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MATERNAL AND CHILD HEALTH: THE 2012 IPU RESOLUTION AND THE CENTRALITY OF PARLIAMENTARY ACTION

 

World Health Organization

Geneva, Switzerland

19 november 2012

 

Honourable colleagues,

I would like to first thank the World Health Organization for inviting me to speak on the role of parliamentarians in implementing the Global Strategy, and the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health.

It is a pleasure to be here among people with such considerable expertise.  

The role of parliamentarians was the subject of a report prepared for the Inter-Parliamentary Union – the IPU – in 2011-2012; I served as one of three co-rapporteurs.

This April, the 126th IPU Assembly, meeting in Kampala, adopted a resolution entitled, Access to Health as a Basic Right: The Role of Parliaments in Addressing Key Challenges to Securing the Health of Women and Children.

The resolution establishes an ambitious framework for parliamentary action. It also complements the objectives put forward in the Global Strategy and report of the Commission on Information and Accountability.

In what is perhaps its key operative paragraph, the resolution "calls upon all parliamentarians, both men and women, and the IPU, to take all possible measures to generate and sustain the political will as well as the appropriate resources needed to achieve the MDGs by 2015, and to put in place the policies and commitments needed for the post-2015 period."

I will highlight some of the other key passages relevant to our discussion today.

The resolution puts forward the argument that the health of women and children must be approached as a broader development and human rights issue.

That is why the need for adherence to international human rights obligations, including the right to health and non-discrimination, are emphasized throughout.

The IPU Assembly made it clear that these issues cannot legitimately be separated.

Much of the discussion in Kampala also pertained to accountability.

The First Report of the Independent Expert Review Group on Information and Accountability for Women’s and Children’s Health states that: “Parliaments have a critical part to play in supporting the Global Strategy. They represent a powerful accountability tool in their own right to drive progress towards improved women’s and children’s health.”

The IPU resolution calls on parliaments to use the oversight and accountability tools at their disposal throughout the budgetary process to ensure that adequate domestic financial resources are allocated for sexual, reproductive, maternal, newborn and child health, and for achieving MDGs 4, 5 and 6 at the national level.

It calls on parliamentarians to use those same tools to work to ensure that all commitments made to the Global Strategy and recommendations of the Commission on Information and Accountability are implemented.

In order to address the core challenge – the actual execution of such actions, which are substantial – the resolution also contains provisions related to parliamentary capacity.

For example, it urges parliaments to ensure that committees entrusted with monitoring issues pertaining to health and gender quality are adequately resourced and operational.

Two things struck me in Kampala that reinforced why I think it important for parliamentarians to be seized with a set of issues - maternal and child health - that have admittedly seen considerable international action in other forums in the last few years.

First, the Meeting of Women Parliamentarians dedicated time to discussing amendments to the draft resolution, with the specific aim of introducing a gender perspective.

The work of those parliamentarians helped to improve the final text by applying a gender equality lens to the issues.

My second take away was the range of voices and national experiences that were heard.

Some 607 parliamentarians from 120 countries participated in the Kampala Assembly.

The proceedings thus reflected the viewpoints of parliamentarians in countries ranging from those that are struggling to strengthen fragile health systems, to those where priorities for official development assistance programs are being debated.

Discussions among colleagues also revealed the real challenges confronting implementation of the Global Strategy and the Commission’s recommendations at the national level in many countries.

The challenges are numerous, including limited resources, limited capacity, and lack of political leadership, as well as practical ones, such as inadequate infrastructure or technology.

Moreover, in some countries, initiatives targeting improvements in women’s health are still seen as controversial.

I think that is why I’m encouraged that we are seeing a number of focused parliamentary initiatives on maternal and child health at the regional level and within national parliaments.

These efforts must therefore receive our support.

Today and tomorrow, when we are discussing priorities for the coming year, I would argue that parliamentary capacity-building should be among them.

With this in mind, it is important for us to avoid the tendency to lump parliamentarians – who are representatives of the citizenry and members of the legislative branch of government – in with a long list of “other stakeholders” when we are discussing international development policy.

Over the years, debates in the development community have focused considerable attention on the need to involve civil society organizations in development efforts, to build the capacity of developing country governments, and to reform the decision-making structures of multilateral intergovernmental organizations.

We spend comparatively little time on the need to strengthen the capacity of parliaments.

Yet, as I've outlined today, when considering the work that is needed to implement the recommendations of the Commission on Information and Accountability, the roles that parliamentarians play in awareness-raising, oversight, and monitoring will be central ones.

My experience as an IPU co-rapporteur also highlighted the importance of cooperation across sectors.

In preparing the draft resolution, and during the deliberations at the Bern and Kampala assemblies, we received important feedback from the World Health Organization, the Partnership for Maternal, Newborn and Child Health, and the UNFPA.

This is exactly the type of collaboration that I believe should be our model.

It is clear that no one actor – whether it is governments, parliaments, international organizations, civil society, global foundations, or health care professionals – can accomplish the steps necessary to attain MDGs 4 and 5 on their own.

While we have seen real progress in some areas, we all know that it cannot be taken as an invitation to complacency, but rather as motivation for sustained action and resolve.

One thing I noticed in particular from the report of the independent expert review group is the ongoing problem with the availability of solid data in many countries.

The IPU resolution calls on parliamentarians to promote the establishment and/or enhancement, before 2015, of accurate civil registration systems to register all births and deaths, and to develop national information systems that include a gender perspective and data from all health facilities and administrative sources and surveys.

As we know, the absence of such systems complicates efforts to pursue policies that are firmly evidence-based.

Parliamentarians themselves need such information to inform their debates and oversight activities.

We must also remember that parliamentarians can be the source of pressure for government action to follow-through on national commitments undertaken as part of the Global Strategy.

I would conclude by noting, as many have, that we are entering into a critical period of debate about the future of international development efforts.

The early stages of planning for the post-2015 period are underway at the United Nations.

Given the continuing uncertainty in the global economy, there will likely be pressures on development assistance budgets and even greater scrutiny for results from the spending that is undertaken.

That is why I’m so encouraged by the comprehensive work that has been done by the independent expert review group in their report to monitor progress.

As the emphasis of this meeting indicates, follow-up on our commitments and implementation at the national level must be our focus going forward.

I would also note that the resolution adopted in Kampala requests the IPU to develop an accountability mechanism – based on the 2011 report of the Commission on Information and Accountability – to monitor the progress of member parliaments in implementing the resolution between last April and 2015. 

I am hopeful that such work will continue at the 128th IPU Assembly next March in Ecuador and beyond.

Thank you - I look forward to our discussion.