Nigeria & 2015 Progress Report 4 Accountability

“What gets measured gets done—a mantra we believe in and will continue to repeat. The accountability agenda for women’s and children’s health emerged because ten years into the Millennium Development Goals (MDG), progress on women’s and children’s health was lagging far behind. Since 1990 maternal deaths have been cut by almost half; some 17,000 fewer children die each day.”

Above is a succinct but powerful message extracted from the ‘FORWARD’ of the Accountability for Women’s and Children’s Health; 2015 Progress Report written by Dr Flavia Bustreo; Assistant Director-General, Family, Women’s and Children’s Health and Dr Marie-Paule Kieny, Assistant Director-General, Health Systems and Innovation, World Health Organization.

The report was released around the September 2015 United Nations General Assembly and provides an update on implementing the Commission’s 10 ambitious yet practical recommendations to fast-track improvements in women’s and children’s health. It also sets out the successes and lessons in implementing accountability frameworks.

Key Highlights of the Report;

1. More than 30 countries show solid examples of strengthening national accountability.
2. Accountability has taken root, with 68 countries demonstrating examples of accountability mechanisms through Country Accountability Frameworks (CAFs) that received a first phase of catalytic funding. Of these,
3. 17 strong performers have been awarded a second phase of catalytic funding. A number of countries made progress despite facing serious challenges due to natural disasters, conflict or the Ebola epidemic.
4. Nearly all Country Accountability Frameworks have prioritized maternal death surveillance and response (MDSR) and civil registration and vital statistics (CRVS). One novel and significant finding is that each of these work streams performs better when the two are done together.
5. Countries continue to strive to improve the collection of data on the 11 recommended indicators, and global level actors have agreed to a global reference list of 100 core indicators for health that streamline and lessen the reporting burden on countries.
6. Significant strides have also been made in tracking budgets, resources and resource flows for reproductive, maternal, newborn and child health (RMNCH). More than 65 countries have adopted the methodology of System of Health Accounts 2011, and now 33 countries have data (compared to 18 last year), leading to a better understanding of domestic expenditures on health, and better harmonization of partners’ financial and technical support.
7. Compacts and similar partnership agreements are improving coordination among development partners to make health aid more effective, and civil society engagement in compacts and annual review processes is a positive trend. Civil society, uniquely positioned to track progress on country commitments, is contributing to greater transparency, advocacy and action, particularly with respect to government spending on RMNCH priorities.
8. Parliaments have strengthened their roles in promoting and supporting RMNCH. At their General Assembly in March 2015, the Inter-Parliamentary Union discussed progress in implementing their landmark resolution of 2012, 3 and exchanged experiences on relevant legislative action and budget allocations.
9. Global community responds to country demand for CRVS guidance and investment. The Global Financing Facility (GFF), led by the World Bank, and the governments of Norway and the United States is an important vehicle for aligned investments in CRVS. The Government of Canada committed US$ 100 million to improving CRVS systems through the GFF and in support of Every Woman Every Child.
10. Government and civil society partnerships have been strengthened: Of the 51 countries with an International Health Partnership (IHP+) Compact or similar partnership agreements, more than one in three include civil society engagement. Fifty-four countries have conducted health sector reviews that include a wider set of partners, particularly civil society.
11. Budget tracking and advocacy enhance mutual accountability for resources: Civil society, parliaments and media from 21 countries are engaged in budget tracking, leading to increased funding for women’s and children’s health. Parliaments sustain their commitments: Parliaments in 30 countries have taken legislative action for women and children, including increased budget allocations for reproductive health.
12. Independent accountability remains essential for the post-2015 period: There is multi-stakeholder consensus on the need for independent accountability for women’s and children’s health post-2015, and this is a priority in the development of the new Global Strategy for Women’s, Children’s and Adolescents’ Health.

The progress report has provided a snap shot of country progress within selected workstreams. Nigeria has being scored favorably well in the below indicators with results showing either achieved or is likely to be achieved by the end of 2015.

1. Country Accountability Framework
2. Civil Registration and Vital Statistics (assessment completed, plan developed and in progress)
3. MDSR System in place National
4. eHealth Strategy developed and being implemented
5. IHP + compact or similar partnership agreement operational
6. National health sector review process with stakeholder participation

However 2 indicators for Nigeria which are very significant for measuring accountability and transparency still require lots of work as the report scored them low “Progress is being made, but a continued effort is necessary to achieve results”. They are as follows;

1. Timely and accurate data available for monitoring core indicators
2. Country reporting on expenditure indicators by financing source

As we move towards 2016 and commencing to implement sustainable development goals (SDGs) and the new Global Strategy for Women and Children’s Health, Nigeria needs to demonstrate a proactive strategic plan to deepen accountability and transparency for health.

1st published in Daily Trust Newspaper of 3rd Nov 2015 by  Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)