Evidence is at the heart of a revolution for women and children

The field of maternal, newborn and child health can be hard to follow. So many acronyms - it’s like alphabetti spaghetti! This is no bad thing – lots of initiatives means that many influential groups, all galvanising their passion to fight the tragedy of preventable deaths of women and their babies.But it can be hard to follow. It’s possible to get totally lost in the jargon, acronyms, global calls to actions, commitments, strategies and now commissions…I want to pick out two acronyms for special attention – CoIA and iERG because they should be at the heart of our new revolution for women and babies. These stand for:

• The Commission on Information and Accountability for Women and Children’s Health
• Independent Expert Review Group

I have picked on these two because I think they are pretty important, but unless you are someone who works within the International Global Health Movement (IGHM) – (I made that one up!) it can be difficult to work out what these are and why they matter.I fervently believe they matter a very great deal and somehow we need to cut through the jargon. We need to get more people to understand what it is that they bring to the party.I also believe that, at their core, these movements are trying to put sound evidence as the basis of moving forward – which is something I am passionate about.There is a story behind themFor many, many years, women and their children continued to die of causes that we have for a long time known how to prevent. Most live in the poorest countries of the world, and in the most remote and excluded areas within these countries.This accumulated toll of unnecessary deaths created a critical mass of outrage – why are these women and children dying? Why aren’t we doing more to tackle it?Slowly at first, more and more people came together, collaborating across fields and expertise, to collectively persuade the world to take maternal and newborn death seriously.In 2010, the issue reached the very top. Ban Ki-moon, United Nations Secretary General launched the Global Strategy for Women and Children’s Health. And, to celebrate this launch, many people and countries made ambitious commitments to say what they were going to do to play their part.But how would we know if these commitments were real promises, hopeful pledges or opportunities for some good PR? The answer from Ban Ki-moon was to set up a commission to come up with very specific recommendations to help make sure that the strategy and the commitments were delivered. The Commission on Information and Accountability was born.Ban Ki-moon, UN Secretary GeneralInformation AND accountabilityLet’s dissect the title a bit - what does accountability mean? I have been thinking about it for a while. To me, it means making sure that we all deliver on our responsibilities, either because we have made commitments or we have obligations (to our families, our communities, or to our jobs and patients).And information - because if we don’t count it, it doesn’t matter. Or more crudely, you can get away with not delivering on your responsibilities because no one knows you haven’t, precisely because you don't count it.Or you count it, but hide it away somewhere obscure so that it is very difficult for ordinary people to find. The evidence is actually all around. But too often it’s hidden in obscure reports – or data is collected and not even analysed.This is true for making a proper investigation on how many health centres have life-saving drugs and which ones don’t, as it is for tracking the money that is meant to pay for them.You would have thought that it should be easy to work out how much money has been allocated to different areas of the country and how much for saving the lives of women and children - because haven’t most countries signed up to multiple commitments and charters, remember the Millennium Development Goals?But it isn’t! So if you don’t know who is dying or where they are dying, and you don’t know if the health clinics have any drugs and you don’t know how much money is available, then where are you? Not very far.And this is really what I think the Commission for Information and Accountability was saying. They were saying:‘Hold on, if you really want to save the lives of women and children then you need to start counting better, and sharing that information and evidence to help you plan. How else can you demonstrate what you are doing and more importantly, how else will you know if what you are doing is making a difference?’  It is also saying ‘and to do this you need to involve people, and we mean real people (aka the public or civil society)’.  Real people!Gasp, why would we do that? Well, you may think your services are very good, but if you don’t ask the people who use them then how can you really tell?  Real people can help you come up with solutions that have a good chance of working in their communities, but they are also part of accountability.Real people have their own responsibilities, but they can act and influence others to deliver on theirs. If the big cheeses know the people, who most often put them there, care, then they are more likely to sit up and fulfil their responsibilities.So the birth of the Commission or CoIA was a very important moment. It made explicit that we have responsibilities and in order to measure whether we are delivering on our responsibilities we need information. We need information for accountability. And the information and evidence needs to be communicated clearly. And not only that, we need people. Real people who also have access to the information so that they can play their part in delivering accountability.Independent Expert Review GroupNext up, let’s welcome iERG to the stage. As this story is about accountability it makes sense that there is some way to keep an eye on how we are all doing since this Commission published its first important report. The iERG is the Independent Expert Review Group.The iERG is a group of very clever people, who are importantly, independent. It has the job of keeping us all on our toes. Checking to see how we are all doing against the various goals and targets we committed to achieve.They investigate and then publish reports to tell us what they have found. So far, two reports. Their latest report (2013) says we are still not doing very well on transparency. And it says that civil society is not really playing a role in accountability in many countries. And without transparency or real people, accountability cannot happen.The Commission has placed accountability very firmly front and centre of the global response to preventable deaths. The challenge now is to translate this opportunity into stronger accountability at country level - and information and civil society will be at the heart of this.It is easy for these reports to get lost in the quagmire of all the important reports and publications that fly around in cyberspace and in overflowing inboxes. But both CoIA and the iERG are worth listening to. And I would suggest that if you have not already, you take a moment and have a read. They both put evidence squarely at the core of action.