A report from the PMNCH Partner’s Forum in Delhi: Moving from Pledges to Action

From November 13-14, 2010, 1,200 participants from over 30 countries met in Delhi, India for the Partners’ Forum of the Partnership for Maternal, Newborn and Child Health (PMNCH). The Government of India hosted the conference, entitled “Pledges to Action", and high-level government officials participated, including a key note speech by the President of India and presentations by the Minister of Health and Family Welfare. The objective of the meeting was to accelerate action in implementing the Global Strategy for Women’s and Children’s Health, which was launched by the UN Secretary General at the MDG Summit in New York on September 22 along with commitments of $40 billion by governments, foundations, civil society organizations and the private sector. The meeting concluded with endorsing the “Delhi Declaration 2010” and statements by various constituency groups, including the NGOs.

Much needs to be achieved to meet the MDGs by 2015. To date, of the 70 countries with the worst MNCH indicators, only 20 are on track to meet either MDG 4 or 5, with only 7 on track to meet MDG 5. A recurring theme of the meeting was “more money for health and more health for the money,” thereby calling for improved efficiency and cost-effectiveness as well as additional funding. Several speakers, including WHO’s Margaret Chan and Flavia Bustreo, discussed their ongoing development of an accountability framework to track financial, political, and service delivery commitments and MDG outcomes, acknowledging the inadequacy of routine and reliable vital registration and health information systems to accurately measure change. There was also considerable discussion about finding effective innovations to accelerate progress, including innovative financing mechanisms and the greater use of mobile phones. The mHealth Alliance presentation described how mobile information technology could be used for storing patient data, providing information and advice, calling for transport for emergencies, and linking hospitals, clinics and communities, for example.

There was insufficient attention to newborns at the conference. Zulfiqar Bhutta, Professor and Chairman of the Department of Paediatrics and Child Health, Aga Khan University, discussed among recent innovations in MNCH, research demonstrating that cleansing the umbilical cord with a chemical antiseptic (4.0% chlorhexidine) can reduce the risk of infections and newborn deaths. Evelyn Zimba, Senior Maternal and Newborn Health Program Manager for Save the Children in Malawi, and David K. Mphande, Malawi’s Minister of Health, spoke in one of the parallel sessions on the scale up of Kangaroo Mother Care for newborns and community-based MNCH in Malawi. Another topic which received scant attention was how to meet the human resource needs to equitably deliver quality services.

What are the next steps? In my view, much depends on the continuing leadership of the Secretary General to promote and monitor commitments, the development of a sound accountability framework by WHO and other partners, and support of a high-level and respected independent body which regularly reviews and reports on progress towards results. And of course governments must prioritize the health of their people during difficult economic times. More attention will be needed in addressing newborn health, given that newborn mortality accounts for more than 40 percent of under-five deaths, and a whopping 55 percent in India.

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