Ending maternal, child deaths requires innovation, accountability: experts

Innovation and strong business impulses will be driving factors in reducing maternal and child mortality in the post-2015 development agenda, experts said during the final day of Canada’s maternal, newborn and child health summit in Toronto.

World Bank president Jim Yong Kim said a lot has changed since the the world decided on its Millennium Development Goals in 2000, and now there’s an opportunity to come up with a vision on how to fund aid projects that will “really stretch people’s imagination.”

He made the remarks during a panel discussion moderated by Prime Minister Stephen Harper, which also included Tanzanian President Jakaya M. Kikwete, Plan Canada's Rosemary McCarney, World Health Organization director-general Margaret Chan, and Dr. Rajiv Shah of the United States Agency for International Development.

Shah praised Canada for taking the lead on an initiative that he described as a “data-driven, business-like, global project to fully end preventable maternal and child death.”

“It has a clear goal, it has clear business plans,” he said. “The level of partnership and collaboration represented on stage today, I think exceeds what we have seen in this space and in this sector at any time in the past several decades.

"The United States is proud to have followed in your footsteps, following the Muskoka Initiative."

WHO's Chan said the new $3.5-billion pledged by Canada for post-2015 is important.

"I'd like to stretch money a bit because that speaks volumes about innovative partnerships," she said.

She referred to Grand Challenges Canada, an organization that funds those who come with ideas combining science, technology and business to deliver concrete results in global health projects. She said she was "struck" with their work that significantly reduced the cost of vital signs monitoring.

"These are the kinds of partnerships — innovative partnerships — that we can bring to bear," Chan said, adding that it was the WHO's role to assure the quality, safety and efficacy of the products.

Accountability in post-recession period

Accountability has also been a huge part of Canada's maternal and child health push since 2010. 

Following the G8 summit, Harper co-chaired a United Nations commission on accountability and transparency to monitor the progress. Among other things, the commission recommended finding new ways to gather health data and improve ways for civil society groups to provide feedback, as well as then sharing the information with the public.

"Not just that we knew in many cases, you know, big numbers were being announced and pledges not necessarily being honoured," Harper explained to the panellists on Friday.

"But also, we understood that entering into the post-recession period, budgets would be extremely tight and to keep focused, we had to be able to demonstrate results, measure what we were doing and show people around the world that we're actually — both donors and recipients were delivering."

One analyst who's extensively studied Canada's foreign aid spending said the government has made a good effort to publish data on maternal and child health projects, but data "is not accountability," just a prerequisite to it — especially considering the information is fragmented.

In a report released Wednesday, Aniket Bhushan of Ottawa-based North-South Institute analyzed the government's spending up until 2013, when only $1.787-billion of the Muskoka pledge was spent (equal to just over 60 per cent). Of that $1.787-billion, the institute was only able to track $1.186-billion at an adequate level of detail but even that had some limitations.

Bhushan recommends one way for the government to meet high expectations on transparency and accountability is to better link related data and present it in a way that people — not just data experts — can understand.

During the panel discussion, Chan noted that the idea of accountability has only recently become pervasive, appearing "in every forum, every meeting, every document we see," with the launch of Muskoka.

"That's a cultural change," she said.