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UNFINISHED BUSINESS IN ACHIEVING GLOBAL AND NATIONAL TARGETS FOR CHILD SURVIVAL

UNFINISHED BUSINESS IN ACHIEVING GLOBAL AND NATIONAL TARGETS FOR CHILD SURVIVAL. A Keynote Address USAID Annual RMNCAH/FP/Nutrition & Wash Conference March 25-29 , 2019 Sarova Woodlands Hotel Nakuru Hon. Dr. JAMES NYIKAL , CBS MP SEME.

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UNFINISHED BUSINESS IN ACHIEVING GLOBAL AND NATIONAL TARGETS FOR CHILD SURVIVAL

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  1. UNFINISHED BUSINESS IN ACHIEVING GLOBAL AND NATIONAL TARGETS FOR CHILD SURVIVAL A Keynote Address USAID Annual RMNCAH/FP/Nutrition & Wash Conference March 25-29 , 2019 Sarova Woodlands Hotel Nakuru Hon. Dr. JAMES NYIKAL , CBS MP SEME

  2. GLOBAL STRATEGY FOR WOEMN’S AND CHILDREN’S HEALTH Global strategies all link • Child health • New Born Health • Maternal Health ( Women’s Health) • Adolescent Health

  3. 2003-2015 PERIOD Emphasis on • Women’s health • Newborn health • Child health • Adolescent health recognized but silent. • Marked progress driven by MDG targets

  4. 2003-2015 PERIOD CONT…… Survival main strategy on MDG platform through • Immunization • IMCI • Malaria Control • Prevention of mother to child transmission of HIV • Access to contraceptives • Delivery by skilled attendants • Addressing the 3 delays • Health System Strengthening

  5. 2015-2030 PERIOD CONT……… Emphasis on all aspects • Maternal Health • Newborn Health • Child Health • Adolescent Health Focus on sustainability of gains made on the MDG platform as SDG targets kick in

  6. 2016-2030 GLOBAL STRATEGY FOR WOMEN’S CHILDREN’S AND ADOLESCENTS HEALTH Pillars of SURVIVE, THRIVE and TRANSFORM are life cycle based as shown by targets particularly for children. SURVIVE • Emphasis on Survival i.e. Stop deaths Targets • Reduce global mortality to less than 70 per 100000 live deaths • Reduce newborn mortality to at least as low as 12 per1000 livebirths in every county • Reduce under-five mortality to at least as low as 25 per 1000 live births • End epidemics of HIV, TB, Malaria ,neglected tropical diseases • Reduce by one third premature mortality from non communicable diseases and promote mental health and well being

  7. 2016-2030 GLOBAL STRATEGY FOR WOMEN’S CHILDREN’S AND ADOLESCENTS HEALTH……. THRIVE • Emphasis on well being post survival, Growth and Development • Emphasis critical for adolescents Targets • End all forms of malnutrition and address the nutritional needs of children , adolescent girls and pregnant and lactating women • Ensure universal access to sexual and reproductive healthcare services (including for family planning) and rights • Ensure that all girls and boys have access to good quality early childhood development • Substantially reduce pollution related deaths and illnesses • Achieve universal health coverage , including financial risk protection and access to quality essential services , medicines and vaccines

  8. 2016-2030 GLOBAL STRATEGY FOR WOMEN’S CHILDREN’S AND ADOLESCENTS HEALTH …… TRANSFORM Emphasis is to: • Promote health • Address social determinants of health • Participate in Economic development Targets • Ensure that all girls and boys complete free, equitable and good quality primary and secondary education • Eradicate extreme poverty • Eliminate all harmful practices and all discrimination and violence against women and girls • Achieve universal and equitable access to safe and affordable drinking water and to adequate and equitable sanitation and hygiene • Enhance scientific research , upgrade technological capabilities and encourage innovation • Provide legal identity for all , including birth registration • Enhance the global partnership for sustainable development

  9. RATIONALE FOR 2016-2030 GLOBAL STRATEGY • Past Success 2010-2015 • Global mobilization of funds • Marked Progress of MDGs • Infant mortality • Child mortality • Maternal mortality • Access to contraceptives • Controlling HIV, Malaria and TB • Persisting Gaps • Maternal mortality • Newborn /still born deaths • Adolescent deaths • Contraceptive use • Identified areas of high returns on investment • Access to quality reproductive health • Availability of contraceptives • Immunization • Breastfeeding and Nutrition • Adolescent healthcare

  10. NEW APPROACH IN 2016-2030 STRATEGY • Social protection approach targeting vulnerable groups • Focus on adolescents to develop healthy productive responsible adults • Life Cycle approach need to link with organization of health services e.g. levels in Kenya. • Focus on social determinants • Action Areas • Leadership • Financing • Health Systems • Community Strategy • Enabling Factors

  11. KENYA NATIONAL HEALTH POLICIES AND STRATEGIES • KENYA HEALTH POLICY FRAMEWORK 2014-2030 • Towards attaining the highest standard of health Salient features include; • Legal framework • Kenya Constitution • Bill of Rights • Devolution • Health Act

  12. KENYA NATIONAL HEALTH POLICIES AND STRATEGIES CONT….. • Organization of service delivery – community strategy and levels of care. • Policy Objectives • Eliminate Communicable diseases • Halt and reverse the rising burden of NCDs • Provide essential healthcare • Minimize exposure to health risk factors • Collaboration with partners

  13. KENYA NATIONAL HEALTH POLICIES AND STRATEGIES CONT…… 2. KENYA HEALTH FINANCING STRATEGY 2016-2030 • Goal – ensure adequacy , efficiency and fairness in financing of health services in a manner that guarantees all Kenyans access to essential health services that they require. • Objectives • Progressive government allocation • Public prepayment revenue collection (NSHI) • Private prepayment revenue collection (Private insurance) • Eliminate Out of Pocket Payment for Essential Services to curb catastrophic family spending • Maximize efficiency • Ensure equity

  14. ROADMAP TOWADS UNIVERSAL HEALTH COVERAGE IN KENYA 2018-2022 Salient features • UHC Priorities and Targets 2018-2022 • Progressive increase of proportion of Kenyans covered • Progressive expansion of scope of benefits package • Improving quality of health service • Financial protection & financing health • Implementation Framework • Legal and regulatory framework • Advocacy and communication • Leadership and governance • Role of other actors( Ministries, private sector & partners) • M & E • Financial Requirement

  15. WHAT IS THE UNFINISHED BUSINESS IN ACHIEVING GLOBAL & NATIONAL FOR CHILD SURVIVAL AND DEVELOPMENT TO FULL POTENTIAL We know what to do. Why are we not doing it, if we are doing it , why is it not working as expected? KENYAN SCENARIO 1. Political leadership • Not welfare & development driven • Self seeking • Power for self enrichment • Power for powers sake • Power for narrow parochial interest • Nepotism ( ethnicity & clannism) • Lack of regard for or lack of understanding of technical realities of development agenda & implementation of projects- e.g. Division of Ministry of Health in 2008 • Underdeveloped Nationhood • Kenya a State not a Nation • No commitment to common welfare and commonwealth nearly by all , citizens and leaders

  16. WHAT IS THE UNFINISHED BUSINESS IN ACHIEVING GLOBAL & NATIONAL FOR CHILD SURVIVAL AND DEVELOPMENT TO FULL POTENTIAL CONT….. 2. Governance • Corruption • Way of life , socially rewarded not sanctioned • Institutionalized • Commendable eradication effort , result to be seen • Incompetence • Inappropriate deployment and utilization of skills , square pegs in round holes • Lack of capacity

  17. WHAT IS THE UNFINISHED BUSINESS IN ACHIEVING GLOBAL & NATIONAL FOR CHILD SURVIVAL AND DEVELOPMENT TO FULL POTENTIAL CONT….. • Legal framework • Constitution • Bill of rights , Articles 43,53,54,55,56and 57 • Devolution • Great constitutional innovation • Poor implementation • Schedule 6 • Transition to Devolved Government Act repealed without impact • TA dead on arrival • Intergovernmental relations systems weak , acts not fully implemented and structures not robust

  18. WHAT IS THE UNFINISHED BUSINESS IN ACHIEVING GLOBAL & NATIONAL FOR CHILD SURVIVAL AND DEVELOPMENT TO FULL POTENTIAL CONT….. ii. Health Act – many sections yet to be operationalized e.g. • Human Resource Advisory Council • Health Professions Oversight Authority • Regulation of Health products and technologies • E-health legislations • Emergency care fund • Procurement Processes • Deliberate delays fuelled by corruption • Complex systems , multiple systems with partner funds

  19. WHAT IS THE UNFINISHED BUSINESS IN ACHIEVING GLOBAL & NATIONAL FOR CHILD SURVIVAL AND DEVELOPMENT TO FULL POTENTIAL CONT….. • Financing Health • Lack of commitment hence persistent underfunding. Abuja target not met by many African countries. • Poor priority setting at times triggered by interests • Poor understanding of health dividend in development • Poor management END OF PRESENTATION

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