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Scoring World Bank Investment in Reproductive Health

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Although I was accredited to attend the World Bank Meeting on Wednesday 9th April 2014 in its headquarters in Washington DC, I couldn’t because same day Nigeria was billed to present its position in another event   ‘47th Conference of the Commission on Population and Development’  taking place at United Nations Headquarters in New York. Regrettably my solidarity for my country was thwarted when it was announced that Nigeria presentation would be the following day and it was too late for me to travel to Washington DC for the World Bank event. I had to do with following the event online.

It was an event for the International Planned Parenthood Federation (IPPF) to present its scorecard for the World Bank investment in Reproductive Health. I saluted IPPF for its brevity and innovation in engaging the bank on how to improve and do better in the health sector. It was co-organized by IPPF and the White Ribbon Alliance (WRA) and attended by Jordan’s Princess Sarah Zeid, officials from the World Bank, and representatives of Civil Society. IPPF unveiled its new scorecard which tracks the progress of the World Bank’s reproductive health action plan aimed at helping people in poverty access critical health services around the world.

In its press release that day, it was revealed that “today, there are 222 million women who have an unmet need for family planning – the figure for total demand for family planning (use and need) is projected to increase to more than 900 million by 2015 ………as a major financier of health projects which contribute to increased access to sexual and reproductive health services for women and men across the 57 Reproductive Health Action Plan priority countries, the World Bank has an important role to play in improving the reproductive health of people living in poverty.

The scorecard revisited: Monitoring and evaluating implementation of the World Bank’s Reproductive Health Action Plan 2010–2015” reveals that, since the introduction of the Reproductive Health Action Plan in 2010, the original ambitions have not been fully realized. It argues that the Bank must increase its new financial commitments to reproductive health each year and ensure a renewed strategy on reproductive health is in place from 2015.

It also observed that it was the sustained advocacy from IPPF and civil society groups urging the Bank to include reproductive health indicators in its strategies and measurements systems, has led to the Bank committing to including contraceptive prevalence rate in the International Development Association 17 Results Measurement System.

The presentation observed that IPPF’s scorecard is an interim assessment of the implementation of the World Bank’s Reproductive Health Action Plan, which was launched in 2010. The Action Plan is ambitious in its aims to improve reproductive health outcomes across 57 ‘high burden’ countries, all of which have high maternal mortality ratios and high total fertility rates.

However, despite the Reproductive Health Action Plan being heralded as a turning point for the Bank’s commitments to reproductive health, IPPF has concerns that since its introduction in 2010, the original ambitions of the Action Plan have not been fully realized. IPPF’s scorecard reveals a mixed result in the Bank’s performance across a number of areas such as;

  1. Reproductive health policy and analysis
  2. Investment in reproductive health
  3. Influencing on reproductive health
  4. Transparency and accountability on reproductive health
  5. Expertise in reproductive health

The scorecard reports makes the following recommendations in relation to the five categories mentioned above.

  1. While respecting the importance of country ownership, IPPF recommends that country engagement documents for the Reproductive Health Action Plan countries (such as Country Assistance Strategies which are currently used by the Bank and Country Partnership Frameworks which will soon replace them) should explicitly reference reproductive health. Including reproductive health indicators in such documents will ensure that the Bank is held accountable to its Reproductive Health Action Plan and will be instrumental in monitoring progress and measuring the impact of the Bank’s investment in these areas.
  2. Data received from the Bank reveal that there was a significant fall in the Bank’s new investments for reproductive health in 2013. IPPF urges the Bank to increase its new investments each fiscal year in reproductive health up to 2015 and beyond, to ensure that the Reproductive Health Action Plan priority countries are supported to achieve improved reproductive health outcomes. As budgets for the Bank’s general health portfolio grow, we would expect to see the relative allocation of funds to reproductive health expanding proportionately.
  3. IPPF urges the Bank to continue to take advantage of its global partnerships to leverage further support for reproductive health and to highlight the links between sexual and reproductive health and issues such as poverty reduction and climate change.
  4. IPPF recommends that information on the Reproductive Health Action Plan, including annual progress updates, should be proactively communicated to civil society on an ongoing basis, in order that civil society organizations are kept informed of the Bank’s work on reproductive health and the results that the Action Plan is yielding.
  5. IPPF urges the Bank to keep a continued focus on ensuring that its staff have specific expertise in reproductive health. This will help to embed a richer understanding of reproductive health issues among Bank staff, and will contribute to their ability to implement the Reproductive Health Action Plan and to champion reproductive health issues more confidently across the Bank.

In conclusion this scorecard is a welcome development as it underpins the need for country specific scorecards for the bank investment in Reproductive Health especially in sub Saharan Africa where the women’s life time risk to maternal mortality is 1 in every 39.

This article is written by Dr Aminu Magashi and 1st published in Daily Trust Newspaper of 20/05/2014. Follow him @HReporters and email him at  healthweekly@yahoo.com

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