Category

global

FROM July 11th, 2019

Thank you to the Dutch Government, Bernard van Leer Foundation, the International Confederation of Midwives, and the Dutch Taskforce for Healthcare for hosting us and facilitating this 23rd Board Meeting.

I know that as we sit here in the Hague, all of our discussions are focused upon our shared value and commitment to ensuring that women’s, children’s and adolescents’ health (WCAH) is at the top of national, regional and global agendas. I think it is right, therefore, that the Board Meeting seeks to evaluate and enhance its political engagement at all levels.

At the World Health Assembly this year, alongside Helga Fogstad, PMNCH Executive Director, Dr Tedros Adanhom Ghebreyesus, WHO Director General, and Her Excellency Mrs Emine Erdogan, First Lady of The Republic of Turkey. I commended PMNCH’s Call to Action on Aligning Women’s, Children’s and Adolescents’ Health and Wellbeing in Humanitarian and Fragile Settings.

Given that more than two billion people live under the threat of conflict and emergencies of diverse and complex natures, and that 69 million people have been displaced by humanitarian crises, we need bold steps to enhance coordination and bring together synchronized knowledge, policies and actions for a whole-system approach to achieving health for all, routinely across nations, in order to build the resilience for effective responses in protracted emergencies and in the humanitarian-development nexus. That is why I so strongly support PMNCH’s initiative and call to action, which is best placed to bring us all together – from every sector, region, country and background – to remove the inefficiencies, identify and address gaps of capacity and delivery in every sense.

PMNCH is uniquely positioned to mobilise broader political strategies, and partnerships of all kinds, as it can act as the standard-bearer and interlocutor between the WHO, global institutions, CSOs, governments, the private sector and frontline healthcare workers. This support is invaluable to Governments and healthcare providers, who we can consider to be the duty-bearers. 

At the Wellbeing Foundation Africa, of which I am the Founder-President, we have learned the value which emanates from engagement with PMNCH in Nigeria, as members who supported the ‘Saving One Million Lives’ campaign, the promotion of routine administration of the reinforced ORS-Zinc formula for management of diarrhoea, and the Midwives Service Scheme, a public sector collaborative initiative, designed to mobilize midwives, including newly qualified, unemployed and retired midwives, for deployment to selected primary health care facilities in rural communities.

I must report from Nigeria that whilst there has been an improved focus on surveillance – and a growing acceptance of the fact that suitable civil registration and vital statistics systems will be essential if we are to achieve universal health coverage – I hope that these milestones in accountability also able to catalyse improved services at the frontline. That can only be achieved with expanded investment in primary health.

I strongly support the PMNCH position that we must put women, children and adolescents at the heart of universal health coverage. The relationship between achieving health for all and WCAH must be at the core of our advocacy as the former is simply unachievable without significant improvements to the latter. 

It is of course no coincidence that women, children and adolescents – despite accounting for 60% of the global population – tend to constitute the groups with the least political influence and power, which is why United Nations, WHO and national policies must explicitly highlight and focus on WCAH as part of their UHC strategies. 

Only then can we claim to be truly working towards the principle of “leaving no one behind,” which is central to the Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030).

On a final note, as the Global Goodwill Ambassador for the International Confederation of Midwives, one of our co-hosts this week, I must highlight the launch at the World Health Assembly this year, of the report ‘Strengthening quality midwifery education for Universal Health Coverage 2030: A transformative approach to improving quality of care’ produced by ICM, alongside WHO, UNFPA and UNICEF. Women and newborns are the most vulnerable in humanitarian and fragile settings where quality midwifery education saves lives by preparing all midwives to legislate for and respond to emergency health situations. As a critical element in achieving UHC and WCAH, I am sure that we all know that midwives can and do lead the way.

 

As Nigeria’s first and oldest country member of this esteemed and dedicated alliance, I am honoured by the Wellbeing Foundation Africa’s PMNCH Board Observer Privileges, and delighted to extend a warm welcome to Helen Clark, former Prime Minister of New Zealand, as Chair of PMNCH – who I know will ensure that women’s, children’s and adolescents’ health and wellbeing are reinforced as a global priority. Thank you.

 

FROM May 21st, 2019

World Intellectual Property Organization (WIPO), AB Building, Salle A, 34, Chemin des Colombettes, CH-1211 Geneva 20, Switzerland

Tuesday, 21 May 2019, 13:00-14:30

 

Thank you to PMNCH for your timely and powerful call to action. As a Nigerian who has long worked with frontline healthcare workers to empower women, their infants and their communities to stay healthy, safe and to thrive, I know that if we are to achieve universal health coverage, and truly leave no-one behind, we must better align our investments and efforts taking a life-course approach to safeguard women, children and adolescents in humanitarian and fragile settings and uphold their human right to the highest attainable standard of health.

Given that more than two billion people live under the threat of conflict and emergencies of diverse and complex natures, and that 69 million people have been displaced by humanitarian crises, we need bold steps to enhance coordination and bring together synchronized knowledge, policies and actions for a whole-system approach to achieving health for all, especially in protracted emergencies and in the humanitarian-development nexus. That is why I so strongly support this initiative and call to action from PMNCH, which is best placed to bring us all together – from every sector, region, country and background – to remove the inefficiencies, identify and address gaps of capacity and delivery in every sense. 

As the Global Goodwill Ambassador for the International Confederation of Midwives I welcome the launch yesterday of the report ‘Strengthening quality midwifery education for Universal Health Coverage 2030: A transformative approach to improving quality of care.’  produced by ICM, alongside WHO, UNFPA and UNICEF. Women and newborns are the most vulnerable in humanitarian and fragile settings where quality midwifery education saves lives by preparing all midwives to prepare for and respond to emergency health situations. 

It lends significant weight to PMNCH’s initiative, as we seek to provide comprehensive training and support necessary for midwives to provide the full scope of services in situations which are often dangerous and highly prone to change. 

In a year when we have lost midwives, nurses and doctors on the frontline of healthcare, we all know how critical this initiative is. 

PMNCH is best placed to mobilise partnerships of all kinds, and can act as the standard-bearer and interlocutor between the WHO, global institutions, CSOs, governments, the private sector and frontline healthcare workers. This support is invaluable to Governments and healthcare providers as the duty-bearers. At the Wellbeing Foundation Africa we have learned the value which emanates from engagement with PMNCH in Nigeria, as members who supported the ‘Saving One Million Lives’ campaign, the promotion of and ORS formula and zinc for management of diarrhoea, and the Midwives Service Scheme, a public sector collaborative initiative, designed to mobilize midwives, including newly qualified, unemployed and retired midwives, for deployment to selected primary health care facilities in rural communities.  

We know that the road to universal health coverage does not rest upon one single static action, but on the spectrum of interventions and initiatives; from water, sanitation and hygiene standards in healthcare facilities to breastfeeding education and training for healthcare workers. In a country as large as Nigeria, resilience throughout the whole nation’s system is necessary if we are going to be able to tackle critical health emergencies in fragile settings, for example in the north-east. That is why a strengthened primary health care system is imperative as the foundation and bedrock of achieving health for all and should be a focal point for investment. 

I call on all partners and stakeholders to rally behind PMNCH, to support this initiative and most importantly commit to action which will make health for all a reality. Together we can make sure that no-one is left behind. Thank you. 

 

FROM February 28th, 2019

Fellow speakers: 

  • Carl Manlan, Chief Operating Officer of The Ecobank Foundation  
  • Dr. Tsitsi Masiyiwa (wife of Strive Masiyiwa, London-based Zimbabwean businessman, founder of Econet Wireless). 

 

Speaking Notes: 

  • Good afternoon. I am delighted to join Carl Manlan, Dr. Tsitsi Masiyiwa and all of you here today for this ‘fireside chat’ as we discuss the progress made by African-led philanthropy on key policy areas. 

 

  • I will share my personal experiences as a philanthropist and the work of the Wellbeing Foundation Africa, of which I am the Founder-President, which has achieved sustainable impact at a grassroots level with cross-sector partnerships embedded in communities. 

 

  • There are inherent strengths which make African-led philanthropy particularly effective. I identify these primarily as the fact that our work is community-led and therefore both more effective and sustainable; and the flexibility which comes from embedded networks leading to the ability to influence policy decisions at a national, regional and global level with data-driven advocacy. 

 

  • I will first turn to the distinct advantage provided by African-led foundations, which is our ability to work with our own communities – not by foisting an external model on them, but by working with them to identify key issues, build up their own champions, and allocate resources, where needed, efficiently and with the buy-in of those who will act as service providers and as service users. 

 

 

  • At the Wellbeing Foundation Africa, we believe that midwives are best placed to lead the way with quality care and to leverage the trust of a community to improve health outcomes for women and their infants. 

 

 

  • Our midwives, known as MamaCare midwives, deliver classes in primary healthcare centres, hospitals, and at camps for internally displaced persons, known as IDP camps, which are a frontline for women and their infants. Despite dire mortality rates in Nigeria – where women face around a one in thirteen risk of maternal mortality in their lifetime – we have not lost even one of our over 250,000 MamaCare mothers during childbirth

 

 

  • Our MamaCare midwives have achieved this not only by providing classes to a global standard – and achieving the WHO benchmark recommendation of at least 8 antenatal visits – but also because they act as even more than lifesavers. They provide safe spaces and safe conversations: no subject is taboo or off-limits. They can only do this because they are part of the community that they serve. Too often, global institutions have faced push-back when trying to deliver services – examples that stand out to me include vaccinations and family planning provisions – because they attempt to do so as outsiders, without the trust of a community. 

 

 

 

  • Placing midwives at the centre of our work gave us an army of community counsellors which has helped to drive the behavioural change to make women an empowered and informed partner. Midwives are the interlocutors between our Foundation, its aims, and women. 

 

 

  • That includes family planning, a subject which is not only addressed during their classes but also at the 6-week postnatal home visit. That one-one-one chat covers the continuation of exclusive breastfeeding but also contraception advice and a discussion about spacing. Informally, direct and rather frank conversations are carried out with husbands and partners. In fact, men have started to attend antenatal classes – sat quietly at the back, I should add – in order to learn how best they can support their partner. 

 

  • We have subsequently built on the experience of working with midwives to work as partners in the Alive & Thrive programme, with expertise and assistance from FHI360 and funding from the Bill and Melinda Gates Foundation.

 

 

  • Alive & Thrive is an initiative to save lives, prevent illness, and ensure healthy growth and development through the promotion and support of optimal maternal nutrition, breastfeeding and complementary feeding practices in rural and urban Lagos and Kaduna States in Nigeria. In Lagos, malnutrition accounts for more than 50% of under-five mortality with a rate of timely breastfeeding initiation at only 28.9%. A mere 19.7% of children 6 months and under in the state are exclusively breastfed and only 10% of children aged 6 – 23 months are fed appropriately. The reality of those statistics is distressing: 47% of children in Lagos under-5 years are stunted, while 34% are under-weight.

 

 

  • Alive & Thrive works through a four-pronged approach:  policy and advocacy; interpersonal communication and community mobilization; mass communication; and the strategic use of data. The Wellbeing Foundation Africa is the key implementing partner currently working with 500 private health facilities across 10 local government areas in Lagos by providing advocacy, capacity building and health promotion in the area of Infant and Young Child Feeding practices, whilst our partners at Save the Children engage with a number of public health facilities. 

 

 

  • We are able to be a successful implementing partner precisely because of our proven track record of community-led programmes. 

 

 

 

    • The second key strategic advantage of African-led philanthropy is the ability to be flexible and draw upon existing networks to respond to crises and to inform programmatic work. 
    • Of course, we want to bring the latest innovations in technology, treatment and training to the frontline but sometimes feedback from the grassroots means that we must re-trace our steps. That has been the case with the Wellbeing Foundation, as our midwives were informing us that water, sanitation and hygiene – also known as WASH – indices were not only poor, but were in fact worsening. 
    • This feedback from the frontline was backed up by a World Bank Water report, aptly named ‘Nigeria: A wake-up call,’ which revealed that WASH indices in the country have actually suffered an alarming decline from an already critical condition. Access to piped water on premises in urban areas dropped from 30% in 1990, to less than 10% in 2015.  A lack of investment in WASH is putting the lives of thousands at risk as the spread of Ebola, for example, is made more likely. WASH is at the heart of Infection Prevention and Control (IPC) and the fact that outbreaks of diseases have been so severe in Nigeria recently – with the WHO commenting that the Lassa Fever outbreak last year was unprecedented – is no coincidence.
    • Meanwhile, women and infants are dying needlessly in labour rooms, with maternal sepsis taking a mother’s life at what should be the most joyous time. 
    • It is not just the current situational analysis which is so bleak, but also the systematic failures to bring WASH standards up to an appropriate level for our population.
    • Nigeria is struggling to maintain its current infrastructure, inadequate as it is for the current population and entirely unfit for the years ahead. Government must lead the way, achieving economies of scale in densely populated areas by providing piped water and not forcing individual families or streets to rely on their own sources. As the World Bank rightly highlights, this also allows for the proper regulation of groundwater, essential in the fight against pollution.

 

  • Poor WASH facilities in schools also lowers attendance and educational achievement, with a particular effect on girls. According to UNESCO, one in ten girls in Sub-Saharan Africa do not attend school during their menstrual cycle, and can miss as much as twenty percent of a given school year.

 

 

 

  • Having been made keenly aware of the issue from the frontline, we were then able to adapt both our programmes and our advocacy work to take on this challenge. 

 

 

  • Our MamaCare midwives began to advocate in healthcare facilities for better standards and taught proper handwashing techniques to staff. Their experiences informed our updated Personal, Social, Health and Economic (PSHE) education programme which takes place in schools, teaching staff and students alike the importance of good WASH standards. We already had the framework in place – and the trust of communities – to adapt our programmes to address a significant health risk 

 

  • But in a country of almost 200 million people we knew that we had to reach far beyond that. This is where the key relationship between frontline experience and the ability to improve capacity by achieving effective advocacy comes in. 

 

  • In May 2018, I launched a global WASH campaign in Abuja at a meeting with Dr. Wondi Alemu, who was then the WHO Representative and Head of Mission in Nigeria. We announced that the Foundation would work with partners including Global Water 2020, an initiative based in Washington D.C. which is designed to accelerate progress toward water access and security for all people in developing countries, with a particular focus on increasing the availability of WASH in healthcare facilities.  A key element of that partnership is advocacy for improved WASH standards, both in Nigeria and around the world.
  • The following month, I led a delegation to Washington D.C. to take part in multilateral meetings with the US State Department, the World Bank, the Center for Strategic and International Studies, the American Academy of Sciences and members of the United States Congress. The visit was intended as both an information gathering exercise and to engender a new spirit of co-operation on WASH. 

 

  • That visit was followed by a formal submission to the 2018 United Nations High Level Political Forum on Sustainable Development. The intervention was made in relation to the forum event “Partnerships that Deliver for Girls and Women – an interactive dialogue to break down silos and achieve the SDGs” organised by Women Deliver. Following that intervention, Nigeria remedied the lack of priority it was placing on its approved WASH World Bank loan. 

 

  • In September 2018 the WBFA partnered with Unilever Lifebuoy Nigeria and Sightsavers to improve hygiene practices to impact more than 2 million children over the following 12 months. The partnership works on programmes which promote hygiene messages and prevent disease, advancing critical hygiene interventions such as handwashing with soap, addressing the issue of child illnesses and mortality due to preventable diseases.

 

  • On 25th October 2018, I called for a state of emergency to be called in Nigeria on the standards of water, sanitation and hygiene. Two weeks later, President Buhari heeded that call and declared the state of emergency to be in place. 

 

  • We have now been asked by The World Bank to head up its campaign in Nigeria to end open defecation, which stands at a rate of 25% and poses a serious sanitary hazard. 

 

  • That example shows how, within a year, effective advocacy grows the capacity of, in this case, a Foundation, to far beyond the sum of its parts.  

 

 

  • I will illustrate my point with a further example. Many medical students around the world use cadavers to train with. They practice on the human body so that when the time comes, they know what they are dealing with.

 

 

 

  • In Nigeria, however, that is however rarely the case. Future doctors, nurses and midwives are normally constrained to the classroom – with an excellent grasp of the theory, but less experience of the practice. 

 

 

 

  • That means that their first ‘practice’ can be on a human being. A midwife bringing a real child into the world. A doctor making an incision on a real mother. For the first time. Through no fault of their own, this is a major contributor to our high maternal and infant mortality rates. 

 

 

 

  • At the Wellbeing Foundation Africa, together with our partners Johnson & Johnson and the Liverpool School of Tropical Medicine, we have already introduced life-like anatomical models to 7 local governments in Kwara State, Nigeria. 

 

 

 

  • Our partnership currently brings the models, together with the training needed, to health professionals on the job. It has been a gamechanger. 

 

 

 

  • I have seen experienced midwives cry with joy as they explain to me that they have only just understood how to evacuate a placenta or implant a contraceptive device.  A young doctor has declared with relief that he now has the confidence to save lives.

 

 

 

  • The results have been extraordinary. So far the Emergency Obstetric and Newborn Care Training Programme, or EmONC – has resulted in a 15% improvement in maternal survival and a 38% improvement in the still birth rate in health care facilities where the project is implemented. It will expand to the whole of Kwara to over 600 extra health workers and 62,900 more women and their babies. 

 

 

 

  • These results prove, once again, that we have the brain power and excellence in Nigeria to transform our country, to bring our health indices up to global standards. To build capacity we must in part look to these strategic partnerships to help us deliver results to the frontline. 

 

 

 

  • Thank you for the invitation to join you today. I will leave you with one final point as we discuss African-led philanthropy. A key issue for our sector is the notion that lower expectations are acceptable, or that dishing out aid is any form of long-term solution. It is not: we should aim for a global standard in all that we do. It has been shown time and time again that we have the capability to achieve on a global level as a nation and as a region once we have the necessary tools, training and infrastructure to do so. Addressing those gaps is part of our challenge in achieving excellence and I believe that partnerships on an equal footing – not aid – are one of the tools we can use to do so. Thank you. 

 

 

 

 

FROM October 17th, 2018

Good afternoon, I am delighted to join you here today. I have been asked to convey the apologies of Mrs Toyin Ojora Saraki, the Founder-President of the Wellbeing Foundation Africa, who is unfortunately unable to be with us. It is my privilege to represent Mrs Saraki here today: my name is Jack Tunmore and I lead Global Communications and Policy for the Wellbeing Foundation, also known as the WBFA. 

I will give a very brief overview of the work of the WBFA and then offer more insight into the two of our programmes which I think are the most relevant for our discussion here today. This session focuses on building partnerships with NGOs, communities, and academia. We bring the perspective of an NGO which works with global partners, academic institutions and Governments, both local and national. 

The Wellbeing Foundation Africa was founded in 2004 by Her Excellency Mrs Toyin Ojora Saraki, with the primary aim of improving health outcomes for women, infants and children. We combine our programmes with advocacy work in Nigeria and around the world: in fact our frontline health programmes inform that global advocacy. 

We have offices in Lagos, Abuja and Ilorin – and a global office in London, which is where I am based. I am fortunate to regularly spend time with our teams in Nigeria, including taking global partners on assessment visits, and when in London I am equally fortunate to be kept closely, and frankly, informed of frontline activities by the WBFA midwives, known as MamaCare midwives, via WhatsApp and Skype. 

Over 200,000 women have taken part in our flagship ‘MamaCare’ classes in Nigeria; antenatal and postnatal classes delivered by our qualified midwives. Despite dire national maternal mortality rates, we have not yet lost a single MamaCare mother. Our WBFA midwives transform the lives of mothers, their children and communities. No topic is off-limits in their classes – trust me, I know – and their results speak for themselves. Our online #MaternalMonday campaign was conceived as a platform for mothers and our WBFA midwives to share their knowledge, experiences & best practice. The aim of that sharing exercise is to raise awareness for the improvement of reproductive, maternal, newborn, child & adolescent health.  We harness the power of story-telling on social media each Monday to share accurate information on maternal health 

Now I will turn to the two programmes which I think are most relevant to our discussion here today. 

The first is the Emergency Obstetric and Newborn Care (EmONC) programme which  is run in partnership with the Centre for Maternal and Newborn Health (CMNH) at the Liverpool School of Tropical Medicine, the oldest and most established school of tropical medicine in the world, and Johnson & Johnson, one of the largest global health companies. The model therefore brings together an esteemed higher-education institution, the private sector and a civil society organisation – which is of course us. 

Our EmONC training takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome obstetric emergencies.

Funding from the Johnson & Johnson Corporate Citizenship Trust allows for a three-pronged model from LSTM and the WBFA: (a) direct, skills-and-drills based method of teaching Emergency Obstetrics and Newborn Care, including newborn resuscitation; (b) Data Management training; and (c) Quality Improvement (QI) training. WBFA’s model is based on community mobilisation, advocacy, and strategic policy advisory. 

The partnership began in February 2015, with the two first phases being active in 7 of the 16 Local Government areas in Kwara State. In February I joined representatives from Johnson & Johnson and the Liverpool School of Tropical Medicine to carry out a ground assessment of the training. The demonstrations witnessed by the team in Kwara were wide-ranging and innovative – we were particularly impressed with the simple inexpensive use of a condom catheter balloon filled with saline to control postpartum haemorrhage, the excessive bleeding after birth which is the leading cause of maternal mortality. As we know, 80% of all maternal deaths result from five complications which can be readily treated by qualified and trained health professionals: haemorrhage, sepsis, eclampsia, complications of abortion and obstructed labour. 

So far, the EmONC training programme has resulted in a 15% reduction in maternal case fatality rate and a 38% reduction in the still birth rate in health care facilities where the project is implemented. 

Since that visit, we can as partners proudly report that we have moved to the next stage of the programme, as from August 2018 to August 2020 our EmONC training is set to expand across the whole of Kwara State. 

Between 2018-2020, EmONC training will be delivered to an additional 27 healthcare facilities in the remaining 9 LGAs. Over 600 healthcare providers will be directly trained and over the 30-month project, an estimated 62,900 women and their newborns will benefit from the interventions implemented.

 

We have taken a quite different approach to our partnerships which seek to improve water, sanitation and hygiene – or ‘WASH’ conditions in healthcare facilities, schools, and communities in Nigeria. 

Poor WASH facilities in schools lowers attendance and educational achievement, with a particular effect on girls. According to UNESCO, one in ten girls in Sub-Saharan Africa do not attend school during their menstrual cycle, and can miss as much as twenty percent of a given school year. Meanwhile, poor WASH conditions in healthcare facilities lead to high rates of maternal and infant mortality. The WHO found that in Nigeria 29% of HCFs do not have access to safe water and toilets and 16% of HCFs do not have handwashing facilities with soap.

In May our Founder-President Mrs  Saraki launched a global WASH campaign in Abuja at a meeting with Dr. Wondi Alemu, WHO Representative and Head of Mission in Nigeria, working with partners including Global Water 2020, an initiative based in Washington D.C. which is designed to accelerate progress toward water access and security for all people in developing countries. A key element of that partnership is advocacy for improved WASH standards, both in Nigeria and around the world. 

In June we carried out a fact-finding and advocacy mission to Washington D.C. to take part in multilateral meetings with the US State Department, the World Bank, and members of the United States Congress. In August, as the United Nations marked International Youth Day, the WBFA took its pioneering PSHE and water, sanitation and hygiene (WASH) education programme to schoolchildren in Ogun State, Nigeria. 

The WBFA’s programme is based on its Adolescent Skills and Drills, Personal Social and Health Education Curriculum, the first locally-developed PSHE curriculum, which is formed of three core pillars – Your Rights and Your Body, Health Relationships, and Planning Your Future. Within those main areas an extensive range of topics pertinent to the health and wellbeing of young people are covered, with a focus on WASH.

The cohort of children, aged between 8 and 17 years old, were taught the WHO standard of hand washing techniques in addition to further break-out sessions, in line with the commitment of the WBFA to support the attainment of UN Sustainable Development Goal 6: Ensure availability and sustainable management of water and sanitation for all. This pilot, which took place over two days, educated 237 children at the Ogun State Summer Camp, before an anticipated roll-out across the state and throughout Nigeria. 

Last month we partnered with Unilever Lifebuoy Nigeria and Sightsavers to improve hygiene practices to impact more than 2 million children over the following 12 months. 

The partnership will work on programmes which promote hygiene messages and prevent disease, advancing critical hygiene interventions such as handwashing with soap, addressing the issue of child illnesses and mortality due to preventable diseases.

Thank you for your attention and I look forward to hearing how we can be a great frontline health partner for you all. 

FROM September 25th, 2018

Good evening. I am delighted to join so many friends here to celebrate midwives and the work of ICM. 

Indeed, we often meet at times of celebration. Last time I joined you at a public event, at the World Health Assembly in Geneva, the atmosphere was joyful as we celebrated midwives leading the way for quality care around the world. I know that we will share some of that spirit tonight. 

Events last week, however, will be weighing heavily on all of our minds, and prompting difficult questions about the safety of midwives and our role as champions and advocates for midwives. 

In March, a 25-year-old midwife named Saifura Hussaini Ahmed Khorsa was kidnapped by militants alongside two other International Committee of the Red Cross aid workers. Saifura, a young mother herself, had moved to Rann in north-eastern Nigeria to selflessly help those in need. 

Saifura’s murder last week is a tragedy for Nigeria and for the global community of midwives. As a mother, as a Nigerian, and as a champion for midwives, I am devastated that we have lost one of our own.  We pray and work for the release and rescue of Hauwa Mohammed Liman and Alice Loksha as we come to terms with this stark reminder of the threat to life and liberty faced by midwives, nurses and health-care workers who selflessly work for the health and wellbeing of others. 

Saifura had specifically been working in a facility for Internally Displaced Persons – where women are of course particularly vulnerable. Two days after the terrible news broke, our MamaCare midwife Rita was herself conducting an antenatal class in an IDP camp, albeit in an area with a quite different security situation. There can be no greater reminder of the need to support ICM’s advocacy and aims than the news last week and the work carried out by midwives like Saifura and Rita, with no fanfare, day after day, in some of the most challenging conditions imaginable. 

I have just come from the ICM stakeholders meeting, where we discussed ICM’s three-year strategy and had a very honest discussion about all of our strengths and weaknesses. There is no truer friend than a critical friend. One point that I must however bring to this forum which I made in that meeting is that ICM punches far above its weight. ICM’s reach is of course huge, representing over 500,000 midwives from 132 Member Associations in 113 countries across 6 regions of the world.  Many of you here this evening would probably be surprised at the number of staff given their remarkable output. I congratulate ICM, in particular Franka and Sally of course, on their outstanding work not only in forging the way ahead for ICM but for leading the way in advocacy and vision. 

I have now been ICM’s Global Goodwill Ambassador for quite some time – four and a half years and counting, in fact. I am fortunate in this role to have my work informed by the Wellbeing Foundation Africa MamaCare midwives, by the team at ICM, and by friends – many of them here – who share our vision and commitment. Like all of you, however, I strive to find new and effective ways to champion the cause of midwives, both as a public advocate and in private. Making the right case to the right people, at any level, is something I know we can share our wisdom on – please never refrain from letting me know how I can be a better champion. 

Thank you to everyone here today for being friends to ICM and champions for midwives. Above all, thank you to ICM for all that you do. 

 

FROM September 24th, 2018

Good evening and welcome to this Forum on Child Health and Malaria, part of the Access Challenge Universal Health Coverage Conference 2018. 

I am Toyin Ojora Saraki, your moderator for this discussion. As Founder-President of the Wellbeing Foundation Africa, Global Goodwill Ambassador for the International Confederation of Midwives, and Special Adviser to the Independent Advisory Group of the WHO Regional Office for Africa, I am deeply committed to achieving Universal Health Coverage by 2030 and I will bring that experience to bear as we discuss Child Health and Malaria as part of that agenda today. 

We will first focus on input from our experts here on the panel and will then pass over to you – the experts in the audience. Allow me to introduce you to:

Mr. Kevin Watkins – CEO, Save the Children UK

Dr. Kesete Admasu – CEO, RBM Partnership to End Malaria

Dr. Katharina Lichtner Managing Director of the Family Larsson-Rosenquist Foundation

Ms. Joy Phumaphi Executive Secretary, African Leaders Malaria Alliance (ALMA 2030)

Dr. Stefan Swartling Peterson – UNICEF, Chief of Health Section

Dr. Henry Mwanyika – PATH, Digital Health Regional Director for Africa

Of course, we all attend many events here at UNGA – all of them no doubt brilliant – but I have to say this format strikes me as the most productive one. Across the four forums – Maternal Health, Child Health and Malaria, NCDs and NTDs in Africa – a shared dialogue will be created, with written input contributing towards a Universal Health Coverage Policy Report, thus creating an essential tool in our joint mission to achieve UHC, with equity at its core. Congratulations to Kate and her team for their work in assembling us all together and for their commitment to UHC. 

As we construct our dialogue today, I would like all of us to have these key goals in mind: 

  • Identify the most effective methods of improving diagnosis and prevention of disease in low resource settings
  • Highlight the importance of African leadership in driving and directing domestic investment in child health
  • Agree the elements of a functioning PHC system in developing countries
  • Shape policy objectives that would contribute to the achievement of the UHC 2030 agenda

 

I know that time is against us, so without further ado let us begin. 

 

Dr. Katharina Lichtner and Dr. Kesete Admasu:  Partnerships and alliances are key to the UHC agenda. How can we break down silos to better channel investment in the prevention and treatment of diseases affecting children? 

Expected answers: 

1). People working in the global health space should foster cooperation by learning each sectors’ ‘language’

2). At the implementation level this is crucial, particularly in terms of knowledge sharing

3). Changing language can change approaches to partnerships

4). Building partnerships beyond the health sector to promote a multisectoral approach

 

Mr. Kevin Watkins and Dr. Kesete Admasu – any hope of achieving UHC is predicated on domestic financing and African Leadership. How can domestic funding be better targeted?

Expected answers:

1). Identify how health systems are financed and assess the effectiveness of these financing methods

2). Ensure domestic financing is better targeted by ensuring that the right public financial management and budgetary processes are in place 

 

Ms. Joy Phumaphi and Dr. Katharina Lichtner, allow me to turn to you and ask: how can we foster confidence between the private sector, charities, and the government?

Expected answers:

1). Foster confidence by making the case to governments using examples of the efficient use of resources

2). Speak the language of governments e.g. referring to GDP. This generates a vested interest for governments and helps to unleash more resources from the investors

3). Assess the most appropriate kind of capital investment for different areas of the research-planning-implementation processes that lie behind financial planning

Dr. Henry Mwanyika and Mr. Kevin Watkins, as we turn to Diagnosis and Prevention, can you speak to how we can integrate the most promising innovations into existing health systems?

Expected answers:

1). By turning away focus from individual pilot projects and focusing on the broad application and mobilization of resources 

2). Following from that, yes: what holds us back is a lack of support mechanisms, and integration requires a focus on infrastructure

 

Dr. Stefan Swartling Peterson, on a subject very close to my heart, what are the elements of a sustainable Primary Health Care system? How do we ensure equity and quality, moving beyond a focus on access alone? What are the challenges facing service delivery?

Expected answers:

1). Importance of quality services and a system which promotes equity

2). Health systems should react to the high disease burden, and this should be context-specific

3). Community operationalization

TS on challenges facing service delivery and effective primary healthcare systems – equity

You emphasized community engagement, why is this so important?

 

At 6.00pm: 

Ask the audience about policy recommendations to improve child health and tackle diseases impacting the health of children

End:

Thank you to our panel – Mr. Kevin Watkins – CEO, Save the Children UK, Dr. Kesete Admasu – CEO, RBM Partnership to End Malaria, Dr. Katharina Lichtner Managing Director of the Family Larsson-Rosenquist Foundation, Ms. Joy Phumaphi Executive Secretary, African Leaders Malaria Alliance (ALMA 2030), Dr. Stefan Swartling Peterson – UNICEF, Chief of Health Section, and Dr. Henry Mwanyika – PATH, Digital Health Regional Director for Africa, for your insights today. Thank you to the audience for your insightful input which will inform the policy outputs from today. I look forward to analysing all of the forums that have taken place today, learning from them, and becoming a more effective advocate for UHC. I know that for me, equity and quality remain absolutely fundamental. Thank you and congratulations again to Kate and her wonderful team.