WHO Christopher BlackThe visibility of maternal, newborn and child health (MNCH) on the global agenda has skyrocketed in recent years.  The exponential rise in prominence of MNCH and the concept of the continuum of care can be traced to major health diplomacy and coalition-building efforts beginning around 2005.  The Partnership for Maternal, Newborn & Child Health (PMNCH) was created in 2005 as the result of a marriage between the Safe Motherhood Initiative, Healthy Newborn Partnership and Child Survival Partnership.  Since its inception as the global platform for aligning and harmonizing efforts to achieve Millennium Development Goals (MDGs) 4 and 5, aimed at reducing child mortality and improving maternal health, respectively, the PMNCH has played a crucial role in fostering collaboration across all major constituencies and raising the profile of MNCH on a national, regional and global scale.  

Collaborative efforts in the 2000s among technical experts from developed and developing countries led to numerous high-level publications in the scientific literature highlighting the evidence of effective, low-cost interventions that, if brought to scale, could accelerate global progress towards MDGs 4 and 5. This evidence based advocacy, most notably the three separate Lancet series on maternal, newborn and child survival, compelled global leaders (such as the heads of state of Canada, Chile, Ethiopia, Norway and Tanzania) to become champions of MNCH. In addition, it contributed to efforts to position MNCH on the agenda of major political entities such as the G8, African Union, APEC and the Inter- Parliamentary Union (IPU).

One critical contribution to the elevation of MNCH on the political map was the launch, in 2009, of the Global Consensus for Maternal, Newborn and Child Health, in conjunction with the report of the High-Level Task Force on Innovative International Financing for Health Systems. The Global Consensus presents key pillars for action for women’s and children’s health and an estimate of the financing gap needed to meet MDGs 4 and 5. The consensus statement, coupled with greater recognition of roadblocks to progress (such as the human resource crisis and insufficient financing for MNCH) made it evident that a global platform for action was needed. In response, the United Nations Secretary-General issued a call for a joint plan for fulfillment of MDGs 4 and 5 in April, 2010. This call was followed by a series of high-level events featuring MNCH, including the joint Women Deliver/Countdown to 2015 conference, the G8 meeting with its flagship Muskoka Initiative spearheaded by the Canadian leadership, the African Union Summit, the initiation of the Campaign for the Acceleration of Maternal Mortality Reduction in Africa, and the G20 Summit. These events culminated in the launch of the Global Strategy for Women’s and Children’s Health by United Nation’s Secretary-General Ban Ki-moon in September 2010 at a United Nations General Assembly Summit.  

The Global Strategy for Women’s and Children’s Health is an ambitious plan to save the lives of 16 million women and children by 2015.  It has mobilized an unprecedented commitment of over $40 billion from heads of governments and states, the private sector, academics, NGOs, heath care programs and UN Agencies.  The PMNCH has taken a leadership role in the analysis of these commitments with its 2011 report entitled, “Analyzing Commitments to Advance the Global Strategy for Women’s and Children’s Health.” The report, which was released at the time of the 2011 UN General Assembly, coincided with the ‘one year on’ Every Woman, Every Child event and was designed to assess progress in realizing commitments in the first year.

The World Health Organization played a key role in the establishment of the Commission on Information and Accountability for Women’s and Children’s Health, charged with developing an accountability framework to monitor and track commitments made to the Global Strategy. The Commission’s report published in 2011, “Keeping Promises, Measuring Results,” echoes the recent resolution of the United Nations Human Rights Council in stressing the fundamental human right of all women and children to health, and includes 10 recommendations for action.  These recommendations have been translated into an action-oriented work plan that has the potential to radically transform women’s and children’s health worldwide.  An independent Expert Review Group was appointed by the Secretary-General in September 2011 to review annual progress in implementing the Commission’s recommendations regarding reporting, oversight and accountability in 75 priority countries.  

The Global Strategy and the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health have created considerable momentum for MNCH and a much overdue window of opportunity to achieve dramatic reductions in maternal, newborn and child deaths.  

Concurrent with the stream of events resulting in the Global Strategy were other critical activities building political commitment for MNCH at global and regional levels. A Global Network of Leaders was formed in 2007 to coordinate the activities of the heads of states committed to the improvement of MNCH. The Network was instrumental in increasing the visibility of MNCH on the global landscape and in generating additional financial resources for MNCH. Political support also came from the IPU, which positioned MNCH as a key area of action for parliamentarians and approved an MNCH resolution at the IPU Assembly in Kampala in 2012.  At a regional level, PMNCH’s work with the Pan-African Parliament resulted in resolutions in 2010 and 2011, calling for prioritized policy and budget action for MNCH. This high-level advocacy work elevated awareness of the importance of strengthening health systems, as well as contributed to the building of a consensus that MNCH indicators can serve as a proxy for assessing health system responsiveness. Although MNCH does not feature prominently in the Rio + 20 agenda, the UN is actively encouraging stronger partnerships with the private sector to continue the movement forward for MNCH. In 2012, the United Nations launched a high-level commission to improve access to essential, but not yet widely accessible life saving health commodities for women and children. The President of Nigeria and the Prime Minister of Norway will serve as founding co-chairs of the commission, which will also include global partners from the public, private and civil society sectors.

The events of the past seven years are a clear demonstration of the power partnership plays in increasing awareness of and political will for MNCH.  Realizing the opportunities for improving women’s and children’s health, put into motion by the Global Strategy and other global and regional activities, will require well-coordinated efforts that use the best available science. At the core of these efforts must be synergized partner collaborations, aimed at advancing the science, advocacy and financing necessary to improve the lives of women and children around the world.