Sharing knowhow and joining forces towards Health for All

MMI Network News, January 2011


Editorial: New emphasis on maternal, newborn and child health

Dear reader,

Despite some very recent advance in maternal mortality and neonatal mortality reduction, the health of many pregnant women and neonates is still bleak and far from achieving the envisaged MDG 4 and 5 targets by 2015. In sub-Saharan Africa alone, nearly 4.7 million mothers, newborns, and children die each year: 265,000 mothers die due to complications of pregnancy and childbirth; 1,208,000 babies die before they reach one month of age; and 3,192,000 children, who survived their first month of life, die before their fifth birthday. This toll of more than 13,000 deaths per day accounts for half of the world’s maternal and child deaths. In addition, an estimated 880,000 babies are stillborn in sub-Saharan Africa and remain invisible on the policy agenda.

Despite strong evidence of what works, serious gaps exist in coverage, quality and equity in providing effective health care along the continuum of care. To address this issue the UN summit held in New York last September ended up putting women’s and children’s health high in the global agenda and adopting a clear strategy that includes: (a) support for country-led health plans with increased, predictable and sustainable investment; (b) integrated delivery of health services and life-saving interventions so women and their children can access prevention, treatment and care when and where they need it; (c) stronger health systems, with sufficient skilled health workers at their core; (d) innovative approaches to financing, product development and the efficient delivery of health services; (e) improved monitoring and evaluation to ensure the accountability of all actors for results. 

After years of hot debate around the effectiveness of global health initiatives, is this emphasis on maternal, newborn and child health well placed or just another example of international health rhetoric? This time it may be different for a number of reasons. 

First, the status of maternal and neonatal health is a good predictor of the functioning of the health system. The maternal health Millennium Development Goal is perhaps the one most dependent upon a well functioning health system (including the availability of facilities, medicines, supplies, staff, and a functioning referral system), so there are synergies in focusing on health systems strengthening and maternal and neonatal health in parallel. This parallelism is important, even if a lot remains to be understood about what health system strengthening means, how it could be done and evaluated and under what circumstances it works. 

Second, in the world of inequality of health services, maternal and child health services stand out as the “worst of the worst”. Of these, of particular concern is access to emergency obstetric care. Here the gradient of inequality is very high. Among the reasons identified financial barriers appear to be the most critical one and different attempts are being tested to overcome them with a variety of approaches and results. In general, since out-of pocket expenditure for maternal health care services has driven many families into poverty, especially in developing countries, the international strategy is to push towards a policy of providing services free at the point of delivery. This “women and children first” is important since it may represent an opportunity to phase in universal coverage. 

Finally, in many settings poor women and children are among the most vulnerable members of the society. They are not listened about their needs and not involved in decision making about resource allocation. This is a “human right gap” that needs to be addressed. The participation of poor women in decision making is important both because it empowers them and because it generates the social capital that is an important component of healthy societies. By enabling women and communities to address their own problems, the social cohesion and public action required to redress inequity more generally is generated. 

In the end, focussing on maternal, newborn and child health seems to make sense from technical, political and human rights perspectives. However, without clarity on future directions, focus and energy could dissipate. For us who are working in international health cooperation action and evidence are needed on several fronts, such as:

  • promoting interventions that address the whole health system not just some parts of it;
  • influencing the demand side of the system;
  • fostering innovation and operational research on the main health care delivery issues at district and community levels;
  • sustaining partnership between public and private non for profit (i.e. faith based organisations);
  • measuring outputs such as coverage, equity and quality with validated and reliable tools;
  • sharing knowledge and results generated in the field for lobby and advocacy in the global health policy forum.

Some important work is already ongoing in the Medicus Mundi International Network, but a lot remains to be done together with enthusiasm! 

Giovanni Putoto
Doctors with Africa CUAMM 

References and resources


MMI Network News, Events and Resources

MMI Network report: Wemos
Chances for Change – Dutch measures to improve the global distribution of health personnel

“This publication by Wemos presents measures, composed by the Dutch Alliance for Human Resources for Health, to be taken by Dutch actors to improve the distribution of health staff across countries. This publication is to inspire Dutch stakeholders involved in training, recruitment, retention, and employment of health personnel to collaborate and undertake tailor-made actions, which jointly constitute a substantial Dutch contribution to global health.” 

MMI Network report: Medicus Mundi Spain
Spain: Health in development cooperation and human action. Report 2010

The annual report "La salud en la cooperación al desarrollo y la acción humanitaria" on health and development cooperation published by Medicus Mundi Spain together with MdM Spain and Prosalus. The report 2010 is focusing on Spanish development cooperation but drawing a broad picture of international health development and health development policy. The report (Spanish language) can be found on the website of Medicus Mundi Spain.

MMI Network report: Wemos
The Globalization of Clinical Trials Testimonies from Human Subjects

In a report published in December 2010, the Wemos Foundation presents the testimonies of people participating in clinical trials in Poland, Russia, the United States, China and India. The book gives insight in the reasons why these people choose to participate and the way in which they are being treated.

MMI Network news
MMI adopts NGO Code of Conduct for Health Systems Strengthening

Last month, the Medicus Mundi International Network signed on to the NGO Code of Conduct for Health Systems Strengthening. The NGO Code of Conduct for Health Systems Strengthening is a response to the growth in the number of international non-governmental organizations associated with increase in aid flows to the health sector. The Code was drafted in 2007/2008 by a coalition of activist or service delivery organizations. The purpose of the Code is to offer guidance on how international NGOs can work in host countries in a way that respects and supports the primacy of the government’s responsibility for organizing health system delivery.

MMI Network news: Medicus Mundi Switzerland
Health workers in Haiti named "Swiss of the Year"

A doctor and a nurse who work in a hospital in Haiti have been named “Swiss of the Year” by a nationwide public television poll. Marianne Kaufmann, a 27-year-old nurse, and 67-year-old Rolf Maibach, who have both been active in the Albert Schweitzer hospital in Deschapelles, north of Port-au-Prince for several years, won 19 per cent of the vote. Both are working for the Bündner Partnership Hospital Albert Schweitzer Haiti, a member of the Network Medicus Mundi Switzerland.

MMI Network campaign: Doctors with Africa Cuamm
This is a war photograph

Padua, 11 November 2010. "In Africa every year 4,5 million children below the age of 5 and 265'000 mothers die. These are figures of a genocide. Most of these deaths are linked with pregnancy and birth and could be prevented." - At its anniversary celebration in Padua, Doctors with Africa Cuamm launched their new campaign "Questa è una foto di guerra" - "This is a war photograph" for better access of mothers and newborns to care.

MMI Network event
Second Global Forum on Human Resources for Health
Bangkok, 25-29 January 2011

The principal theme of the Forum is "Reviewing progress, renewing commitments to health workers towards MDGs and beyond". The Medicus Mundi International Network, a member of the Global Health Workforce Alliance (GHWA) and the Health Workforce Advocacy Initiative (HWAI), will participate in the Forum, represented by Anke Tijtsma and Remco van de Pas (Wemos), Samuel Mwenda (ACHAP) and Johan van Rixtel (Cordaid).

MMI Network event: ACHAP
Improving women’s and children’s health in Africa
Faith based organizations' response towards the MDG targets
Accra, 20-26 February 2011

"The conference will create an opportunity for Christian Health Associations to take stock of where we are with regard to our contribution to the MDGs and discuss opportunities for strengthening capacity, partnerships and health systems for quality, accessible and sustainable maternal and child health service delivery through the faith based health networks in Africa. The conference participants will be from Christian Health Associations and Christian Health Networks from Africa and partner organizations." An outline document of the 5th Biennial Africa Christian Health Associations Conference is available now.

MMI Network event: Medicus Mundi Switzerland
Linking HIV and reproductive and sexual health and rights
Bern, 7 April 2011

UNAIDS, the International AIDS Society, the Global Fund and other international bodies are aware of the need of better integration of HIV/AIDS, reproductive and sexual health and rights and other key health priorities. At the local level, many NGOs already work in an integrated way. However, many challenges emerge. Based on experience of partner organisations and their South partners and following up the global discussion level, the conference will discuss challenges of HIV and reproductive health in policy and practice. | aidsfocus conference 2011  

MMI Network event
Annual Assembly of the MMI Network
Geneva, 19 May 2011

As in the previous years, the Annual Assembly of the Medicus Mundi International Network will take place in Geneva. We will meet in a hotel near Geneva which has provided us in 2008 already with a pleasant environment for our events. Our Assembly is linked with the 64th World Health Assembly which will take place from 16 to 24 May 2011 at the Palais des Nations in Geneva. Please mark the dates.
MMI Network member: Cordaid
Cordaid and health and well-being

"Cordaid's goal is to improve the health and socio-economic situation of poor and vulnerable groups, including women. An important part of that is reinforcing healthcare systems and structures, from patient organisations to worker’s unions and from self-help groups to lobbying organisations." (Monique Lagro, sector manager) | "Cordaid and health and well-being" as well as three other brochures explaining Cordaid's work can be downloaded from the Cordaid website.

MMI Network member: Smile Train Italy
Annual Report 2010

"With great satisfaction we introduce to you the Annual Report 2010 that includes the activities of Smile Train Italy during the past year and the new proposals for the future. The world crisis, as foreseen, has struck all countries, but with determination, that distinguishes us, and with the support of our friend and supporters we have succeeded in also completing in 2010, the projects and the actions that Smile Train Italy had scheduled." (Fabio Massimo Abenavoli, President of Smile Train Italy, January 2011)

PDF (6 MB):

MMI Network: Fatebenefratelli
What we do is the Church in action

The Hospitaller Order of St. John of God (Fatebenefratelli) is present in 53 countries. It provides different services together with the Health and Welfare Ministries and other civil organisations as well as local authorities. The Superior General of the Order, Brother Donatus Forkan, talked with the Bulletin of Medicus Mundi Switzerland about the way they are working.

MMI Network member: EPN
Celebrating 30 years Ecumenical Pharmaceutical Network

"In 1981 the World Council of Churches started, within its Christian Medical Commission, a programme to address pharmaceutical issues in Church Health Systems. This programme evolved over the years into what is now the Ecumenical Pharmaceutical Network. As such this year, EPN celebrates 30 years of support to pharmaceutical service delivery in Church Health Systems. During the course of the year 2011, we will take a trip down memory lane and celebrate this anniversary through several publications and events.”


MMI Updates

Since we started to use the real-time short messaging service "Twitter", we published there already more than 780 bits and pieces of news on international health policy. Each update is 140 characters or less - these are the rules of the game. Just enough for a headline, eventually an author, a date, the source – and a shortened link to the website where you find the full information. Have a look at a selection of our “tweets” published during the last month:

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