In 23 of these countries, USAID’s family planning programs also make a substantial contribution to mortality reduction, through health timing and spacing of pregnancies as well as reduction in the lifetime risk of dying as a consequence of pregnancy and childbirth. In partnership with Feed the Future, USAID’s nutrition programs reduce under-nutrition, a key determinant of maternal and child mortality. In countries in sub-Saharan Africa where malaria’s contribution to maternal and child mortality is high, USAID’s malaria programs make substantial contributions to overall mortality reduction. USAID’s programs also build on partnership commitments launched at the June 2012 Call to Action. 2012—Born Too Soon The United Stated Agency for International Development (USAID) is fully committed to saving newborn lives as part of a comprehensive maternal, newborn, and child health program through its investments in the U.S. Global Health Initiative. USAID has worked closely with Governments, UN Agencies, civil society organizations, professional associations, and the private sector to support efforts to generate evidence on high-impact newborn interventions and service delivery approaches, sparked the development of game-changing innovations to reduce maternal and neonatal mortality, supported the update of global guidelines and policies, worked with Governments to introduce them at the country level, increasingly engaged the private sector to be part of the solution, and built global public-private alliances to harness the resources and creativity of diverse organizations. USAID will continue to use these effective and inclusive approaches to support selected high-impact and affordable interventions that can prevent and manage complications associated with preterm birth as part of an integrated newborn and child health program with the aim of ending preventable child death. UZBEKISTAN (2011) Uzbekistan commits to ensure that 96% of children aged 6-59 months receive vitamin A twice a year by up to 2015; 100% coverage of pregnant women with HIV counseling; and testing and reduction of mother-to- child HIV transmission down to less than 2%. Uzbekistan also commits to improve quality of care provided to mothers and children by training 25,000 health workers up to 2015 on evidence-based modern technologies to provide reproductive health services, emergency obstetrical care, effective prenatal care, international criteria of live birth, basic care and resuscitation of newborns, breastfeeding and rational nutrition of children, integrated management of childhood illnesses in the primary healthcare and hospitals and child growth monitoring. VIET NAM (2011) Viet Nam commits to increase rate of pregnant women with access to PMTCT services from 20% to 50%; increase the rate of people with disabilities who had access to RHC services from 20% to 50%; increase rate of pregnant women received antenatal care (at least three visits during 3 trimesters) from 80% to 85%; increase the rate of couples who received pre-marital counseling and health check from 20% to 50%;and the rate of women giving birth with trained health workers from 96% to 98%. YEMEN (2010) Yemen will enforce the ministerial decree to provide free contraceptives to all women of reproductive age, and free deliveries, and will endorse a safe motherhood law to minimize harmful practices. Yemen will expand Reproductive Health services to reach 85% of all health facilities, focusing expansion in rural areas, and increase by 20% the percentage of health facilities that provide basic and comprehensive Emergency ObstetricGOVERNMENT 32