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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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Ahead of the Curve for Financing for Development: Innovations in Health Financing

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

Addis Ababa was the setting last week of the third UN Financing for Development Conference (FfD). A diverse mix of constituencies were represented here – all focused on financing the Sustainable Development Goals, all representing constituency perspectives they believe key in eliminating extreme poverty. The Addis accord will define financing for the decades to come and these discussions have been dominated in plenary sessions by the banking and finance sectors. Global health, as a concern, has not been highlighted in the accord discussions much to the consternation of our community. However global health was strongly represented in the various side sessions going on throughout the conference, representing at least a fifth of the side sessions on Day 1. For an area of concern that didn’t “make” the plenary, this is a strong indication of how important the global health community knows the financing issue to be, and reflects the investment being made to determine the means of implementation and funding for the health agenda through 2030.

Along these lines we’ve seen several significant innovative financing initiatives launched at FfD. The Global Financing Facility (GFF) for Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) was launched on Monday, July 13, in a high-level event hosted by the UN Secretary General and attended by several heads of state, representatives of many partner UN agencies, and a number of civil society and business representatives. This representation reflects the multi-sectoral nature of the GFF which is meant to combine the efforts and possibilities of bilateral and multilateral government contributions, the potential of domestic resource mobilization and the power of private markets to leverage new funding for RMNCAH, a traditionally underfunded priority area.

While the modalities of implementation of the GFF are still being worked out, it is rolling out in four front runner countries – Ethiopia, Kenya, Tanzania and the DRC – and the President of Kenya and the Deputy Prime Minister of Ethiopia attested at the launch to the promise it holds. At the same time, a recurring theme around the GFF is how it will work in practice, and how full engagement by civil society and private sector partners at country level will be ensured. An “open conversation” between GFF leaders and civil society representatives was held prior to the launch; this discussion underscored the need for more communication and outreach on the part of the GFF to all constituencies engaged in the RMNCAH space, especially at the country-level in the Global South.

Another example of innovative financing for health unveiled at FfD is the Health Credit Exchange (HCX), unveiled on Monday by GBCHealth and its partners the MDG Health Alliance and Total Impact Advisors. This mechanism represents another attempt to recognize the comparative advantages of different actors in the global health ecosystem and combine their efforts to greater effect. It is designed to provide a marketplace for private sector concerns to invest in already proven projects needing to go to scale or add additional program components. In its role as matchmaker it is hoped that outcomes and impact of important initiatives in global health will be exponentially expanded. The HCX works on the principle of performance-based financing, with private sector funding being paid out following the delivery of agreed-upon milestones. While this model has been successful in providing donor funding to governments, it will challenge non-profit implementing partners to come up with the capital necessary to undertake work prior to payment. Like any marriage there will likely be a need for partners to get to know each other and adjust their styles accordingly. We are hoping that this initiative will be a success, but in any case, attempts like this to launch innovative financing mechanisms are critical to achieving the ambitious goals we have set for ourselves and the global community.

The jury is still out on the success of FfD, and all indications are that the agreement will not meet the ambitious aspirations held by many. The absence of global health as a key component of the negotiations reflects short-sightedness on the part of the global finance community, parts of the UN and many (although not all) bilateral governments. However the presence at the conference of many of global health’s most influential leaders including Mark Dybul, Tim Evans, Ariel Pablos-Mendez, Margaret Chan, Michel Sidibe and Seth Berkley refutes the idea that the global health community is not thinking about financing; to the contrary, the concrete examples of innovative financing introduced at the conference demonstrate the community’s forward-leaning stance to unlocking this complex challenge.

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Migrant Workers’ Right to Health: A Global Advocacy Agenda

This blog was cross-posted from the Institute for Human Rights and Business 

Migrant workers face many inequities. Yet health is a fundamental right – and systemic violations do real harm to workers, communities and companies themselves.

Migrant workers face many inequities. Yet health is a fundamental right – and systemic violations do real harm to workers, communities and companies themselves.

Recent headlines describing the plight of thousands of migrants drowning at sea as they tried to make their way from Africa to Europe, are but the most recent reminders of the treacherous journey many encounter in their search for work. Yet, these and other dangers are only part of the story.

The health of migrant workers who eventually manage to find employment abroad is under-prioritized and under-protected in many countries around the world. It is natural to focus on acute violations like drownings, fires, and building collapses. But the health rights of workers extend well beyond assuring their safety. The daily, systemic violations – which are not acute and not even recognized as rights violations – need equal attention.

Access to the highest available standard of health, which includes reproductive health (RH) and family planning (FP), has long been recognized as a basic human right and vital to the quality of life of individuals and communities. The international community has developed well-defined body of rights established by United Nations and International Labour Organization treaties and conventions.

Efforts to clarify the roles and responsibilities of corporations with respect to human rights are newer but no less significant developments. Recent standards developed within the UN system including the Guiding Principles on Business and Human Rights and the Women’s Empowerment Principles, as well as private efforts based on existing human rights and labor standards such as the Dhaka Principles for Migration with Dignity, seek to ensure that all businesses recognize their responsibilities to respect human rights, including those of the most vulnerable. With a large number of the estimated 105 million workers leaving their homes to find work in other countries, including in supply chains of international scale,[1]companies have a responsibility to respect these human rights norms and to demonstrate that respect through ongoing due diligence processes. Too often, however, companies fail to recognize the possible human rights violations of workers who cannot access needed health services due to their employment arrangements. Private industry needs to step up, and the human rights community needs to put worker health on its agenda.

A range of health related issues highlight the challenges involved:

Hazardous Labour and Living Conditions

For migrant workers, their livelihood and economic potential is tied to their health status. However, they are seen often as temporary inputs instead of investments. This fuels a business mentality of meeting very minimal health standards. The labour these workers provide is typically “dangerous, difficult, and demanding,”[2] which puts them at an “elevated risk for an enormous range of injuries and illnesses due to the nature of their jobs.”[3] This situation is exacerbated by the living conditions faced by many migrant workers. Male and female migrants also encounter health risks and violence due to the customary co-location of commercial sex venues with temporary and migrant labour camps.

Barriers to accessing care

In many cases, migrant workers lack access to health services simply because health needs are not even considered a part of their employment arrangement. According to the International Organization for Migration (IOM), “this omission is due to the perception that health is something that should be discussed only by health specialists, even though many of the causes and solutions to improve migrants’ health are found in other sectors, such as labour, social protection, immigration and law enforcement, among others.”[4] Language barriers further inhibit access, long working hours, distance to health facilities, and lack of credentials to access public services. Imagine the actual and perceived barriers to health care for an Indian working in Dubai, a Nepali working in South Korea, or a Bangladeshi in Jordan. Low utilization of health services among migrant workers does not reflect low need.

Gender-specific vulnerabilities

Today, nearly 50 percent of international migrants are women, whose primary motivation for migrating is not surprisingly employment.[5] Occupational health standards typically address reproductive health from the perspective of protection: against pregnancy tests, against chemicals that may damage fertility; and against harassment and violence. Protection is no doubt essential, but women workers are also harmed when their RH needs are not acknowledged. For example, the lack of access to sanitary napkins at the workplace can lead to gynecological infections, not to mention lower productivity. Migrant workers, like many displaced populations, are more likely than the general population to encounter sexual contact – both wanted and unwanted – when placed in new surroundings.[6] FP and RH services are critical components of women’s empowerment and their ability to fully participate in the economy – to get a job, stay in a job, and be promoted.

Recommendations

Migrant workers face many inequities. Yet health is a fundamental right – and systemic violations do real harm to workers, communities and companies themselves. It is in the self-interest of business to address worker health rights, as companies that do so have improved productivity and worker-management relations. Just as different governments have varying levels of resources, companies depending on their size and type have different capabilities. However, respecting the right to health is not about workplaces becoming primary care facilities but instead about applying better management and workplace health practices.

For the human rights community, worker health and reproductive rights are inseparable from women’s empowerment, gender equality and labor rights. We would assert that companies that demonstrate care for worker health, not just safety, are more likely to perform better across a range of human rights concerns. The following recommendations for policy makers, business leaders and civil society are intended to advance efforts to protect the right to health of this vulnerable population within the global workforce:

  1. Human rights advocates should integrate health, including sexual and reproductive health rights, firmly into their efforts to improve employment standards related to migrant workers.  The human rights community and labor rights organizations in particular can help bring about structural policy changes by advocating for the inclusion of health related provisions in the global policies, incentive structures, and public and private regulatory mechanisms that companies are expected to address. For example, health should be included in migrant worker contracts.  Additionally, medical examinations should be part of pre-departure procedures along with health promotion activities.
  2. Policy makers should support legislative and other actions that ensure workplace policies and practices concerning quality health services apply to migrant workers. Regardless of the employment arrangement or contract length, migrant workers’ basic health needs should be addressed. There are many approaches for doing this – improving workplace-based services (which could include hiring a health professional of the same nationality), contracting with NGO service providers, referring to quality public or private health services, and establishing good workplace health policies ensuring worker health rights. Marie Stopes International, for instance, has successfully provided on site services, trained workplace providers, and developed strong referral networks. Business for Social Responsibility’s HERproject uses peer educators at workplaces to increase health knowledge and behavior change. Those who already provide services to migrants may consider partnering with community health entities to bundle a comprehensive package of services that includes health. Many models exist; the will is lacking.
  3. Business leaders should step up efforts to make reproductive health and family planning a part of the corporate gender and women’s empowerment agenda. Business leaders have many opportunities to highlight the links between their corporate responsibility to respect human rights and their policies and practices on women’s health issues in the workplace. For example, the annual UN Forum on Business and Human Rights, to name one, provides an important platform to highlight the role of business in respecting health and reproductive health rights and to discuss good practice in this area.

In the end, wherever human rights and women’s empowerment come together, health and reproductive rights needs, in particular for migrant workers who are often most vulnerable to rights abuses, should be on the agenda and a part of the discussion. Doing so is critical in demonstrating that progress can be made. This is equally important in the context of reproductive health, which is often mistakenly viewed as too sensitive a topic for some countries and for business when in fact it has been successfully addressed at workplaces in some of the most culturally conservative places in the world.

Business can help advance health rights for migrants and all workers through their operations – and there’s a strong business case for doing so. Silence on this issue means invisibility and inaction.

 


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