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The Maternal Health Thematic Fund - Towards Equality in Access, Quality of Care and Accountability, Phase II (2014-2017) - Progress report



UNFPA’s Maternal Health Thematic Fund (MHTF) is a catalytic fund, aligned with country-led processes to address health system bottlenecks; promote innovations; strengthen partnership; and focus on scalable, high-impact interventions to improve and safeguard the health and well-being of women and girls. It supports evidence-based programming in 39 countries with the highest burden of maternal mortality and morbidity, taking an integrated approach that brings together the areas of midwifery, obstetric fistula, emergency obstetric and newborn care (EmONC), maternal death surveillance and response (MDSR) and first-time young mothers (FTYMs). All interventions are strategically selected to have the greatest impact. The Thematic Fund complements UNFPA Supplies; together, they work to enable women and girls to make fundamental decisions about their own bodies, attain the highest possible standard of sexual and reproductive health, and exercise their reproductive rights.

This report highlights the key results achieved over Phase II of the MHTF, from 2014 to 2016, structured around the three cross-cutting principles of accountability, equality of access and quality of care, as outlined in the MHTF Business Plan Phase II (2014-2017). The report foregrounds the MHTF’s role in supporting health systems strengthening, and addresses its catalytic nature, its promotion of sustainability and its strong emphasis on advancing innovation. A vision and direction are outlined for the third phase of the MHTF, which will be further elaborated in a forthcoming Business Plan Phase III (2018-2021).

The MHTF during its second phase continued to demonstrate its unique value at the forefront of supporting countries to lead and accelerate the delivery of improved maternal health information and services for women and girls. It has assisted the development of national policies and programmes; strengthened national technical capacities and the collection, analysis and use of data; and backed global, regional and national advocacy for maternal health (and sexual and reproductive health more generally). It has reinforced UNFPA’s role and visibility as a global maternal health leader and convener focused on evidence-based, high-impact interventions spanning clinical and health systems strengthening as well as multisectoral approaches, all under the umbrella of fundamental human rights and gender equality principles.

Headline results from 2014 to 2016 include 19,200 estimated maternal deaths averted in the 39 MHTF-supported countries. Around 39,000 fistula surgical repairs were provided through targeted programming to “leave no one behind,” in tandem with over 90 partners in the Campaign to End Fistula, which also addresses the reintegration of survivors with their families and communities. In midwifery, the MHTF supported countries to develop and implement comprehensive policies for education and regulation with over 32,000 midwives supported in both pre-service education and in-service training, and over 300 midwifery schools strengthened. The MHTF has helped countries to strengthen strategic planning, development and monitoring for national EmONC facility networks, with the “availability of EmONC” in 21 countries reaching on average 30 per cent of the EmONC international standard. Six countries had the capacity to regularly monitor the availability and quality of EmONC services. All 39 countries have initiated an MDSR programme; 70 per cent are implementing it at a national scale. An additional area of focus introduced in Phase II was first-time young mothers, aimed at increasing the number of deliveries with a skilled birth attendant, boosting uptake of post-partum family planning to prevent or space pregnancies, and enhancing agency in decision-making related to SRHR. As a result, 19 countries have prioritized FTYMs in their national reproductive, maternal, newborn, child and adolescent health (RMNCAH) plans.

Partnerships have been critical to the MHTF at all levels in Phase II – country, regional and global. UNFPA successfully drew on MHTF interventions and results to contribute to various initiatives and partnerships, including Every Woman, Every Child; the H6 Partnership; the Global Financing Facility; the Partnership for Maternal, Newborn and Child Health; and the Campaign on Accelerated Reduction of Maternal Mortality in Africa, to highlight a few.

In Phase II, the MHTF has comprised two multidonor funding streams: the Thematic Trust Fund for Maternal Health and the Thematic Fund for Obstetric Fistula. An operating budget of approximately $59.7 million from 2014 to 2016 has had an implementation rate above 90 per cent, with 81 per cent of funding targeting the country and regional levels. This underscores the MHTF’s high absorption capacity with tangible results achieved, and a real opportunity to deliver more results with more resources.

In looking forward to UNFPA’s new Strategic Plan (2018-2021), a third phase of the MHTF is now being elaborated to support the achievement of universal access to sexual and reproductive health, to realize reproductive rights and to reduce maternal mortality, all towards accelerating progress on the International Conference on Population and Development (ICPD) agenda. This new phase will build on results achieved, capitalize on lessons learned and draw on emerging opportunities to offer support that is ambitious, far-reaching and innovative. Quality, equitable and accountable maternal health services will be at the heart of all activities, towards advancing improved health and well-being for women and girls, leaving no one behind and reaching the furthest behind first. The MHTF’s commitment and vision is to emphatically change the maternal health paradigm from one where hundreds of thousands of women and girls in the developing world still die from preventable pregnancy-related causes or suffer a severe pregnancy-related morbidity, to one where women and girls have access to quality sexual and reproductive health services that allow them to survive and thrive, transform their lives and their societies, and drive realization of the 2030 Agenda for Sustainable Development.