Global Health and Diplomacy (GHD): At the Muskoka G8 Summit in 2010, Prime Minister Harper said "Canada has far and away the strongest financial position, fiscal position, of any country that's sitting around that table today. [Maternal and child health] has been our flagship initiative for this particular conference. So, I thought it was more than appropriate that Canada lead with a disproportionate contribution." Do you believe the Canadian public supports this initiative? What support has Canada received from other global partners since the meeting in Muskoka?
Minister Beverly Oda (BO): Our Government received a strong mandate from Canadians and we will continue to make our foreign aid more effective, focused and accountable. Canadians support our efforts to make a real difference on the ground in the lives of people in need, especially for mothers and their newborn infants. Through the G8 Muskoka Initiative on Maternal, Newborn and Child Health, global partners pledged more than $7.3 billion in new funding. Canada's contribution totals $2.85 billion, of which $1.1 billion is additional funding pledged last year. Canada received significant support from the global community in our efforts to address this issue. One example of this is the UN Secretary-General's Global Strategy for Women's and Children's Health, which also brings much-needed attention to this crisis.
GHD: Prime Minister Harper announced recently that Canada has selected 28 maternal and child health projects to share $82 million in funding between now and 2015—a commitment that was made during the G8 Summit in Muskoka in 2010. What are some of the projects receiving funding?
BO: These projects support Canada's commitment to reduce mortality rates in developing countries. Expected results from some of these projects include: Addressing the health needs of more than 70,000 women and children in Cambodia; Helping 875,000 beneficiaries, including 150,000 children under the age of five, gain better access to life-saving health services that address critical childhood illnesses such as malaria, diarrhea and pneumonia; Increasing access to nutritious food and essential vaccinations for more than 45,000 children under the age of five in Ethiopia; and Providing preventative and critical care training to 120 health centre staff in Uganda.
Some of these projects include: Expanding integrated community case management of childhood illnesses in Sikasso and Koulikoro. The program will reach 875,000 beneficiaries, including 150,000 children under the age of five, and will ensure that access to life-saving health services that address critical childhood illnesses, such as malaria, diarrhea and pneumonia, is improved and that use of health services is increased. Reaching more than 1.85 million people in 26 districts and sub districts of Bangladesh, Ethiopia, Ghana, Mali and Zimbabwe, the project will improve the quality of community outreach and facility-based maternal, newborn and child services while building capacity of communities, especially that of women, to adopt health-seeking behaviors and participate in local health care management. In Mali, respiratory infections, diarrhea and malaria account for 54 percent of child mortality. In Pakistan, pneumonia and diarrhea account for 25 percent of child mortality. The project will work with the ministries of health of both countries to improve the health and nutrition status of an estimated 330,000 children under the age of five, and 161,000 women of reproductive age.
GHD: Several universities are getting funding for projects as well. What does Canada hope to achieve by funding these projects?
BO: The projects being undertaken by five Canadian universities - Queen's University, the University of British Columbia, the University of Calgary, the University of Western Ontario, and the University of Manitoba – support Canada's commitment to reduce mortality rates in developing countries. They help to: Strengthen and develop midwifery and pediatric nursing programs in Rwanda; Develop educational capacity to deliver continuing professional development and provide an enabling environment for policy development in Bangladesh; Train a number of health care professionals in Bangladesh to detect, refer and treat sepsis, a life-threatening form of infection in the which the bloodstream is overwhelmed with bacteria. Train health care workers in Uganda and Kenya in preventative and critical care for maternal, newborn and child health.
Canada's expertise on this issue gives our academic institutions a unique opportunity to make a lasting difference in the lives of women and children in need. Our Government is committed to capitalizing on the knowledge and experience in our academic and private sectors in our efforts to make a lasting difference.
GHD: How can we ensure that donor governments meet their pledges and recipient governments spend the resources effectively?
BO: Because of Canada's drive to bring increased accountability to aid programs, the UN Secretary-General asked Prime Minister Harper to co-chair the UN Commission on Information and Accountability for Women's and Children's Health with Tanzania. The Commission recommended concrete actions to improve the tracking of pledged resources and the measurement of results. By taking these steps we can strengthen accountability and ensure that investments make a real difference in the lives of women and children. Canada is supporting global and country-level efforts to implement the Commission's recommendations to help ensure that the results of our investments can be better measured and that resources can be better tracked by: Integrating the recommendations into CIDA programs and policies undertaken by the agency and its partners; Supporting country partners in adopting the recommendations through strengthened health systems capacity, and innovation in data collection and health information; and Contributing to international outreach and engagement efforts to ensure that the Commission's recommendations are adopted and implemented. On March 17, 2011, the Government of Canada launched an Open Data portal for all Canadians. As part of that effort, statistical data and other information on Canada's international assistance and CIDA's activities are now available in data sets and machine-readable formats for all Canadians: researchers, students, media or anyone interested in international assistance. On November 28, 2011, Canada also announced that it would join the International Aid Transparency Initiative. Canada is committed to making our aid more accountable, and we call on others to also take steps to increase the transparency, and effectiveness, of their aid and development programs.
GHD: Is there a report yet for donor governments to track their commitments and results?
BO: Canada took an active role, calling on all global partners to be transparent and open with respect to their Muskoka commitments. As a result, the 2011 G8 Deauville Accountability Report outlined, for the first time, all G8 commitments to the Muskoka Initiative. This report details the state of pledges and the results of the L'Aquila Food Security Initiative (2009) and the Muskoka Initiative on Maternal, Newborn and Child Health. To access the report visit: http://www.g20-g8.com/g8-g20/g8/english/the-2011-summit/report-of-the-presidency/report-of-the-g8-presidency.1138.html
GHD: How can governments, NGOs, and the private sector work together to implement women's health programs more effectively in countries with very little public health infrastructure?
BO: The G8 Muskoka Initiative provided critical momentum in establishing the UN Secretary-General's Global Strategy for Women's and Children's Health, which will make global aid more effective. Action is needed from all players, including donors, developing country governments, the private sector and NGOs. We can substantially reduce the mortality rates of mothers and children with simple, low-cost, proven interventions. Based on country needs and in line with national plans and priorities, these commitments may include scaling-up targeted interventions, such as immunization, the prevention of mother-to-child transmission of HIV, nutrition supplementation, or training skilled birth attendants.
GHD: Could you elaborate on your countries of focus on the "three paths" of strengthening health systems, reducing the burden of diseases that are killing mothers and children, and improving nutrition by increasing access to healthful and nutritious food?
BO: You are correct, Canada is concentrating its Muskoka Initiative efforts along three key paths: strengthening health systems, preventing and treating the leading illnesses and diseases, and improving nutrition. For example: Under strengthening health services at the community level, Canada is working with partner countries to improve health delivery through improved training of doctors, nurses and midwives and expanding access for women and children to needed health care services and facilities. Under preventing diseases and illnesses that are the leading causes of maternal and child mortality, Canada is helping provide increased vaccination services and medicine to prevent the transmission of HIV/AIDs from mother to child. Under improving nutrition, Canada is funding international organizations and country efforts to increase access to healthy and nutritious food and needed nutritional supplements such as Vitamin A that will improve infant and child health. Canada focused its efforts, in collaboration with the international community, to focus our work in countries where our expertise can make the most impact.
GHD: Which countries is Canada focusing on for geographic investments?
BO: CIDA's geographic MNCH investments focus on 10 countries with high child and maternal morbidity and mortality rates. 80% of Canada's additional $1.1 billion Muskoka Initiative contribution is directed to sub-Saharan African countries including: Ethiopia, Malawi, Mali, Mozambique, Nigeria, Sudan and Tanzania – because the region faces great challenges in addressing maternal and child mortality. Canada is also focusing on gaps in maternal, newborn and child health in Afghanistan, Bangladesh and Haiti.
GHD: Tell us about some of the partnerships and alliances Canada is leading in this maternal health initiative.
BO: Canada is working with country partners, Canadian civil society organizations, private sector organizations as well as multilateral and global partners to improve health services to mothers and children across the globe. For example, through its work with the Micronutrient Initiative, the GAVI Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria, Canada is helping to deliver life-saving vitamins, vaccines and treatment and care programs to millions of women and children in developing countries. Through its partnership with the Micronutrient Initiative and Teck Resources Ltd – a Vancouver-based mining company – Canada also supports the delivery of zinc alongside oral rehydration salts for the treatment of diarrheal episodes to save the lives of thousands of children in Senegal. Most recently, in November, Canada launched the Canadian Network for Maternal, Newborn and Child health during a round table meeting with Canadian health stakeholders in Ottawa. The Network made up of maternal, newborn and child health experts, medical practitioners and civil society organizations aims to support Canada's efforts to improve maternal, newborn and child health by increasing coordination and collaboration among Canadian partners.
