2016: Old Challenges, New Hopes: Accountability for the Global Strategy for Women’s, Children’s and Adolescents’ Health

While the global community moves forward in addressing public health issues through the adoption of the Sustainable Development Goals (SDGs) and the release of the updated Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030 with its accompanying accountability framework, the Independent Accountability Panel (IAP) acknowledges that more must be done and soon to ensure women, children and adolescents live healthy and fulfilling lives in this inaugural report.The function of the IAP is to annually provide a ‘snapshot of progress’ towards the Global Strategy and ensure the implementation of the strategy is effective. This follows a global demand to meaningfully hold governments, international agencies and the private sector accountable.With high inequalities within and across countries, the rate of progress to reach the global goal of 70 deaths or less per 100,000 live births must be three times faster than the previous Global Strategy period (1990-2015).By chapter, the IAP reports:

• Chapter 2 - a conceptual framework based on international human rights law. The framework focuses on monitoring and review, with particular emphasis on actions and remedies (see Image 1).

• Chapter 3 - monitoring activities by all stakeholders should promote accountability and transparency to avoid dividing or duplicating efforts and creating unnecessary burdens. Health information systems require strengthening to improve monitoring activities. Disaggregated data is necessary to accurately show what is happening in and across population groups. 
• Chapter 4 - inequality is the central focus of the IAP’s analysis of results, addressing economic, gender and age inequalities where possible. A select group of indicators were picked to show progress toward the Global strategy objectives (survive, thrive and transform) for the three population groups (women, children and adolescents). Indicators on legal rights have been included across all indicators for each group.
  • Progress is slow in satisfying the demand for family planning. However, across 89 countries, the gap between rich and poor is narrowing. In Ethiopia, contraceptive use has significantly risen and was higher among the richest. At the present rate, equality will be achieved by 2061.
  • Birth rates among older women have noticeably decreased while for adolescents they have remained almost the same, declining from 59 births per 1,000 women in 1990 to 51 in 2015. Adolescent birth rates have reduced in wealthier groups but not the poorest.
  • Sixty-three countries must increase the speed of their improvement in neonatal death rates to achieve the target of 12 or less newborn deaths for every 1,000 live births.
  • Countries with the highest number of stillbirths have the least available data. In 2015, 77% of all stillbirths took place in sub-Saharan African and South-East Asia.

This era sees the largest cohort of adolescents ever and this brings the opportunity to ensure they become agents of change as well as beneficiaries of development.

• Chapter 5 - this section explains the actions and remedies necessary to ensure women, children and adolescents lead healthy and fulfilling lives. It specifically looks at the difficulties of accountability in humanitarian settings where women, children and adolescents are particularly vulnerable. It also discusses the gap in human resources. The monitoring of human resources will be a focus in future IAP reports.
• Chapter 6 – with regard to financial resources, the Panel recommends that donors allocate resources to civil society and country-level accountability mechanisms. New national mechanisms should complement existing mechanisms.

The panel concludes with a call to action for women, children and adolescents to survive and reach their full potential, and for settings with poor health outcomes to change through:

• Global institutional leadership
• Domestic and international resources with clear investment plans
• Institutional development of skills, including information, and legal and human-rights based systems, and private institutions. Support should also be given to enabling civil society.

To read the report for free, click here.Independent Accountability Panel. (2016). 2016: Old Challenges, New Hopes: Accountability for the Global Strategy for Women’s, Children’s and Adolescents’ Health. IAP.