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Plenary session 4 - Accountability, human rights and scaling-up: Whose job is it anyhow? PDF Print E-mail
Co-Chairs:
H.E. Dr. Jose Van Dunhem, Vice Minister of Public Health, Angola and Dr. Peter Salama, Associate Director, Health Section, UNICEF

1. Health and Human Rights

Professor Charles Ngwena, Department of Constitutional Law, University of the Free State, South Africa  spoke of the need to put maternal, newborn, and child health and MDGs 4 and 5 within an equity-focused, gender-based, human rights framework to enable countries to monitor the equitable delivery of services.  He suggested several actions to ensure accountability including  acting as advocates for and custodians of equity and human rights in all MNCH policies and programs developed at the national and international levels and enforcing existing international, regional, and other conventions and laws to ensure the protection of women and children. 

2. Monitoring commitments by governments and partners

Augustine Mkandawire, Senior Research and Monitoring Specialist, African Monitor
Dr Mkandawire shared the work of the African Monitor including the purpose of its “Grassroots Focus Index", and the pilot and country studies examining governments' and donors' priorities, expenditure frameworks, commitments, investments, and budgets directed towards achievement of the Millennium Development Goals (MDGs).  In conclusion,  He called for the private sector to become more involved in the achievement of the MDGs, and for better data collection systems to be put into place so that long-term, sustainable plans can be established.
 
Joint Panel Discussion on Scaling-up:  Making it Happen
 
Afghanistan:
H.E. Nadera Hayat Burhani, Deputy Minister of Public Health, Afghanistan 
H.E. Burhani described her country as impoverished due to 25 years of war and political instability causing the destruction of the health care infrastructure, a drop in the life expectancy to 46 years, and an increase in MNC mortality rates.  However, H.E. Burhani noted that the Minister of Public Health’s prioritization of MNCH has resulted in significant improvements in the training of community health workers, and health service coverage such as increases in immunizations, antenatal care services, and the proportion of births attended by a skilled health provider.  Substantial reductions in under-five and maternal mortality since 2003 have also been recorded. One contributing factor to Afghanistan’s success is its decision to contract services out to NGOs.  The future challenge of the Afghan government is, among others, to establish 255 health facilities in the rural districts while increasing programs which empower women.
 
Egypt:
Dr. Emad Ezzat, Acting Chief of Cabinet, for Minister of Health and Population in Egypt, described Egypt’s steady progress since 1990 when the government prioritized MNCH, helping to put Egypt on track for MDGs 4 and 5. There have been significant reductions in under five and maternal mortality. Egypt started with focus on the Expanded Immunization Program, but now have a very comprehensive MNCH package.  An extensive midwifery program was also launched along with programs promoting postnatal home visits to strengthen breastfeeding practices. More recently IMCI has been revised to including newborn care, and the new Oral Rehydration Salts (ORS) with zinc for the treatment of diarrhea.  Dr. Ezzat noted that Egypt still has many challenges including persisting health care disparities between upper and lower Egypt that it hopes to address through greater political will, stakeholder cooperation, and coordinated donor support.   
 
Nepal:
Dr. Bishnu Prasad Pandit, Officiating Secretary, Ministry of Health and Population, Nepal named the key factors leading to substantial child and maternal mortality reductions in Nepal:  Political commitment to MNCH has been key with good coordination between partners facilitating the roll out of new programs. The expansion of community healthworkers has been instrumental for the scale-up of Immunization program, vitamin A programs, and case management programmes for pneumonia with the recent addition of neonatal sepsis case management. Future challenges confronting Nepal include reaching remote populations living in the mountainous regions, increasing the number of rural health workers, and building the skills of community health workers