Strategy for health 2016-2030

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Date
2016-01-01
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UNICEF, new york
Abstract
Tremendous progress in maternal and child health has been achieved over the past two decades. The global under-five mortality rate has dropped 53 per cent since 19901 and global maternal mortality has fallen by 44 per cent over the same time period.2 Despite these achievements, inequities remain both among and within countries. In addition to a continuing communicable disease burden, incidence and prevalence of non-communicable causes of death and disability are unacceptably high in low- and middle-income countries. Furthermore, the contexts in which children live are changing.3 Children in 2030 will live in a world that is older, more urban and more interconnected. With fertility rates dropping and life expectancies rising, children’s share of the world’s population will decline and dependency ratios will increase. At the same time, income growth will shift children into wealthier, but not necessarily healthier, environments. State fragility is also expected to persist in countries that struggle with extreme poverty and weak governance. In addition, emergencies, including public health emergencies and those stemming from environmental causes, are expected to increase in frequency.4 In recognizing these trends and defining a vision for the future, the Sustainable Development Goals (SDGs) include a call to “ensure healthy lives and promote well-being for all at all ages” through ending mortality from conditions covered by the Millennium Development Goals (MDGs), addressing emerging issues such as non-communicable diseases (NCDs) and achieving universal health coverage. To support achievement of these goals, the United Nations Secretary General launched the Every Woman Every Child (EWEC) Global Strategy for Women’s, Children’s and Adolescents’ Health, expanding the focus from the MDG era on ending preventable deaths (“Survive”) to also ensuring health and well-being (“Thrive”) and expanded enabling environments (“Transform”). Guided by the SDGs and the Global Strategy, as well as the Convention on the Rights of the Child (CRC) and the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW),5 UNICEF envisions a world where no child dies from a preventable disease and all children reach their full potential in health and well-being. For the initial five-year period from 2016-2020, UNICEF’s Strategy for Health (hereafter called “the Strategy”) sets two overarching goals: 1 End preventable maternal, newborn and child deaths 2 Promote the health and development of all children To achieve these goals, the Strategy considers the health needs of the child at all life stages. It highlights the need for intensified efforts to address growing inequities in health outcomes, including a particular focus on addressing gender-specific needs and barriers that may determine whether boys and girls are able to reach their full potential in health and well-being. Recognizing the diversity of contexts in which UNICEF operates, the Strategy provides flexibility for UNICEF country offices to tailor their approaches. That said, in all contexts, it emphasizes the importance of multi-sector approaches to enhance child development and address underlying causes and determinants of poor health outcomes. It aims to shift UNICEF from vertical disease programmes to strengthening health systems and building resilience, including calling for better integration of humanitarian and development efforts and encouraging risk-informed programming in all contexts. This means development programmes should anticipate risks and deliberately build systems that can flexibly respond to changing circumstances. In addition, emergency programmes, including for public health emergencies and outbreaks, should be designed to “build back better” or enact reforms that make the health system more effective even after the disaster has passed. In order to increase focus and coherence across health programmes, the Strategy identifies three approaches: l addressing inequities in health outcomes; l strengthening health systems, including emergency preparedness, response and resilience;6 and l promoting integrated, multi-sectoral policies and programmes. These three approaches should underpin all of UNICEF’s programming and engagement in the health sector. It calls on country offices to choose from a bounded set of actions in order to concentrate resources, improve the consistency and quality of its health programmes, and achieve greater impact for children. To reinforce UNICEF’s recognized leadership role in equity, as well as the organization’s potential to design and implement integrated, multi-sector policies and programmes, the actions seek to reinforce UNICEF’s mandate to advocate for the child’s right to health by bringing deep field experience to the policy table at global, regional and national levels. The Strategy also identifies areas where UNICEF should only engage on an exceptional basis, focusing on its comparative advantage and leaving space for other actors to lead, which may bring better results. Finally, the Strategy aims to build on UNICEF’s significant experience and history of action for child survival, while evolving to meet the changing needs of children. This means retaining the emphasis on maternal, newborn and child survival, particularly in lower capacity contexts, while adapting to a shifting disease burden and complex health architecture.
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