FEWO Committee Report
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Government
Response to the Second Report of the Standing Honourable
Hedy Fry, P.C., M.P., Dear Honourable Fry, Pursuant to Standing Order 109 of the House of Commons, we are pleased to respond on behalf of the Government of Canada to the Second Report of the Standing Committee on the Status of Women entitled, Maternal and Child Health, which was tabled in the House of Commons on June 16, 2010. Maternal, newborn and child health is one of the most important development and women’s health issues today. The Government of Canada recognizes and appreciates the Standing Committee for their interest and dedication to this issue. The Government shares the Standing Committee’s vision of helping to improve the lives of millions of women and children. The Government of Canada has carefully considered the report and taken note of the observations and recommendations contained therein. The Government’s response clearly explains how each of the recommendations is being implemented. The Government of Canada would like to thank the members of the Standing Committee for their work in preparing this report. Sincerely, The
Honourable Beverley J. Oda, P.C., M.P. Government
Response to the Second Report of the Standing The Government of Canada has carefully considered the Report of the Standing Committee on the Status of Women. The Government would like to thank the members of the committee and the Government Members who tabled their dissenting report in the House of Commons, for their work in preparing this Report and welcomes its continued interest in supporting Canada’s contribution to the Muskoka Initiative on Maternal, Newborn and Child Health (MNCH). This response specifically addresses the recommendations included in the Committee’s report, and demonstrates that the Government has acted, and continues to act on these recommendations. 1. Context It is estimated that over 500,000 women die in pregnancy and childbirth each year and that maternal health is the Millennium Development Goal (MDG) where the least progress has been made. Furthermore, nearly nine million children in developing countries die each year before their fifth birthday, more than one third of which are attributable to under-nutrition. This year in June, as President of the G8, Canada championed the Muskoka Initiative on Maternal, Newborn and Child Health (Muskoka Initiative), a major plan aimed at saving the lives and improving the health of millions of women, newborns and children. Canada’s contribution to the Muskoka Initiative will target the leading causes of maternal, newborn and under five child mortality and morbidity, and support high-impact, proven interventions along the continuum of care, from pre-pregnancy through delivery to the child's age of five. At the Summit, Canada demonstrated significant leadership and commitment to this initiative, lobbying support from other G8 and non-G8 members and organizations. Canada’s contribution of CAN $1.1 billion over five years in new funding is a substantial contribution to the overall US $7.3 billion commitment. Canadians demand real results for their aid dollars and expect Canadian investments to make a tangible difference in the lives of women, newborns and children in the developing world. We will design an accountability framework to measure progress, track results and ensure that Canadians’ aid dollars are used effectively to contribute to a sustainable reduction in maternal, infant and child mortality and morbidity. We will hold ourselves to account according to the G8 agreed indicators. Following the announcement of Canada’s commitment to the Muskoka Initiative, the Government began working in collaboration with developing country and civil society partners on the development of a comprehensive programming plan to best utilize and mobilize the money allocated for this Initiative. 2. Response to the Committee’s Recommendations Recommendation 1 That the Prime Minister encourage his G8 counterparts, other countries, and public and private sector donors to collectively and adequately fund the maternal health commitments undertaken at the 2009 G8 Summit. In order to achieve this objective, the Committee further recommends that the level of funding committed at the upcoming G8 Summit in Canada be sufficient to close the gap that exists in international financing between current levels and what is needed to achieve the Millennium Development Goals (MDGs) on child and maternal health by 2015, estimated at $30 billion over the next five years. All development commitments should be time bound, with clear start and end dates; they should be explicit about whether funding is additional or inclusive of previous commitments; and they should also be clear about how much each donor and partner country is contributing. At the 2009 G8 Summit in L’Aquila Italy, G8 leaders committed to supporting a comprehensive and integrated approach to the achievement of the health related MDGs to improve maternal and child health. The recent 2010 G8 Summit in Muskoka built on this commitment and aimed to save the lives of women, newborns and children around the world. Canada recognizes that a gap presently exists in international financing, between the current funding levels and those needed to achieve the Millennium Development Goals (MDGs) on maternal and child health. By championing maternal, newborn and child health, Canada is bringing much needed attention and financial support to these often-neglected goals. This commitment and leadership was demonstrated during the G8 Summit where, as President, Canada led a collective effort to improve the health of millions of women, newborn and children with the Muskoka Initiative. The Government of Canada is committed to advancing MDGs 4 and 5 by targeting the leading causes of maternal, newborn and child mortality and morbidity to ensure the most lives saved. Canada committed CAN $1.1 billion over 5 years in new money to the Muskoka Initiative, to support maternal, newborn and under-five child health. From the beginning, Canada insisted that only new money would be included in the Muskoka Initiative in order to respond to the need for further resources for MNCH, while protecting other health priorities. Canada’s contribution is part of a US $7.3 billion commitment involving donor pledges of US $5 billion from G8 members and US $2.3 billion from other countries and organizations. All of whom are committed to expanding life saving services and programs to accelerate progress on MDGs 4 and 5 to significantly reduce the deaths of women, newborns and children in developing countries. Recommendation 2 That the Government of Canada play a strong leadership role at the upcoming G8 Summit in Muskoka by making a firm commitment to realize its share of the G8 funding that will be needed to meet the MDGs on child and maternal health by 2015, an amount which is estimated to be $1.4 billion over the next five years. This commitment should represent new funding and should not be allocated at the expense of existing programs. The Government of Canada recognizes the significant financing needs of MNCH. At the 2010 G8 Summit, it committed CAN $1.1 billion over 5 years in new money to the Muskoka Initiative. An estimated 80% of this CAN $1.1 billion will be directed to sub-Saharan Africa where the need is greatest. The total Canadian contribution to the Muskoka Initiative will be CAN $2.85 billion over five years. In addition to CAN $1.1 billion in new money, the Government will also renew existing funding of CAN $1.75 billion over the next five years, for what will be a permanent and long-term commitment. Canada’s contribution is part of a US $7.3 billion commitment involving donor pledges from G8 members of US $5 billion and an additional US $2.3 billion from other countries and organizations including Norway, the Netherlands, New Zealand, Republic of Korea and Spain, as well as the Bill and Melinda Gates Foundation and the United Nations Foundation. In addition to those who made financial contributions, Canada was proud to receive endorsement of the Muskoka Initiative from: the Governments of Australia, Liechtenstein, Sweden and Switzerland, the Hewlett Foundation, the McCall McBain Foundation, the Packard Foundation, the Rockefeller Foundation, as well as the group of eight international agencies in the health sector (the World Health Organization, the Global Fund to Fight AIDS, TB & Malaria (GFATM), UNICEF, Global Alliance for Vaccines & Immunization (GAVI), the World Bank, the United Nations Population Fund (UNFPA), Joint United Nations Programme on HIV/AIDS (UNAIDS), the Bill and Melinda Gates Foundation), the Heads of the Schools of Public Health of 22 universities in the United States and the Micronutrient Initiative based in Canada. Recommendation 3 That the Government of Canada ensure that the financial support provided to developing countries to improve maternal and child health is delivered in a way that is consistent with the commitments undertaken in the Paris Declaration on Aid Effectiveness, by working within national plans for maternal and newborn health, where these exist. Consistent with the commitments undertaken in the Paris Declaration on Aid Effectiveness and in alignment with the principles established at the Halifax G8 Development Ministers’ Meeting last April, Canada’s programming efforts will support country-led policies and plans on maternal, newborn and child health and will align with plans that are locally supported. Development Ministers agreed in Halifax that “health systems needed to be strengthened to provide integrated and comprehensive services at the local level” which include “access to primary care; equipped and resourced facilities; trained frontline health workers; and robust health information systems”. The commitments made will support strengthened country-led national health systems in developing countries, in order to enable delivery on key interventions along the continuum of care, i.e., pre-pregnancy, pregnancy, childbirth, infancy and early childhood. At the heart of Canada's contribution to the Muskoka Initiative is the importance of strong partnerships between Canada and developing country partners. An example is the Letter of Intent confirming a renewed maternal, newborn and child health (MNCH) partnership signed between Canada and Mali during the Minister of International Cooperation’s recent trip to Africa. The Canada-Mali partnership will concentrate on training health workers, strengthening Mali's comprehensive primary health systems at the local level, improving nutritional health, and reducing the effects of disease on mothers, newborns, and children under five. The two countries have also agreed to enhance the coordination and integration of Canada's development efforts in order to achieve greater effectiveness and lasting results in reducing maternal and child mortality. Recommendation 4 That the Government of Canada’s financial commitment to the G8 maternal and child health initiative include funding for all evidence-based interventions across the continuum of care for both mothers and children, as called for by the Maputo Plan of Action and the Cairo Plan of Action. This comprehensive plan should include, but not be limited to: training and support for frontline health workers; better nutrition and provision of micronutrients; treatment and prevention of diseases such as pneumonia, diarrhea, malaria and sepsis; screening and treatment for sexually transmitted diseases, including HIV/AIDS; proper medication; immunization; clean water and sanitation; dissemination of reproductive health and family planning advice, services and supplies; access to safe abortion services where abortion is legal; quality emergency care for complications from unsafe abortions; skilled care for women and newborns during and after their pregnancy; access to emergency obstetric care; and births attended by trained personnel. The Committee recommends that Canada encourage its G8 counterparts to follow suit. The Muskoka Initiative includes elements such as: “antenatal care; attended childbirth; post-partum care; sexual and reproductive health care and services, including voluntary family planning; health education; treatment and prevention of diseases including infectious diseases; prevention of mother-to-child transmission of HIV; immunizations; basic nutrition and relevant actions in the field of safe drinking water and sanitation”. It also states that “(a)ction is required on all fronts that affect the health of women and children. This includes addressing gender inequality, ensuring women’s and children’s rights and improving education for women and girls”. The Government of Canada's financial commitment to the Muskoka Initiative will include funding and increased access to a series of proven, evidence-based, high-impact interventions, including family planning, across the continuum of care. The Canadian contribution will focus on saving the lives of women, newborn and children and will target the leading causes of maternal, newborn and child mortality to ensure the most lives saved. In alignment with the principles of the Halifax Development Ministers’ Meeting in April 2010, Canada will seek to support comprehensive and integrated approaches. The Canadian International Development agency (CIDA) will support governments and organizations that provide a range of reproductive health services. Canada will also provide support to developing countries for strengthening their national health systems to provide a continuum of care including sexual and reproductive health care and services. In countries where Canada will focus its MNCH efforts, Canada will respect a developing countries’ health strategies and policies. Canada’s contribution to the Muskoka Initiative will be used to support safe, reliable and high quality family planning methods and information, which are an essential part of a comprehensive MNCH programming which will reduce recourse to abortion, decrease unplanned pregnancies and maternal mortality and morbidity, and promote newborn and child survival. Most importantly, Canada’s contribution to the Muskoka Initiative is aimed at making a difference in the lives of women and children. In order to achieve this goal, Canada has agreed to work towards the long term sustainability of results; to build upon proven cost-effective, evidence-based interventions; to focus on countries facing great needs while continuing to support those making progress; and to support country-led national health policies and plans that are locally supported; and to increase the coherence of our efforts through better coordination and harmonization at the country, district and community level. Recommendation 5 That the G8 encourage a policy environment that permits appropriate community based delivery of treatments for the main childhood illnesses and injuries with an emphasis on pneumonia, diarrhea, malaria, measles, mumps and rubella, and newborn care for sepsis. The Muskoka Initiative takes an evidence-based approach, and was developed in close cooperation with the World Health Organization (WHO), the Partnership for Maternal, Newborn and Child Health, and other leading organizations, including the Organization for Economic Co-operation and Development (OECD) and the World Bank. Based on guidance from the WHO and others, the Muskoka Initiative is focused on strengthening national health systems, in order to support the delivery of key interventions along the continuum of care from pre-pregnancy to childhood. Priorities for support include prevention and treatment of major childhood diseases. During the 2010 Development Ministers’ Meeting in Halifax, Ministers agreed to a set of core principles to ensure long lasting results for the Muskoka Initiative. The G8 funding (including Canada’s contribution) will be guided by these principles, which consist of: building upon proven, cost-effective, evidence-based interventions; focusing on the countries with the greatest needs while continuing to support those making progress; supporting country-led national health policies and plans that are locally supported; increasing coherence of development efforts through better coordination and harmonization; and improving accountability. These core principles will ensure that community-based delivery of treatments for diseases and illnesses such as pneumonia, diarrhea, malaria, measles, mumps and rubella are as effective as possible and lead to an overall reduction in the number of childhood illnesses, injuries and deaths. Furthermore, Canadian funding will target the strengthening of health systems. Strong health systems are fundamental for the development and delivery of community based treatments for women, newborns and children. 3. Conclusion The Report of the FEWO on Maternal and Child Health has provided input to the Government’s efforts to improve maternal, newborn and child health in the developing world. This work is ongoing and efforts have already resulted in moving the subject of maternal, newborn and child health to the forefront of the international stage and has solidified Canada’s position as a leader on this issue. The planned “Ministerial Roundtable on the Muskoka Initiative” will build a common understanding of the principles, direction and priorities that CIDA will follow in implementing the Muskoka Initiative and generate dialogue with international and Canadian health and development experts and partners that share knowledge, ideas and information regarding MNCH. Canada will continue to seek out opportunities to work with Canadian experts, other donors, partner countries and key multilateral organizations to pilot innovative ways of scaling-up comprehensive and integrated health services at the district and community levels for women, newborns and children. Canada’s focus will be on learning from past successes, working with our developing country partners to document what works, and using this information to improve all of CIDA’s programs. |