Assessment of Current Status of SRH/MCH in the EAC Region EAST AFRICAN INTER PARLIAMENTARY FORUM ON HEALTH POPULATION AND DEVELOPMENT 14 TH NOVEMBER 2013

Part 1: Assessment of Current Status of SRH/MCH in the EAC Region Introduction Methodology Outputs from the assessment Part 2: Status of Legislation, Policies and Strategies for SRH/MCH in the EAC Region Overview of SRH/MCH policies & legislation in the Region National political will & commitment for SRH/MCH How political will and commitment manifest Legal framework for SRH/MCH policy implementation SRH policy implementation remains a challenge Factors that hinder policy implementation Recommendations for the Members of Parliament & Policy Makers at the Regional Level, and in Partner States

Introduction The findings to be presented are based on an independent assessment of SRH/MCH issues in the Region to understand progress in – prioritising SRH/MCH issues – improving access to SRH/MCH information and services, – improving SRH/MCH outcomes. The broad objectives of the study were to assess status of: – SRH/MCH policies and legislations – SRH/MCH outcomes – RH Commodity Security

Methodology Review of policies, legislations, programme documents Key informant interviews with stakeholders working in RH/MCH policy development, program design and implementation Secondary data analysis

Outputs from the assessment

Status of Legislation, Policies and Strategies for SRH/MCH in the EAC Region EAST AFRICAN INTER PARLIAMENTARY FORUM ON HEALTH POPULATION AND DEVELOPMENT 14 TH NOVEMBER 2013

Overview of SRH/MCH policies & legislation in the Region Policy and legal frameworks that are relevant to SRH/MCH are – informed by global and local evidence – demonstrate political will and country ownership – provide a framework for implementation of interventions to ensure access to SRH/MCH information, services and products. Strategies and guidelines facilitate implementation of policies at the service delivery level.

are signatories to international protocols which prioritise SRH/MCH and this has been reflected in national development plans and multisectoral policies have costed Road Maps for reducing maternal and neonatal mortality have comprehensive RH policies and strategies – FP, MNCH (incl PMTCT), AYSRH (except Burundi), SRH/HIV (Tanzania in development), SGBV and reproductive tract cancers National political will & commitment for SRH/MCH All Partner States:

How political will and commitment manifest

Legal framework for SRH/MCH policy implementation Legislation review mostly revealed synergies between SRH/MCH policies, with few exceptions Abortion laws are uniformly restrictive – recent changes in Kenya Discrepancy between legislation and policies to prevent early pregnancy Kenya Marriage Bill looking to incorporate women’s empowerment issues

All EAC Partner states have good policies but implementation is weak Not all SRH priorities have guidelines or implementation plans, with the exception of MNCH, HIV and FP. HIV/SRH integration has not been scaled up (except Rwanda) Political support for youth to access SRH needs to be translated into action Poor coordination at subnational levels (Burundi’s national coordination mechanism is new) SRH policy implementation remains a challenge

Factors that hinder policy implementation Unsustained resource allocation Weak health system e.g. number and capacity of human resources Ineffective coordination of stakeholders Inequality in access to services by vulnerable populations Demand-side barriers from clients

Recommendations for the Members of Parliament & Policy Makers at the Regional Level, and in Partner States 1. Establish legal and procedural mechanisms that ensure alignment of SRH programmes at sub-national level (decentralized units) with national priorities and policies. 2. Establish or strengthen accountability mechanisms and procedures on the performance of reproductive health commodity security and SRH programmes that are suited to the mandate of responsible organs. 3. Advocate for increased allocation of resources for SRH and its commodities from both national budgets and external loans and aid. Recommendation 1, 2, 3Recommendation 4, 5 & 6

4. Support and encourage harmonisation of standards and prequalification of RH commodities in the EAC region to reduce costs, delays in delivery & utilisation. 5. Advocate for establishment of tracking mechanisms for SRH resources at sub-national level. 6. Champion and advocate for quality SRH services in their constituencies and participate in educating citizens in order to promote demand and use of SRH services Recommendations for the Members of Parliament & Policy Makers at the Regional Level, and in Partner States Recommendation 1, 2, 3Recommendation 4, 5 & 6

Thank you