Transcript GLADYS SOMEREN DIVISION OF REPRODUCTIVE HEALTH

COUNTRY ACCOUNTABILITY FRAMEWORK
CONSULTATIVE MEETING ON ENDING PREVENTABLE MATERNAL
DEATHS IN KENYA
BOMA HOTEL NAIROBI
27TH -28TH AUGUST 2014
HEAD DIVISION OF FAMILY HEALTH
BACKGROUND
September 2010, the Secretary-General of the United Nations
launched the Global Strategy for Women's and Children's
Health.
GOAL
•
Protect 120 million children from contracting pneumonia
•
Prevent 88 million children from stunting
•
Prevent 33 million unwanted pregnancies
•
Prevent 15 million deaths of children under the age of 5
•
Prevent 570,000 deaths of pregnancy related complications
From recommendations
The strategic work plan
to actions
Accountability Framework
COMMISSION
RECOMMENDATIONS
Monitoring of results
Birth and death registration
1. Vital events (CRVS)
2. Health indicators & equity
3. Innovation
4. Resource tracking
5. Country Compacts
6. Reaching Women/Children
Maternal death surveillance & response
Country
Actions
eHealth & innovation
Monitoring country resources
Concluding compacts
7. National oversight
Advocacy and action
8. Transparency
9. Reporting aid for Women/
Children’s health
10. Global Oversight
Monitoring results
Global
Actions
Tracking resources
Global review (iERG)
THE 7 KEY COUNTRY THEMATIC
AREAS
1. Monitoring of births, and deaths through civil registration and vital
statistics.
2. Monitoring of results (strong M&E, data quality verification &
transparency.
3. Maternal death review( MPDSR)and quality of care evaluation in health
facilities
4. Use of E-Health and Innovation (ICT) in health information systems
5. Tracking of financial resources – National health expenditure tracking,
RMNCH sub-accounts
6. Annual review – e.g. annual health sector review including all relevant
stakeholders
7. Advocacy and action – political commitment, community participation,
National Countdown conferences, parliamentarians,…
CAF MILESTONES AND PROGRESS
•FEB 2012-Tanzania regional workshop
•Feb 2013-National stakeholders workshop
•April 2013- catalytic funds disbursed
•Sept –Oct 2013 County workshops held
•2014- Midterm assessment conducted
How Kenya Prioritized Catalytic Fund
USD 250,000
CAF PROGRESS/ ACHIVEMENTS
Civil registration, vital
 Strategic Plan for the civil
statistics (CRVS) assessment
registration department
completed, plan developed
was developed.
 The MOH in partnership
with the Civil Registration.
CAF PROGRESS CTN
Maternal death surveillance
and response (MDSR) system
in place
Monitoring and Evaluation
 Kenya developed tools for
MPDSR.
 Training of 11 selected preservice training institutions
scheduled.
 Countrywide audit of
MPDSR implementation
done – analysis on-going.
 Consensus on the 11 core
indicators and the data
sources.
 Kenya is developing a
roadmap for strengthening
M&E.
CAF PROGRESS
National eHealth strategy
 Both the national e-Health
policy and strategy were
developed.
 Four quarterly National eHealth/m-Health Forums
convened by MOH.
Country reporting on health
 The country was able to
expenditure by financing source
disseminate the findings of
NHA 2010 and 25 officers
were oriented on the Social
Health Accountability 2011.
CAF PROGRESS CTN
Rights based law and policy
assessment completed for
RMNCH
National health sector review
 Enforcement of Constitution
of Kenya 2010 provisions for
reproductive health.
 Taskforce formed to provide
technical input for
development of RMNCH
legislation.
 Legal drafting on-going prior
to forwarding for Cabinet
review and Parliamentary
debate.
 Last Health Summit held in
2012.
 2013 Annual health review
conducted but not validated.
Political leaders engaged in
RMNCH
• Head of State’s directive
on Free Maternity
Services in all public
health facilities effective 1
June 2013.
• Kenya First Lady’s ‘Beyond
Zero Campaign’ for MNCH
and EMTCT. Campaign has
been replicated by
spouses of County
Governors in all 47
counties.
MPDSR Audit Preliminary Report
• Coverage 15 high maternal mortality burden
counties
• 75 facilities – county referral, Sub county,
Health Center and Dispensaries
• Data for Jan – Dec 2013
• Maternal Deaths 243 by facilities while Civil
Registration captured 258
• Perinatal deaths 3,790 at facilities
• All deaths reported at facilities 23,354; while
the Civil Registration Dept reported 23,725
• Reporting of cause of death not complete
“They will say that the mother just died, or
say she died of something else. A woman who
dies with a baby in her womb becomes such a
big issue. So that information is just concealed.
Or they refuse to say it” FGD Respondent.
• Any death that occurred outside the facility
e.g. on transit to facility are not reported
Challenges – why maternal deaths
– Lack of supplies and equipment to facilitate health
workers’
– Gaps in referral system eg lack of ambulances for
emergencies
– Poor access to facilities, therefore mothers resort
to deliveries at home
– Misconceptions around facility deliveries
– Irregular facility level maternal death reviews
CAF RECOMMENDATIONS
• Support for development of advocacy tools for
RMNCH.
• Support for strengthening of capacity to
conduct annual Data Quality Assessment.
• Strengthened capacity for conducting
community reporting and verbal autopsies of
maternal and perinatal deaths.
RECOMMENDATIONS CTN
• Support for scaling up of e-health/m-health
capacity building activities to additional sites.
• Resource mobilisation from stakeholders to
support the catalytic fund
Who is accountable??
• Everyone is accountable to improving
maternal and child health
• “The accountability framework brings
together different departments that normally
don’t collaborate. “It made people talk to
each other. It has been a shift of paradigm.
When you sit more with people, you learn to
know their business.”
Indeed No woman should die
while giving life !!!