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Three Big Tasks for Every Woman, Every Child

Cristian Baeza's picture

Sri Lanka. Photo © Dominic Sansoni / World Bank


So the big news out of the MDG Summit today is the launch of Every Woman, Every Child, the new joint action plan to help reach MDGs 4 and 5 on child and maternal health.

The World Bank, numerous UN agencies, governments and civil society groups have all pledged their support. But another document with pledges is not going to make much difference to poor mothers and children in developing countries unless we act on three things.

First, we need to invest in innovative programs that produce better health  and link our funds to proven results!

One of the most effective things is making payments to health providers or patients conditional on measurable actions, such as delivering babies in health facilities, providing micronutrients, family planing services and other.

A Bank-led impact evaluation found that as a result of pay-for-performance in Rwanda, 21% more women delivered in health facilities and 64% more children 0-2 had preventative checkups.

That’s why the Bank has committed an additional $600 million in results-based financing to help the poorest countries achieve the MDGs.

This money will be focused on 35 countries, particularly in Africa and Asia, which face both high birthrates and poor child and maternal nutrition and disease.

Second, in the process of linking funds to results (Bank and own country funding) we need to help poor countries strengthen their health systems to make sure they maximize the impact of their own resources and  aid gets to those that need it most.

This means we must take care of all the essential building blocks for health, including making health care free or affordable for poor mothers and children; putting logistics and distribution in place so that critical supplies such as bed nets, lifesaving drugs reach those that need them; and holding health care service providers accountable for delivering quality care.

Third, we must link better health outcomes with poverty reduction and economic growth.

Health is an economic issue: Poor health affects ability to learn, and earn – while serious illness can push families into poverty.

And it’s not enough to invest more in health sector programs; investments in other sectors such as education, agriculture and infrastructure are equally, or sometimes more, important to better health.  After all, if there is no transport for an expectant mother to get to the health facility, she's going to deliver at home at much greater risk to herself and her newborn baby.

Comments

Submitted by Anonymous on
Delivering at health centres is very expensive and as long as hospitals and clinics charge such high sums, people will continue to resort to home delivery.

Submitted by Patricio Marquez on
The point made on on the "link between allocation of funds to results (Bank and own country funding) and the need to help poor countries strengthen their health systems to make sure they maximize the impact of their own resources and aid" is a critical one. As the lessons learned from different sectoral initiatives around the world indicate, focusing only on interventions alone will not suffice. Implementing effective result-based approaches that are sustainable indeed require institutions and institutional strengthening initiatives that are properly sequenced and adjusted to the absorptive and learning capacity of the countries. And the third point, is right on the mark. Perhaps we need to adopt a more balance approach to health challenges: while supporting reforms in the "health services for the sick" we also need to pay attention (I would say added attention) to addressing the determinants of poor health outcomes--this would require a multisectoral response. Quoting the classics: "Healthy people don't need a doctor--sick people do." Luke 5:31, New Testament Gospels.

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