The World Bank s Reproductive Health Action Plan 2010-2015 Human Development Network July 19, 2011 Year 1 Implementation & Progress
Summary Reproductive Health Action Plan developed at the request of the Bank s Executive Board May 2010 Aims at addressing RH is 57 high burden countries Focuses on improving RH outcomes through health systems strengthening Considerable progress made in Year 1 on delivering on the RHAP Results Framework SRH is reflected more prominently in the Bank s lending and technical assistance; and Our relationship with global partners on SRH is more robust. 2
Contents of the Presentation Context of the Reproductive Health Action Plan (RHAP) Year 1 Activities and Achievements Opportunities and Challenges 3
The RHAP Targets Interventions for High Burden Countries and Most Vulnerable Populations To do this we are focusing on : 57 LICs with high maternal mortality and high fertility; Especially, meeting the reproductive health needs of the youth; Improving RH outcomes through health systems strengthening; Leveraging partnerships with governments, CSOs, Academia, Bilaterals and Multilaterals Whilst the focus is the LICS we capture lessons learnt from the experiences in MICs 4
The RHAP Aims to Address Persisting High Levels of, and Inequities in Maternal Mortality and Fertility Maternal Mortality Ratios 2008 Fertility Rates By Wealth Quintiles 2006/7, 2008 (select countries) Poorest 5.2 8 Second 4.2 7.4 Third 3.3 6.7 Fourth 2.7 4.9 Richest 1.9 2.8 358,000 maternal deaths globally annually 87% of these in SSA & SAR Adolescents bear 23% of the disease burden due to pregnancy and childbirth 0 5 10 Angola 2006/07 Philippines 2008 Significant intra and inter country inequity High unmet need for family planning in SSA (26%) 5
Contents of the Presentation Context of the Reproductive Health Action Plan (RHAP) Year 1 Activities and Achievements Opportunities and Challenges 6
RHAP Results are Measured Against Three Components COMPONENTS DESCRIPTION OF ACTIVITIES Analytical and Advisory Work Analytical and advisory work on RH to inform Country Assistance Strategies; lending and policy dialogue on health in the RHAP focus countries Bank Capacity and Expertise on RH Develop capacity and expertise within the Bank on RH, through recruiting technical specialists where possible and strengthening understanding and expertise of staff working in health sector. Improving Portfolio Monitoring on RH Conduct monitoring of Bank s portfolio on reproductive health Establish a baseline for tracking Tier I & II indicators * *Tier I indicators: Country development outcomes Tier II indicators: Country intermediate outcome indicators Note: A comprehensive list of RHAP implementation results in Year 1 is presented in the Annex (slides 16 20) 7
The RHAP is Well On-Track on These Three Components Component 1 ACTIVITIES ACHIEVEMENTS in Year 1 Conducted Analytical and Advisory Work to Inform Bank Operations RH profiles for 47 countries completed and disseminated. 5 country case studies on success factors for progress on MDGs 4 and 5 will be completed by October 2011 Completed survey in 36 countries on integrating maternal and child health subaccounts into national health accounts; 7 countries already tracking Reproductive Maternal Neonatal and Child Health expenditures, and 10 to initiate tracking CASs in 7 high MMR/high TFR countries approved and all include discussion on RH Regional report on RH disseminated in SAR; initiated in AFR, EAP, and ECA 8
and it is Well On-Track for Delivery in the Regions ACTIVITIES ACHIEVEMENTS in Year 1 Africa: East Asia & the Pacific: Case studies on breaking the family planning and nutrition dilemma. Advanced policy dialogue on integrating FP and nutrition in community based approaches in Ethiopia, Mali and Rwanda;, with interest from Malawi Delivery strategies for sexual and reproductive health and second chance education and training for youth. Supported policy changes through identifying effective strategies in Papua New Guinea, Solomon Islands, and Vanuatu Eastern Europe & Central Asia: South Asia: Latin America and the Caribbean Review of reproductive health content in medical and nursing education curricula. Recommendations being incorporated into curricula in Tajikistan, Uzbekistan, Moldova, Armenia, Azerbaijan and Kosovo Review of access barriers to RH services. Recommendations on RH and HIV convergence, stigma and harm reduction resulted in the National Plan for Convergence on RH and HIV and recommendations on harm reduction have influenced design of the new National AIDS program in India; policy changes in Maldives Review of legal framework of legal rights on teen pregnancy. Framework is being developed for Central America
The RHAP is Well On-Track on These Three Components ACTIVITIES ACHIEVEMENTS in Year 1 Component 2 Enhanced Bank Expertise and Capacity on RH 18 Bank staff designated as RH champions in their regions and 4 staff with RH expertise hired Bank s training course on RH revised based on RHAP; first training under revised curriculum in Budapest in May 2011 Training for statisticians on measurement of maternal mortality conducted in collaboration with H4+ partners* in Nairobi *H4+: UNAIDS, UNFPA, UNICEF, WHO and World Bank 10
The RHAP is Well On-Track on These Three Components ACTIVITIES ACHIEVEMENTS in Year 1 Component 3 Regularized Portfolio Monitoring on RH Health projects approved in FY11 with RH components in DR Congo, Mozambique, Nigeria, Swaziland, Bangladesh, Pakistan, Iraq, Yemen, as well as Argentina and Brazil 2 RH-specific projects in Mali and Burkina Faso under preparation Baseline for tracking RH indicators for high MMR/high TFR countries and available online established 11
Contents of the Presentation Context of the Reproductive Health Action Plan (RHAP) Year 1 Activities and Achievements Opportunities and Challenges 12
Looking Ahead, There are Opportunities to Continue Scaling Up Reproductive Health RHAP has created a tide of opportunity for the Bank to engage with the world on the RH agenda RHAP has energized a dialogue and provided concrete space for engagement with civil society (CSO Consultative Group) RH is well-positioned in the IDA16 results matrix The UNSG s Global strategy for Women and Children (MDGs 4 and 5) synergizes with the RHAP The WDR 2012 provides a platform to showcase RH as a key priority 13
Overall There Have Been Substantial Achievements, But There are Challenges Moving Forward Scaling up the most effective ways to incentivize much needed demand for RH, including family planning, at country level Delivering on the continued need to strengthen country level capacity Ensuring full leverage of the Bank s multi-sectoral advantage to improve RH outcomes including leveraging RH as a tool for women s empowerment 14