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We Can’t Achieve Health Goals for Women Without Women Leaders

This blog was written by Dr. Christine Sow, GHC President and Executive Director, and cross-posted from Chemonics

For months we have been talking about and planning for the “post-2015 era.” Now it is just around the corner, with the Sustainable Development Goals (SDGs) ready to be adopted in September. While discussion thus far has been oriented on the agreement and its parameters, focus is now shifting to the means of implementation. With the structure of the SDGs now clear, the differences between the Millennium Development Goals (MDGs) and the SDGs are now apparent too. For instance, the SDGs more than double of the number of goals and shift to a universal application of the framework to both North and South.

So now the resounding question facing us is: How do we do things differently to surpass the achievements made under the MDGs and actually reach the SDGs?

The problem is complex and multi-faceted. This programmatic shift involves reaching many more different and highly complex goals, along with culture and behavior change.

A critical, acknowledged component of the SDGs is a focus on women and girls. They are noted in almost every discourse as deserving of and requiring extra and specific attention in order to right inequities, provide appropriate services to improve their health and well-being, and unlock their potential as contributors to economic growth and improved governance.

However, a serious inequity affecting women in the SDG era is spoken about much less – the great gender imbalance in the leadership of international development and the SDG ecosystem.

The global health arena is a perfect example of this paradox. Maternal health and the role women play as caregivers and custodians of their families’ health is front and center in the vast majority of global health work. At the same time it is estimated that in many countries more than 75 percent of health workers are women (it’s also worth noting that the availability of statistics on the gender disaggregation of health workers is remarkably limited). But a closer examination of leaders in global health reveals that the gender structure of the global health field is a pyramid – predominantly female at the lower levels with fewer women present at top leadership. A recent desk review by Global Health Council revealed that 18 percent of top USAID-funded contractors are led by women while this figure reaches 35 percent in the top USAID-funded NGOs. Only 23 percent of government delegations to the 2015 World Health Assembly were led by women. Only one out of the top five UN agencies working on health is headed by a woman: Dr. Margaret Chan of the World Health Organization (WHO).

This issue within global health has begun to be acknowledged through initiatives such as 300 Women Leaders in Global Health, launched in 2014. While the social media popularity of this list demonstrated that there is no shortage of women leaders in global health, the translation of these names into true visibility and acknowledgment is indirect. Many global health event panels, steering committees, and executive positions are still heavily dominated by men.

Faced with a highly complex and challenging set of goals, the international development community cannot afford to distance or exclude a significant proportion of its talent pool and hope to achieve goals that speak to inclusion and equity. Women must lead as well as benefit from the new global consensus on development.

 

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Climate Change Adaptation and Population Dynamics in Latin America and the Caribbean: Key Issues for Policy Makers

Global climate change trends indicate that even with mitigation efforts, our planet will continue warming into the next century, leading to more extreme climate conditions and weather events. The Latin America and Caribbean region is particularly vulnerable to some of the most challenging aspects of climate change—sea-level rise affecting coastal cities, changes in precipitation impacting agriculture, glacial melting threatening water reserves. Population trends—like migration and urbanization—can exacerbate these challenges or, in some cases, serve as methods of adaptation. Building resilience to climate change through adaptation efforts and women’s empowerment are key strategies for enabling continued development across the region in climate-uncertain times.

The Wilson Center has worked closely with USAID Missions in Latin America and the Caribbean over the past two years to convene key stakeholders in the region and to explore promising tools in climate change adaptation through a series of seminars. On July 28, they brought to Washington top experts and policymakers from those seminars in Colombia, Barbados, Dominican Republic, El Salvador, and Peru, to further broaden the dialogue about climate adaptation and population dynamics in Latin America and the Caribbean; and to encourage the development of new policy and programmatic tools that help countries of the region meet the financial, organizational, and political challenges that climate change presents.

Webcast available here.

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Help us advocate to save moms and kids around the world!

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Since 1990, nearly 100 million children around the world have been saved due to global efforts to reduce child mortality, and maternal deaths have been cut nearly in half. The US government has played a large role in this great success story.

Yet still, each day, more than 17,000 children’s lives and nearly 800 mothers’ lives are lost due mostly to preventable causes. If you’re like us, you think this is unacceptable. The good news is, history has shown us what we can do when we work together – and research has backed it up. We can end preventable maternal, newborn, and child deaths within a generation. But we must all play our role to make it happen!

The opportunity: a more coordinated US strategy

A group of over 20 diverse nonprofits are advocating for the United States Congress to fulfill its promise to save the lives of moms, kids, and babies around the world by supporting a new piece of legislation that scales up simple solutions and requires a coordinated, streamlined strategy to end preventable maternal, newborn, and child deaths by 2035. Learn more about the bill here!

How you can help #SaveMomsandKids

We are advocating for this bill because we believe that moms, children, and babies are best served when resources and expertise are brought together to achieve maximum impact. The same is true for our voices, and that’s why we need your help.

We are starting a virtual “chain” around the world comprised of people who believe we must do all we can to #SaveMomsandKids. Join our global chain to show policymakers that US citizens, along with others around the world, support coordinated efforts for maternal, newborn, and child health. It’s easy:

  1. Take a photo linking arms with your friends, family, colleagues – anyone you want.
  1. Share the photo on Twitter using the hashtag #SaveMomsandKids with a message sharing why you are joining the initiative. Or, use one of these sample messages:
  • All moms and kids deserve a chance to be healthy and happy. Join our chain to #SaveMomsandKids [PHOTO] (Link to this blog)
  • Join the virtual chain of people who believe we must do all we can to #SaveMomsandKids [PHOTO] (Link to this blog)
  • Let’s start a chain reaction to #SaveMomsandKids around the world. [PHOTO] (Link to this blog)
  • Don’t break the chain! Join us to #SaveMomsandKids [PHOTO] (Link to this blog)
  • Today we are coming together to #SaveMomsandKids around the world. Will you join us? [PHOTO] (Link to this blog)
  1. Optional: Tag your representative asking for support of the bill. Find a list of congressional Twitter handles here. (Find who your senator or representative is here.)
  • Example: .@RepAdamSmith You’re a vital link in the chain to #SaveMomsandKids. Will you join us? [PHOTO] (Link to this blog)
  1. Follow #SaveMomsandKids for other opportunities to share information, graphics, and other content. Be part of the conversation!

Why we need you

This week, advocates will be on Capitol Hill to educate congressional offices about the bill. A group of moms and kids will also deliver paper chains colored by kids to let the members of Congress know they are a vital link in the chain. The paper chains will have the #SaveMomsandKids hashtag – pointing policymakers to the Twitter campaign, where they will see your photos as evidence of your support for the issue.

We need your help to show members of Congress the growing chain of people around the world urging them to #SaveMomsandKids.

Will you be a part of this global movement? Check out who has joined the chain already at #SaveMomsandKids.

Each partner inserts their own shortened URL linking to their blog

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Six Reasons Ministries of Finance Should Invest in Health Workers

This blog was cross-posted from VITAL and written by Misrak Makonnen and Kate Tulenko

Last week’s high-level talks about human resources for health in Addis Ababa, Ethiopia, resulted in the Addis Ababa Call to Action on financing the health workforce, signed by the nine ministries of health that participated.

The call to action is a powerful tool that ministries of health, national health professional associations, and other health systems and health workforce champions can now use to advocate to their ministries of finance to invest more in health workers as the most direct way to meet their countries’ health goals.

Yet the fact that none of the ministries of finance that participated in the Addis health financing meetings earlier in the week participated in the later health workforce meeting highlights the challenge we face in simply getting the attention of ministries of finance, much less persuading them to act.


“We need to ensure that the offices that manage health workers have the resources they need to function properly.”


We must take our messages directly to the ministries of finance. As Ethiopian Minister of Health Dr. Kesete-Birhan Admasu reminded us at the event, many different sectors and other ministries are competing for their attention, so we must deliver messages that stand out and speak to ministries of finance in the terms they understand: dollars saved, gross domestic product (GDP) growth, efficiencies created, productivity increased.

And we must reach out to all ministries of finance, not just those in low- and middle-income countries.  All countries have imbalances of health workers, and poor and rural communities have less access to health workers and less access to careers in the health sector. Global aging and the rise of noncommunicable diseases will aggravate these challenges even more.

Here are a few key messages for ministries of finance on why they should invest in health workers. Please spread the word:

  1. On average, health worker wages represent 45% of ministry of health budgets. This resource must be maximized through increased productivity. We need to ensure that the offices that manage health workers have the resources they need to function properly.
  2. Health worker wage bills can be driven down over time by deploying more community health workers and midlevel providers (such as midwives, clinical officers, and advanced practice nurses). Not only does the evidence show that they deliver equivalent quality work, but they are faster and more cost-effective to train and more likely to be retained in-country and in underserved communities.
  3. Evidence from the World Bank shows that countries that invest more in health workers have greater overall GDP growth, even when correcting for all other factors. Healthier workforces are more productive. Increasing budgets for health workers should be viewed as an investment in national productivity, not an expense.
  4. It’s no coincidence that the Ebola epidemic occurred and spread out of control in Liberia, Sierra Leone, and Guinea. These countries have some of the lowest health worker densities and weakest health systems in the world. The Ebola epidemic shattered their economies and set them back decades. Health workers and health systems pay for themselves.
  5. Evidence from BRAC and the World Bank shows that the cost of training midwives is more than paid for in the lives they save and improved health they bring about. Midwives are a best buy in health care and can deliver services for family planning, HIV/AIDS, maternal health, and newborn care.
  6. In many low- and middle-income countries, up to 30% of government workforces are ghost workers. This includes the health sector. Eliminating ghost workers can free up funding to train and hire real health workers. An increasing roll call of countries—including the Dominican Republic, India, Bangladesh, and the Democratic Republic of Congo—is holding their health workers accountable for their presence at their assigned posts. This is one concrete way to demonstrate a commitment to good governance.

Let’s make sure ministries of finance hear these messages. Investing in their countries’ frontline health workforces is a sound investment in health, well-being, and financial stability—the data support it.

Misrak Makonnen, IntraHealth’s country director in Ethiopia, participated in and helped plan the Investing in Human Resources for Health for Sustainable Development in Africa High Level Ministerial Meeting. 

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Data as a critical component of the new financing paradigm for sustainable development

By Dr. Christine Sow, President and Executive Director, Global Health Council

Data, measurement and accountability have been front and center at the recent UN Financing for Development Conference (FfD). On Wednesday, July 15 I participated in a morning event – extremely well attended despite the early hour – “Harnessing the Data Revolution for Sustainable Development” hosted by The ONE Campaign, the governments of the U.S. and Mexico, the UN Economic Commission for Africa (ECA) and the Sustainable Development Solutions Network. One of the most radical panels at FfD, it highlighted voices from government, private sector and civil society calling for the availability, quality and use of data for planning, tracking and holding to account power holders around the Sustainable Development Goals (SDGs).

While the FfD conference ostensibly focused on the financing mechanisms and principles that will underpin the SDGs, the importance of the availability and use of high quality data was noted again and again as critical to the success of the various approaches and mechanisms being discussed at the conference. Not least was the idea that quality data is necessary to “follow the money” – both in terms of donors accounting for their funds but arguably more importantly for countries to track how funds are used internally for the purposes of rational planning and accountability. If the buzzword of the post-2015 agenda is “domestic resource mobilization,” countries will need to know how much money they need to mobilize and where to use it.

Momentum for open and useable data is growing. This is particularly critical because of the power it will give to those committed to accountability – Knowledge is power is an old adage, and the data revolution for sustainable development can provide badly needed power to those who need it most. Carlos Lopes, Executive Secretary of the ECA, stated: “We are tired of reporting – we need data for planning our own future.” He cited the importance of the Africa Data Consensus to ensure the existence of communities of data users who are also data producers: “They will benefit from increased transparency and usability of data and they will repatriate the data to Africa. Good will is essential but Africans have to do it themselves.” He further noted the need for transparency around the quality of data, and the importance of holding organizations accountable about the numbers they publish; along these lines he announced that the ECA will start openly grading the data sources used for global reporting – using green, yellow and red – against international norms and standards. All these ideas are radical – they speak to the need to put control in the hands of the people and governments themselves rather than trusting others to produce data and tell us what they show.

Another significant contribution from government during this session (and throughout the conference) was the impassioned discourse of the Secretary General of the Organization for Economic Cooperation and Development (OECD), Angel Gurria. He spoke convincingly about the need for evidence-based policy rather than policy-based evidence and the promise that the data revolution holds to push policymakers in this direction. And he poetically spoke of the three Ps: population, planet and poverty, gracefully encapsulating the priorities and concerns that are fueling the debates of the FfD conference and the upcoming Sustainable Development Goals Summit that will take place in September 2015. In an earlier session he had also spoken to the need to capture funding flows, specifically noting the need to quantify contributions from private sector, civil society and philanthropic sector when we think about global funding for development. The Total Official Support for Sustainable Development (TOSSD) framework has been launched to do precisely this – contributing an important new tool, and albeit a clunky new acronym, to the sustainable development space. Gurria also reminded us that investment in ODA is largely a reflection of political will (a theme that came up again in at least one other session, “Who Pays for Progress?” held by Action for Global Health and its partners), noting that the UK has increased the proportion of its budget going to ODA despite the economic pain and restructuring it has undergone over the better part of the last decade.

It is exciting and invigorating to see data gaining ground as a key component of the upcoming development paradigm; easy access to high quality data will be the essential step to expanding the power of communities and governments to account and hold accountable for the commitments we will so publicly make as we move into the era of the SDGs.

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