Keeping the promise on women and children; The role of Parliaments

1. Keeping the promise on women and children; The role of Parliaments Sylvia Namabidde Ssinabulya MP ,Uganda London,30thNov 2011

2. Parliament has an important role to play in the attainment of MDG 4&5. • This role has been recognized by the Partnership for Maternal, newborn and child health(PMNCH) and together with the Inter Parliamentary Union have been collaborating to highlight this important role.

3. Successive meetings of Parliamentarians on MDG 4 and 5 have been held; London in 2007,Hague 2008 and Kampala 2009. • Successive IPU conferences have also been addressing the roles of members of Parliament • The 118th IPU Assembly in Cape town in 2008 was held in conjunction with the Countdown to 2015 conference to enable Parliamentarians exchange ideas and experiences with a range of stakeholders. • The 120th Assembly in 2009 in Addis Ababa and the 122nd Assembly in 2010 in Bangkok

4. Five core Actions have been identified that Parliaments can take in positioning ,promoting and protecting the health of women and children. These are around the core functions of Parliamentarians.

5. Representation • Advocacy through which policies are shaped • Legislation • Budgeting • Oversight and holding Governments accountable.

6. Representing the voice of women and children • As representatives of the people, it is our job to speak on behalf of women and children, to ensure that their voices are heard and to ensure that their rights and concerns are reflected in national development strategies and Budgets. • We represent the people in dealing with other branches of government and with international and regional bodies • Plans and programmes must be informed by real priorities of the people.

7. Advocating nationally and Internationally • MPs are well positioned to advocate for MDG 4&5. • In Uganda the women’s Network on Maternal Health • Advocacy should be targeted to key ministries • The ministry of Health to ensure that sector budgets and plans adequately reflect the needs of MNCH • Moved a motion for a resolution of Parliament to make maternal health apriority • The ministry of finance, because it plays a pivotal role in the development and implementation of the national budget. • We also Target a range of other stakeholders whose activities impact on MNCH including those that work on;

8. Advocacy cont’d • Those that work on Poverty reduction, Gender and women affairs, rural development, transport • water and Sanitation, • Education, • Agriculture, • Civil society organizations etc ,in Tanzania Parliament works with the Health Equity Group to address issues of health care funding and delivery

9. Legislating to ensure universal access to essential care • We should use our legislative mandate to develop a comprehensive legal framework for MNCH • We should ensure that International treaties and commitments such as CEDAW are integrated into national policies • In June 2009,the UN Human rights council recognized maternal mortality and morbidity as pressing human rights concerns.

10. We must ensure that women and children have access to a full range of health interventions across the continuum of care from pre pregnancy to early childhood and beyond provided by trained health workers in communities and in health facilities. • Legislate to remove financial barriers that limit access to health care and also ensure that there are social protection mechanisms in place that can help address inequities that prevent the most vulnerable people from accessing health care.

11. This has been done through • Reviewing of existing legislation • introduction of Private members Bills • Support to progressive legislation introduced by the executive

12. Zambia and Uganda where there are a number of caucuses that deal with MDG 4&5 • The women’s caucus in both countries was instrumental in the process leading to legislation to protect women during and after pregnancy through provisions in the national employment Act and Labour Act

13. Budgeting for Maternal, newborn and child health • No matter how well laws and policies are designed, they will not be effective if there is no funding to support their implementation. • Press for increases in the Budget for health • In Uganda ,mobilized funding from the World Bank to finance the Roadmap to accelerate reduction of maternal and new born mortality • Create clear budget lines for MNCH ;In Uganda we now have a budget line for Contraceptives

14. Work with government to explore sustainable financing options such as mechanisms to enhance tax revenue collection and other forms of domestic resource mobilization together with social protection

15. Good examples of Vietnam and Rwanda where Parliament passed legislation to remove financial barriers that prevented universal access to healthcare. • Introduced legislation that ensured that health care for children under six would be provided by the government free of charge. • A health care fund for the poor was established in vietnam and later on a National health insurance law was passed in 2008

16. Holding governments to Account for implementing policies and funding for MNCH programmes. • Make governments account for funds put in MNCH programmes, • Making sure that the money improves the health of women and children • Monitor the budget performance • Review policy and programme documentation • Visit programme sites and health facilities

17. Challenges faced by Parliamentarians • Insufficient linkages between Parliamentarians and other representative groups e.g CSOs and local governments • Parliament’s ability to engage in policy making is sometimes constrained by the country’s legislative process.In Uganda for example MPs are restrained from moving Private mebers Bills that put a charge on the consolidated fund

18. Engagement can also be constrained by lack of research and analytical support that is critical in the preparation of laws and analysis of budget documents • Most times discussion of development issues is done between donors and the executive arm of government depriving Parliamentarians of the chance to contribute.

19. The oversight function is affected when Audit reports are received late and when government does not allow sufficient access to information and participation in joint health sector reviews.

20. How can Donors and other International organizations enhance oversight on MNCH • Help MPs to carry out country specific needs assessments to identify the gaps and urgent priorities • Enable us get access to the latest international evidence on issues of MNCH .Members must debate these issues from an informed point of view backed by accurate and timely data. • Provide capacity building on Budget analysis, legislative drafting and analysis, Gender budgeting skills

21. Support MPs to engage the media and also to conduct public hearings • Facilitate benchmarking visits to countries with success stories • Facilitate exchange of information between Parliaments.

22. The role of Men • This is very important • Male MPs are very vital partners • Even in community mobilisation men must be involved • Use men as change agents to support MNCH programmes and give out the messages for Family Planning etc

23. ASANTENI