How East Africa can achieve maternal and child health MDGs through information-sharing

Saturday July 06 2013

Dr Richard Sezibera

When leaders of country governments sign political commitments such as the Millennium Development Goals, they are not only making commitments to the global community but more importantly to the people whose lives depend on the country’s ability to meet these targets to improve health.

With stunting rates for children under five at 58 per cent in Burundi, the maternal mortality rate at 488 per 100,000 live births in Kenya, the child mortality rate at 76 per 1,000 live births in Rwanda, 27 per cent unmet need for contraceptives in Tanzania, and skilled attendants at only 59 per cent of births in Uganda, the countries that comprise the EAC have an opportunity to improve reproductive, maternal, and child health through leveraging the collective market size, knowledge, and successes in the region to meet the targets identified in recent political commitments.

Recognising the great breadth and depth of knowledge within the EAC, the Open Health Initiative to Improve Reproductive, Maternal, Child, and Newborn Health in the East African Community Partner States (OHI) aims to support the partner states reach their goals for women’s and children’s health by focusing on three thematic areas: Accountability for results and resources, results-based financing, and innovation.

Only through quality data can the EAC as a region measure, target, and scale up successful interventions.

Within the current financial context, improving women’s and children’s health in the EAC partner states will primarily rely on using existing funds — domestic and external — more efficiently and effectively.

The OHI is therefore prioritising increased accountability and transparency for results and resources by all stakeholders as essential to improving women’s and children’s health.


In a clear and decisive step in prioritizing the health of women and children, the OHI was approved by all five heads of state in the EAC in November 2012 and implementation began in January this year.

How will greater accountability save lives?

Accountability will ensure that data are properly recorded and reported and that financial information is tracked and shared.

Given current global financial constraints, we must do more with what resources and knowledge we have by increasing accountability and efficiency of resources and decreasing duplication of efforts.

Accountability requires that leaders at all levels look beyond themselves. That they leave their comfort zones and focus on the needs of the most vulnerable in our societies.

In signing the OHI into regional policy, the partner states agreed to track all health budget and expenditure data and publish a routine report of actual allocations for women's and children’s health.

This action will require not only greater effort from national governments, but full co-operation and openness from global donors and stakeholders.

Monitoring and reporting the progress of targets for improving outcomes of women’s and children’s health to high levels of governments will help keep policy makers and government officials accountable against stated commitments and to their constituencies.

Tracking resources and comparing allocations with health outcomes will inform decision-makers on whether more resources are needed in areas such as family planning, training skilled birth attendants, or conducting immunisation campaigns.

Moreover, tracking resources and results will let us know which regions of a country are struggling most and can help improve equity of care and access and identify best practices that can be leveraged regionally.

The capacity to learn from each other exists in East Africa.

In Rwanda, for example, the national health resource tracking system provides a detailed overview by health area of money being budgeted and spent and is linked with key objectives of the health sector strategic plan, ensuring that money is allocated based on previously made commitments and goals.

Since all development partners and donors are engaged along with the government, the system is transparent and co-ordinated, resulting in more informed decision-making and a more efficient use of limited resources and hence potentially better health outcomes for patients.

It is possible to track all budgets and expenditures against an agreed health strategic plan.

Many more such examples exist across East Africa.

At the global level, given the economic and financial challenges we face, and the struggle by all countries to meet the MDGs, there is an acute need to ensure effective use of funds towards clear outcomes.

Resources available to countries must be predictable and long term. They must also be protected from the vagaries of global politics.

It should not be acceptable that development partners, for whatever political reasons, deprive governments and communities of the resources they already have committed to contribute towards achieving MDGs.

The lives of women and children are too important to be allowed to fall through political cracks. Alas, in East Africa, we have seen this happen all too often.

Despite the adoption of policies and commitments to improve women’s and children’s health, there are resource shortages and funding gaps to supporting successful interventions.

As a key strategy in the implementation of the OHI, the Acceleration Fund for Reproductive, Maternal, Child, and Newborn Health will help address some of the funding shortages by making flexible resources accessible in real time to partner states that can be used for scaling up high impact interventions in women’s and children’s health.

Right now, across all five of our partner states, there exists an unacceptably high maternal and child mortality that is hindering the development and advancement of individuals, families, and nations.

No woman should die or suffer debilitating results from childbirth and every newborn should have a healthy childhood. We owe this to our people.

Dr Richard Sezibera is the Secretary General of the East African Community