Ensuring progress through accountability: monitoring, review, and remedial action

 “Accountability is a constructive and balanced process that looks at commitments – and what actually happened – and, where appropriate, provides practical recommendations on what might be done better,” as laid out in a presentation at the Partners’ Forum on Women’s and Children’s Health in New Delhi (PDF).  There are three main steps in the accountability process:

  • a monitoring mechanism that brings together existing data on women’s and children’s health
  • a review process which assesses whether pledges and commitments have been kept
  • remedial action that is recommended for the stakeholder under review and others who can help such action.  

The Global Strategy for Women’s and Children’s Health generated commitments from more than 90 public and private institutions towards achieving the MDGs 4 and 5. These included financial commitments of $40 billion as well as policy and service delivery commitments. Monitoring progress and making actions accountable for results came into sharp focus in the Global Strategy as one of the areas for urgent action. In the Global Strategy, the UN Secretary-General’s requested The World Health Organization to chair “a process to determine the most effective international institutional arrangements for global reporting, oversight and accountability on women’s and children’s health”. And, the UN Commission on Information and Accountability for Women’s and Children’s Health was established, in response.  This Commission is currently working on ‘proposing a framework for global reporting, oversight and accountability on women's and children’s health’ and is inviting comments on its papers on accountability for resources and results.  

In line with the mandate of the Delhi Declaration 2010 - From Pledges to Action and Accountability (PDF) PMNCH, is committed to supporting the Global Strategy, as “an active participant to track commitments and results and thus ensure mutual accountability”.

Monitoring and tracking of maternal, newborn and child health currently takes place through different channels. Governments regularly collect data but in many places the current systems are weak. Some international mechanisms and organizations such as the UN reports on the progress on Millennium Development Goals, Demographic Health Surveys, analyses from the Institute of Health Metrics and Evaluation, etc. The Countdown to 2015 initiative is a global collaboration which monitors funding, coverage, equity and outcomes in maternal, newborn and child health.  

Holding stakeholders accountable involves more than monitoring, tracking and reviewing. Remedial action is the important component which can ensure progress. This calls for political will and for the active involvement of global, national and local communities in realising women’s and children’s right to life and health. The UN Human Rights Council recognizes preventable maternal mortality and morbidity as a human rights challenge. Examples of this right being upheld are emerging. In two cases, The Delhi High Court in June 2010, ordered the government to compensate for violating the maternal health rights of two women, and to take the required remedial action to strengthen health services.