‘Anaemia is a public health concern for adolescent girls in Indonesia. So, weekly iron and folic acid supplements were given through several national ministries. At the end of the project, 52,000 adolescent girls in 244 schools may have contributed to preventing 4,071 cases of anaemia. In India’s case, ‘Intensified Mission Indradhanush (IMI) launched in 2017 and targeting 173 districts and 17 urban areas with persistently low immunisation coverage has had an estimated 5.95 million children and 1.19 million pregnant women being vaccinated up to January 2018.
In fact, according to Indian Prime Minister Narendra Modi, “India is on course to attain SDG targets of 2030 much ahead in time due to focussed attention on adolescents. India is the first country to assure independent, empowered and healthy lives for women, children and newborns.”
“These are two of the 12 country case studies focussing on cross-sectoral collaborations in six priority areas from Every Woman Every Child initiative, published as part of The BMJ series titled ‘Making Multisectoral Collaboration Work’.”
Answering “real-world questions” such as when is multisectoral collaboration most effective and what factors enable them to contribute to transformative change, the case studies show how diverse sectors intentionally shape new ways of collaborating and learning, using “business not as usual” strategies to transform situations and achieve shared goals.
Also read: Partners’ Forum: Coming together for Maternal, Newborn and Child Health
The country case studies focus on adolescent health and well-being (Indonesia and United States); early childhood development (Chile and Germany); empowerment of women, girls and communities (Guatemala and South Africa); humanitarian and fragile settings (Afghanistan and Sierra Leone); quality, equity and dignity (Cambodia and India); and sexual and reproductive health and rights (SRHR) (Malawi and Malaysia).
“At the end of Millennium Development Goals (MDGs) in 2015, we needed to take stock of everything we had accomplished as well as we had not. And what we had not accomplished was equity. There had been progress, quality and rights, but then, we looked at areas that needed more attention such as adolescents, humanitarian fragile settings, SRHR, empowerment of women and children,” Helga Fogstad, Executive Director, Partners for Maternal, Newborn and Child Health (PMNCH), apprised Delhi Post.
The series paper was released at the recently concluded Partners’ Forum in New Delhi organised by PMNCH which is hosted at the World Health Organisation in Geneva, and Ministry of Health and Family Welfare, Government of India in collaboration with many other stakeholders.
Note that in line with the Sustainable Development Goals (SDGs), multisectoral action is a key action area of the Global Strategy for Women’s, Children’s and Adolescents’ Health as well as other global health priorities, like universal health coverage, the prevention and control of non-communicable diseases etc.
“It was The Partnership that actually developed the Global Strategy for Women, Child and Adolescent Health which had 7,000 organisations fed into it and a line behind it. Before 2010, even each UN agency had different numbers, different recommendations about these issues. It was a war on numbers and not on the critical issues. So, it was essential to get together the communities including academia to agree on essential interventions,” mentioned Fogstad.
‘They offer fresh insights into what works and into challenges involved in collaborating across sectors. Collectively, they informed a synthesis paper that sets out key lessons and a model of enabling factors for effective multisectoral collaboration,’ reads the series paper.
Focusing on the “power of SDG 17, which provides for partnership for the goals, the series mentions that ‘this final goal could be easily overlooked by cynics as an administrative add-on, aiming merely to scoop up financing. It is here, however, that the goals’ power is hidden within broad indicators such as “policy coherence” and “multistakeholder partnerships”.’
Selected form over 300 responses to global call for proposals, the studies vary in terms of their setting, breadth of scope and time span.
“We thought to ourselves, what case studies are out in the world that have focussed on these areas and have nailed the dot and have really proved that they bended the curves on preventable deaths or have really improved health and well-being. So, then, we did a broad call for proposals on the six thematic areas. We got over 310 proposals with countries mentioning their acts and initiatives. We put together a Global Steering Committee that assessed these proposals and filtered them down to 70 based on their relevance,” shared Fogstad with Delhi Post.
“Because, we were looking for projects that could be scaled up, some of them didn’t make the cut because they were yet to even start,” she added.
Also read: ASHAs, MLPs and betterment of primary healthcare
While Chile Crece Contigo (Chile Grows with You, ChCC) is a comprehensive social protection policy focussed on prenatal period and on children aged 0-4 years, Cambodia’s ID-Poor is a collaborative effort between education, health, agriculture among others to ensure identification of poor households in need. Similarly, Malawi has a toll-free hotline for access to health and nutrition information and Malaysia has subsidised human papillomavirus (HPV) to immunise women against cervical cancer. Sierra Leone’s participatory radio programme has sensitised communities during the Ebola virus while despite instability, Afghanistan has shown progress in access to primary health services.
According to the series, there are four key takeaways. Firstly, as with the universality of the SDGs, multisectoral collaboration has ‘relevance across diverse geographical, economic, social, cultural, and historical contexts and – crucially – the modalities employed are remarkably similar across settings’. “There is knowledge base to share on what works in multisectoral collaborations,” according to the series.
“Also, the case studies show the “dynamic” and “evolving nature” of multisectoral collaboration.”
Thirdly, they aim at disrupting “business as usual” arrangements and replacing them with “intentional, innovative actions” framed in a way that multiple sectors can contribute. And lastly, allowing the projects to scale up can help development partners and governments to learn from each other.
“These 12 are the cornerstone of the theme of this partnership forum. It is what has worked cross-sectoral that has been scaled up in some way to bend the curve of preventable deaths and heighten the well-being,” Fogstad told Delhi Post.
