Kampala Notebook: What African Union Promises Could do for Mothers and Children

Chikezie Chikezie Anyanwu, Save the Children's Africa Advocacy Advisor

Kampala, Uganda

July 28, 2010

Today I’m recovering from the last three days marathon of the heads of state meeting at the African Union summit.  With the theme of “Maternal, Newborn and Child Health and Development in Africa,” this summit offered the perfect chance to muster major action to save the lives of millions of children and mothers.    

I’m sorry to say that although Africa has around 12 percent of the world’s population, half the world’s child and maternal deaths occur here.  So there’s much work to be done.   

A few days ago, I wrote here what Save the Children and many other advocates and experts were calling on our leaders to deliver at this summit.  I’m happy to report good news.  African heads of state have issued a declaration on that includes many commitments we believe are necessary to dramatically reduce the annual 4.5 million child deaths and 265,000 maternal deaths on the continent.    

On the resources question, the leaders recommitted themselves to meeting their 2001 promise in Abuja to devote 15 percent of their national budgets to health.  In reality, few countries have reached this goal as of yet.  In the last budget year only three did—Rwanda, Tanzania, and Liberia—and that’s down from six countries the year before.  So I’m happy that African leaders recognize they must continue to chase this goal, and not just push it aside.  Prioritizing health funding is central to results in maternal, newborn and child health.    

The leaders also promised to strengthen their health systems “to provide comprehensive, integrated maternal, newborn, and child health care services.”  They listed several important strategies, including addressing the health worker shortage as we had called for.     

The leaders themselves called the current situation a “human resource crisis.”  They pledged to train community health workers to help fill the gap.  That’s good policy because you don’t need a huge amount of money or time to train these workers, and they can deliver most of the services needed to save mothers and children’s lives.  Also, these workers come from the community and, especially when they are women, they can reach mothers and children who are isolated from existing health services.     

However, I’ll point out that while community health workers can deliver lifesaving prenatal and Afr new born healthpostnatal care, and prevention and treatment for leading child killers pneumonia, diarrhea, and malaria, they cannot necessarily provide skilled attendance at birth.  That’s also critical to saving mothers’ and newborns’ lives.  So African nations must also look at ways to increase the number of midwives, nurses, and doctors—and work to retain these professionals.     

Another major concern of Save the Children and partners has been around making sure health services reach all women and children.  Too often, poorer mothers and children don’t have the same access to health care (and thus survival) as better-off compatriots.  So I was very pleased to see the leaders pledge to reduce out-of-pocket payments and to single out a strategy we’ve pushed for—making health care for pregnant women and children under 5 free.     

The final pieces of good news that came out of the Summit was the decision to institute a strong and functional monitoring and evaluation framework at national level for data generation, the establishment of a continental task force on Maternal, newborn and child health as well as commitment to an annual report to the AU assembly moving forward on Maternal, newborn and child mortality. This should help hold governments accountable for their delivery on maternal, newborn and child mortality interventions.       

If the leaders follow through on what they’ve pledged in Kampala, you can be certain that many more African children and mothers will survive and go on to lead healthy, productive lives.  That’s good for families, communities, and the very future of the continent.    

So there’s the question of that word “if.”      

In the closing ceremony last night, President Bingu wa Mutharika of Malawi implored his fellow leaders to act on the declarations they had passed.    

He said: “The time has come for us is to go for action, so that our people are able to see and appreciate the tangible results and benefits that this organization will bring to them.  I believe that we have the means, and we have the political will to do so.  Let us use these means and the political will to show to our people and the rest of the world that indeed we mean to move the economic and social transformation of our continent.”    

Amen to that!    

I hope African heads of state will heed Bingu’s words, because they are the ones with the power to transform promises into action.  If the political will is indeed there, African mothers, newborns, and children will stop dying of preventable causes.  So let’s continue to raise our voices, and do our part to build and sustain that political will! 

Closed Doors but Open Outcomes at the African Union Summit

ChikezieChikezie Anyanwu, Save the Children's Africa Advocacy Advisor

Kampala, Uganda

July 22, 2010

Today foreign ministers and health ministers from across Africa are meeting in Kampala. Here at Munyonyo, the luxury resort where the 15th African Union Summit is being held, there’s a breeze off Lake Victoria and questions are swirling in the air.

What will come out of this summit? Will leaders exercise the resolve to act forcefully on the summit’s maternal and child health theme? Will they find unity?

I’ve been catching up with some sympathetic African Union ambassadors and officials as they come out of closed door sessions to see what I can learn. Their initial report has yet to be released and, much more than in past summits, the ultimate declaration from heads of state is still very much up in the air.

The good news to report is that African civil society has found remarkable unity on what we’re asking our leaders to deliver. Representatives from Save the Children and more than 70 health and human rights organizations gathered in Kampala in the days leading up to the summit to discuss its theme: “Maternal and Child Health and Development in Africa.”  

We are community members, advocates and experts from diverse countries, backgrounds, and organizations. But I was struck by how strongly we agree on what African leaders need to do to save the lives of mothers, newborns and children in our countries. It’s worth noting we are also echoing nearly identical principles that experts from ministries of health across Africa developed at an African-Union-organized Continental Conference in Ethiopia this April. 

At the heart of the matter lies this reality: 4.5 million African children and 265,000 African mothers die every year because there’s a lack of political will to get the well-known, proven, cost-effective health solutions to those who need them.

So the biggest question we have for our leaders at this summit is: Will they do what it takes to save the lives of mothers and children in their countries?  

If they do, here’s what maternal and child advocates and health experts across Africa are saying will make all the difference:

  • PUT A PLAN IN PLACE.  Every African country must develop and implement an accelerated national plan for reducing maternal, newborn and child deaths.
  • MAKE SURE THE RESOURCES ARE THERE.  Every African country should meet and exceed its 2001 promise in Abuja, Nigeria to spend at least 15 percent of the national budget on health care.  Additionally, a meaningful portion of this budget must specifically dedicated to maternal, newborn, and child health.
  • ADDRESS HEALTH WORKER SHORTAGES.  Countries must recruit, train and retain more doctors, nurses, and midwives to help reduce the overall gap of 800,000 health workers in Africa by 2015.
  • ADDRESS THE COVERAGE GAP BETWEEN RICH AND POOR.  Countries must ensure health care, including emergency obstetric care, is accessible for the poorest people and is free at the point of use for pregnant women and children under 5.

Stay tuned to see what happens!