Table 1 Ideas, actor-groups, and political context in relation to the development of a global MNCH community, 2005–2015
2005–2010 | |||
Ideas | Political context governments | Political context multilateral | Political context civil society |
MDGs 4 & 5 present opportunity to create a joint “MNCH” identity for greater mutual impact | 2006: African Union (AU) announces Maputo plan on sexual and reproductive health to accelerate MDG results | 2005: World Health Report, Make Every Mother and Child Count, promotes continuum of care, calls for enhanced progress in reducing mortality | 2005: PMNCH formed as “super-network” of maternal, newborn and child groups to advocate for joint achievement of MDGs 4 and 5 |
“Continuum of care” created as operational framework for integrating maternal and child health service delivery | 2006: Norwegian PM Stoltenberg convenes new Global Business Plan for MDGs 4 & 5; 2007, announces $1b for MNCH, launches head of state network on RMNCH | 2007: MDG5b created on reproductive health | 2005: Countdown to 2015 progress report grows out of Lancet special reports on child and newborn health |
Evidence-based advocacy, based on epidemiological and economic measurements, adopted by wide range of MNCH actors. Rights/moral-based messaging declines. | 2008: Inter-Parliamentary Union co-hosts global meeting with Countdown to 2015 on RMNCH | 2009: UN Secretary-General Ban Ki-moon identifies maternal and child survival as priority for action; calls for development of global plan of action | 2006: Lancet produces evidence series on maternal health, anchored by new global epidemiological analysis |
Norms and beliefs articulated through the Global Strategy for Women’s and Children’s Health (2010) | 2009: AU launches national CARMMA campaigns to advance Maputo plan | 2009: High-Level Task Force on Innovative Financing influences first-ever costing of gap in reaching MDGs 4 and 5 | 2007: Women Deliver holds first global conference in London, uniting advocates and marking pivot to evidence-based advocacy |
Multi-stakeholder “partnership” narrative asserted to promote delivery of Global Strategy and influence of MNCH policy community in global health arena | 2010: G8 pledges US$5b for MNCH at Muskoka summit in Canada | 2010: Global Strategy for Women’s and Children’s Health led by UN Secretary-General Ban Ki-moon attracts US$40b in pledges through a new partnership platform, Every Woman Every Child | 2009: MNCH Consensus agreed among broad range of UN, civil society, donor, and health professional partners: first-ever technical and financial consensus |
2010: AU heads of state hold summit on RMNCH | |||
2011–2015 | |||
Ideas | Political context: governments | Political context: multilateral | Political context: civil society |
Accountability discourse takes hold in MNCH community to measure progress towards MDGs and Global Strategy – technical orientation cedes gradually to rights-based measures of accountability as SDGs take shape (2011–2015) | 2011–12: Parliaments intensify support for MNCH through Inter-Parliamentary Union resolution and Pan-African Parliament resolutions | 2011: Commission on Information and Accountability for Women and Children, chaired by leaders of Canada and Tanzania, sets out goals and targets based on the Global Strategy. Calls for creation of an “independent Expert Review Group” to track progress, reporting to UN Secretary-General | 2011: PMNCH opens private sector constituency, recognising contributions in innovation and efficiency |
Increasing complexity of MNCH architecture underlines need for global health governance reforms | 2012: DFID, BMGF and UNFPA convene London Family Planning Summit, raising $2.4b in pledges; FP2020 created to support and track progress, linked to the Global Strategy | 2013: Global Investment Framework for Women’s and Children’s Health launched in conjunction with Lancet Commission on Investing in Health | 2012: First annual report of independent Expert Review Group emphasises need for stronger global health governance, national data, human rights and participation |
Rising economic power of LMICs and stagnating donor aid prompts greater shared concern with national leadership and financing | 2014: Open Working Group report on post-2015 SDGs emphasises integrated health and development goals, based on sustainability and human rights, including adolescent and reproductive health | 2014: Global Financing Facility for Every Woman Every Child created to harmonise aid and leverage domestic funds | 2014: PMNCH publishes Success Factors study to advocate for stronger links between health outcomes and social and economic determinants in post-2015 era |
Emergence of integrated SDG framework highlights focus on social, political, economic and environmental determinants of health | 2015: MDGs end, SDGs launched | 2015: Updated Global Strategy on Women’s, Children’s and Adolescents’ Health developed in support of SDG agenda | 2015: “Citizen Hearings” on women’s and children’s health led by NGO coalitions at sub-national, national, and global levels to demand greater accountability |