Partnering for Policy Reform

Every day in West Africa, approximately 225 women and 1,200 newborns die from complications in childbirth, and another 4,500 to 6,500 women survive with life-altering disabilities, such as infertility and incontinence. Maternal mortality and morbidity rates remain alarmingly high, despite the fact that all countries in the West African subregion are signatories to international declarations on reproductive and maternal health.

Strengthening Partnerships for Better Health

Harmonizing health policies and mobilizing resources for health is a key goal of the West Africa Health Organization (WAHO), a subregional body supported by 15 member states. But to ensure appropriate regional action, data on each country’s respective efforts to improve maternal health were needed. According to Professor Angela Okolo, WAHO’s Program Officer for Maternal and Perinatal Health, “we knew that the maternal and newborn health statistics in the subregion were very poor, yet we did not know what individual countries were doing at the policy level to reduce the number of maternal and newborn deaths.”

To implement a comprehensive maternal and perinatal health strategy for the subregion, WAHO drew up a detailed questionnaire to conduct a situational analysis of current economic and social policies for maternal and neonatal health on the country level. At the same time, Action for West Africa Region-Reproductive Health (AWARE-RH), a project funded by the U.S. Agency for International Development (USAID), developed a similar tool to determine whether the policies implemented reflected the countries’ commitments to international declarations on maternal and neonatal health.

To maximize the utility of their results, WAHO and AWARE-RH combined their efforts by creating one cohesive questionnaire that could assist WAHO in identifying policy gaps. “This is a notable example of fruitful collaboration among partners,” said Professor Okolo. “We were both seeking similar information; however, our approaches were different. Once we put our heads together and combined questionnaires, we were able to obtain better, more complete results.”

Identifying Advocacy Goals

WAHO and AWARE-RH administered their combined questionnaire in nine countries and recorded the data using a jointly developed tool that tracked each country’s maternal and neonatal health policies. This tool then enabled WAHO to identify policy gaps, focus its advocacy efforts, and move the policy agenda in maternal and neonatal health forward.

Based on the preliminary outcomes of the tracking tool, WAHO drafted the following three resolutions to submit to the next Assembly of Economic Community of West African States (ECOWAS) Health Ministers in October 2007:

All ECOWAS countries should create a budget line for reproductive health within the national health budget. This budget line should represent at least 5% of the health budget by 2010. Twenty-five percent of the reproductive health budget should be allocated for emergency obstetric and essential newborn care, and 5% for reproductive health commodity security.
All ECOWAS countries should ensure the inclusion of emergency obstetric and newborn care into pre- and in-service training curricula by 2010.
All ECOWAS health ministers should advocate for the minimum age at marriage for girls to be raised to 18 years by 2015.

Strengthening Advocacy Skills

To develop an advocacy plan for adopting these draft resolutions by the ECOWAS Health Ministers, WAHO, with technical support from AWARE-RH, organized a subregional advocacy training. During this training, members of WAHO’s Steering Committee for the Reduction of Maternal and Perinatal Mortality used REDUCE, AWARE-RH’s computer-based advocacy tool, to estimate the negative impact of maternal deaths on the subregion’s economy.

REDUCE determined that without additional investments in maternal and child health programs, the region would experience a $5 billion loss in productivity. If additional policies were adopted and further investments in maternal and child health interventions were made, however, productivity could be augmented by $2.5 billion. By presenting the economic benefits of increased commitment to maternal and child health, WAHO hopes to convince the ECOWAS health ministers to adopt the three resolutions and implement them rapidly at the country level.

Next Steps

Through continued collaboration with AWARE-RH, WAHO is better equipped to assist countries in adopting reproductive and maternal health policies that will improve the well-being of their citizens and increase economic productivity.

For more information, please contact Carmen Coles, Advocacy Advisor at AWARE-RH, at ccoles@aware-rh.org.

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