African civil society organizations are calling for greater accountability and transparency from African leaders regarding the use of public funds for the survival of mothers and babies. Activists will take advantage of an international conference on 1 July 2014, the Partners Forum, organized by the World Health Organization, to put pressure on senior Government officials from across the continent.This call to action marks the launch of an African-led network demanding better use of existing funds for African women and children’s health as well as a greater share of African national budgets allocated to mothers and babies’ survival.The Africa Health Budget Network (AHBN) believes we need to get specific about promises made for women and children’s health, and to track whether these promises have been kept. Their first priority, however, is to make sure that African governments are open and transparent about what they spend on health. While most African government have already made commitments about improving the health of their population, including through greater spending, it is difficult to check whether they are keeping their promises if the budget is not publicly available or if the information in the budget is not clearly presented.The members of the Africa Health Budget Network have compiled a scorecard[1] showing how open African Governments are about their health spending. Out of the 26 African countries profiled, only one, South Africa, is sufficiently transparent.Dr Aminu Magashi Garba in Nigeria said: "African activists are now using the internet and social media to discover more about their government's priorities. We note that our governments are shy about sharing public expenditure on health in our country. We want to know more. This matters to the women and children of my country, Nigeria. We will be in Johannesburg in June, at an international conference, to call for greater transparency in health spending, and to demand increased expenditure on the health of Africa's women and children. Their health and survival is, after all, critical to Africa's future prosperity." Dr Mohamed Yilla, Country Director for the Mamaye Campaign in Sierra Leone, added that “countries like Sierra Leone with poor survival rates for mothers and babies are often also plagued with underinvestment in the health sector. Civil Societies in Sierra Leone have been advocating for increased and more transparent health financing for a couple of years.Since we have started, health budget has increased. It is vital that CSOs continue to put pressure on the Government to meet its commitments. The African network will help us share experiences and lessons-learnt to improve our advocacy.”For more information on how to get involved contact Dr Aminu Magashi Garba, Regional lead of Africa Health Budget Network at ahbn@evidence4action.net , +234-80-23810589, visit our webpage and like our Facebook page and follow us @AHBNetworkNOTE TO EDITORS:About the Africa Health Budget Network The Africa Health Budget Network is a group of African and global organizations and individuals already using or wishing to use budget advocacy as a tool to improve health service delivery in Africa. It concentrates on three strands of work: connecting members to formal training opportunities, events and tools; promoting learning and sharing within the network; and applying coordinated and focused pressure on African leaders with respect to their health financing commitments.About Health Budgets in AfricaAccessing acceptable, high quality health care is a fundamental right of every human being[2]. Although Sub-Saharan African countries have succeeded in decreasing maternal mortality ratios by 49% between 1990 and 2013, 179,000 women still die from pregnancy and childbirth every year, largely due to lack of access to quality care[3].Adequate investment in health systems, including health workers, drugs and infrastructure, could stop these preventable deaths and bring economic and social benefits worth nine times as much[4].Despite this evidence, less than half of African Union governments currently spend at least $54 per person on health, the minimum needed to cover basic health services[5]. Accelerating coverage of RMNCH interventions at a rate to match that of best the performing countries in Africa would imply spending only $9.05 more per person per year, on average[6].While many service delivery and health financing commitments have been made in the context of the Global Strategy for Women and Children’s Health and other, regional initiatives (see Table 1), few of these commitments have been met. Ensuring that commitments made by African governments are delivered and implemented requires a concerted focus on accountability. Budget advocacy is a useful tool to strengthen accountability as it enables participants outside (or even within) government to measure the amount of resources allocated to and spent on particular commitments. Table 1: Health financing commitments made by African governmentsInitiativePromise madeCommission on Information and Accountability (2010)Track and report (i) total health expenditure and (ii) total reproductive, maternal, newborn and child health expenditureCreate "compacts" between country governments and all major development partners to enable predictable commitmentsRelate spending to commitments, human rights, gender and other equity goals and results.Abuja declaration (2001)Allocate at least 15% of annual budget to improve the health sectorMaputo programme of action (2007)Institutionalise National Health Accounts (NHA)Allocate a higher proportion of national health budgets to SRHAfrican Union plan of action to end preventable maternal, newborn and child mortality (2013)Increase resources for CARMMA/MNCH (Existence of CARMMA trust fund)Implement health financing policies and strategies to promote Universal Health CoverageReduce proportion of out of pocket expenditure to total health expenditure [1] www.mamaye.org/en/evidence/africa-health-budget-network-transparency-scorecard The scorecard uses data from the Open Budget Index 2012, http://survey.internationalbudget.org/#download[2]United Nations Committee on Economic Social and Cultural Rights. CESCR General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12) [Internet]. United Nations; 2000. Available from: http://www.unhcr.org/refworld/pdfid/4538838d0.pdf[3] World Health Organization, UNICEF, UNFPA, The World Bank & the United Nations Population Division. (2014). Trends in Maternal Mortality: 1990 – 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Geneva: WHO.[4] Stenberg, K. et al (2014) Advancing social and economic development by investing in women’s and children’s health: a new Global Investment Framework, The Lancet, 383: 1333-54.[5] World Health Organisation, Global Health Expenditure database, “General government expenditure on health / cap Purchasing Power Parity (NCU per US$), 2012”, accessed 23rd May 2014.[6] Table 2, p. 1343, Stenberg, K. et al (2014) Advancing social and economic development by investing in women’s and children’s health: a new Global Investment Framework, The Lancet, 383: 1333-54.
Call to action marks the launch of an African-led network demanding better use of existing funds for African women and children’s health as well as a greater share of African national budgets allocated to mothers and babies’ survival.