ALLIANCES AND PARTNERSHIP MOBILIZEDFOR CHILD HEALTH AND DEVELOPMENT

IV WORKSHOP ON CHILD DEVELOPMENTM.C. SOUTO VIDIGAL FOUNDATION

Dra Matilde MaddalenoCoordinator

Healthy Life Course

PAHO as a Specialized Agency of the UN and Inter–American System

RegionalOffice of theWorld HealthOrganization

SpecializedAgency of the

Organization ofAmerican States

UN SystemPAHOPAHOInter-AmericanSystem

To lead strategic collaborative efforts among

Member States and other partners to

promote equity in health, to combat disease,

and to improve the quality of, and lengthen,

the lives of the peoples of the Americas .

MISSION

PAHO’s StructurePAN AMERICAN SANITARY CONFERENCE

•PAHO’s maximum authority

•All Member States are represented

•Meets every five years

•Elects the Director

•Sets overall strategy and policy for the Organization( NEW STRATEGY FOR CHILD HEALTH AND DEVELOPMENT 2011)

DIRECTING COUNCIL

•Meets each year when there is no Conference

•All Member States are represented

•Approves programs and budgets

EXECUTIVE COMMITTEE

•Prepares the agendas, documents, and resolutions for the Conference and the Council

PAN AMERICAN SANITARY BUREAU

•Secretariat

Headquarters

Country OfficesCenters

CFNI

CAREC

PANAFTOSABIREME

CLAPINPPAZ

CEPIS

INCAP

Presence of PAHO in the Region

** Technical representative

Journey is Based on Our Core Commitments

Special Populations

Key

Countries

PAHO

Vision

Equity

Pan-

Americanism

Technical

Priorities

We are an organization with

• A vision of health in the Americas

• Values of Equity and Pan-Americanism

• A triple focus on • Key Countries• Special Populations• Technical Priorities

We Are Not Alone On Our Journey…

Our integration with WHO has strengthened, and coordination has increased

WorldHealth

Organization

NGO’s

OAS

Bi/Multi-Laterals

Foundations/ Private sector

Special Populations

Key

Countries

PAHO

Vision

Equity

Pan-

Americanism

Technical

Priorities

PAHO CHILD HEALTH AND DEVELOPMENT

Child Health in LAC• 350,000 children die before the age of 5

• Under 5:– 44% of deaths are due to infectious diseases

– 16% suffer from chronic malnutrition

– 29% suffer from anemia

– In 40% of the municipalities, only 5% under the age of 1 are DTP3 vaccinated

Child Health and Development on the Global Agenda

• CHD LESS VISIBLE

• Diminishment of allocation of financial resources

• Effective low cost interventions community and family level are not delivered or with low coverage

• Need for coordination, greater attention, increase of resources, community outreach

Strategic Alliances in Child Health and Development

ECD - An Integrated Scientific Framework Could Drive More Effective Investment

and Innovation Across Sectors

Education

Health

Economic Development

Child Protection

Science

ECD- Multiple Sources of Knowledge Currently Inform Policies in Poorly

Connected Sectors

Education

Economic Development

Child Protection

Health

Science &Experience

Science &Experience

Science &Experience

Science &Experience

Challenges ECD for the Health Sector

• New paradigm

• From child survival to child development

• Social determinants and quality of life

• Multi- professional

• Inter sectorial

• Trans- disciplines

• Comprehensive-Integrated Policies

• Family and life course approach

• Community participation

• New model of health services deliever

• Trained Human resources

Health

Importance of Strategic Alliances for ECD

“ Strategic alliances have the potential to accelerate the development, deployment, and sustainable delivery of tools and technologies that will ( PROMOTE HEALTH AND DEVELOPMENT?) , save lives and dramatically reduce the disease burden in the world”

~Bill and Melinda Gates

Strategic Alliances for ECD

• 2 or more organization come together and mutually pool their resources and ideas for long-term purpose/goal

• Comprised of two components:

– Strategy

– Relationship

Components for Building an ECD Strategic Alliance

Private

Joint Strategy

Establishment of Roles and Responsibilities

Resources/ Ideas

Governmental Public

Long Term Goals

Resources/ Ideas

Interactions of Alliances

Inconsistent use of terms:

• Cooperation

• Coordination

• Collaboration

Interactions of Alliances

Cooperation : fully autonomous entities share information to support each other’s organizational activities (UN and partners, ECD networks, )

Interactions of Alliances

• Coordination : autonomous groups align activities, sponsor particular events, or deliver targeted services in pursuit of compatible goals.

• Harvard University , ALAS Foundation, ECD Networks, PAHO/WHO.

Interactions of Alliances

• Collaboration parties work collectively through common strategies. Each relinquishes some degree of autonomy toward the realization of a jointly determined purpose.

• ECD PROJECTS CHILE CRECE CONTIGO, MEXICO, COLOMBIA

• GLOBAL (The Global Alliance for Vaccines and Immunizations GAVI

Components for Building a Strategic Alliance

Governmental Public

Long Term Goals

Private

Joint Strategy

Establishment of Roles and Responsibilities

Resources/ Ideas Resources/ IdeasCooperation

Coordination

Collaboration

Keys to Building Successful Strategic Alliances / PAHO

• Clearly define goals and objectives

• Allocate sufficient resources

• Define accountability

• Monitor progress through regular reporting

• Management of Alliances needs

Advantages Strategic Alliances

• Prevent duplication of activities and investment, contain costs AND MORE EFFECTIVE USE OF PUBLIC RESOURCES

• Greater than the sum of their parts• Secure critical resources ( human and

capital)• Strengthen position in governments

But……

• Coordination and collaboration increases the costs of the information systems

• Sectors have been programmed to compete for limited resources and funds

• Decision process more difficult

Challenges to ECD Strategic Alliances

Objectives: challenging and long-term in nature

Span national borders

Decision-making

Managing risk and relationships

Expectations

Pooling Resources

Commitment v. Control

Multiple partners

ECD Strategic Alliance

CHALLENGES ECD COLLABORATION

• Differing goals and understanding of the problem

• Stakeholders often focus on only a few influences that contributes to ECD

• Multiple personal and environmental factors• Multiple ecological level interventions• Social determinants have different areas of

policy action and related actors.• Requires flexibility of stakeholders organizations

and those who fund them• Monitoring and evaluation

Construcción de un sistema de protección social que establece garantías sociales para las condiciones básicas esenciales pa ra el desarrollo humano

Sistema Integral de Protección Social

SOME LESSONS LEARNEDSOME LESSONS LEARNED

Vivienda Social

Educación Chile

Solidario

Seguridad Social

Acceso universal a

la salud:Profundizar la Reforma

Código Trabajo

Salud de los Trabajadores

Reforma sistema

previsional

Subsidios sociales

Protección del Adulto Mayor

Protección de Infancia

Mejoras laborales: subsidios para

jóvenes, subcontratos

200 Barrios: Política de Vivienda

y Urbanismo

Lessons Learned Chile Crece Contigo

Share a conceptual framework ( social determinants, equity andhuman’s right )

One image – different ministries and ministers.

Strategic planning based on rights and guarantees over supply side of theprogram.

One fund and several implementers.

Population approach with emphasis in most vulnerable.

Strong support for local implementation

Leadership and political support of Dra. Michelle Bachelet President ofChile

Public recognition

Lessons Learned…….• Flexibility of different actors

• Better use of available public and private resources.

• Community participation in the management, deliver andmonitoring of the system.

• Result based management to improve development of childrenbased in

� Standards for universal and comprehensive Development

� Quality assurance of programs and interventions

� Monitoring and evaluation of processes and results

� Accountability .

IM, MCH 2010

EVOLVING MODEL OF CHILDREN’S HEALTH AND DEVELOPMENT . KALEIDOSCOPEMODEL

NEW PARADIGM preconceptional stage

“ Every Child Wanted in the Americas”

IM, MCH 2010

EVOLVING MODEL OF CHILDREN’S HEALTH AMD DEVELOPMENT. KALEIDOSCOPE MODEL

EVOLVING MODEL CHD

• INFLUENCES OVERLAP AND INTERACT

• INFLUENCES CHANGE OVER TIME• HEALTH AND DEVELOPMENT

RESULTS FROM A DYNAMIC INTERACTION OF DIFFERENT FACTORS

• REPRESENTED BY A KALEIDOSCOPE• CRITICAL AND SENSITIVE PERIODS • LONGITUDINAL APPROACH. NEW

INFORMATION SYSTEM

Gestación

DELIVERY NEONATAL

Programa de Apoyo al Desarrollo Biopsicosocial

Nacimiento

SERVICES TO CHILDHOOD

DURING PREGNANCY

Primeros 4 años de vida

LIFE COURSE APPROACH AND CHD

LIFE COURSE

PRECONCEPTIONAL

NEXT STEPS PAHO�NEW STRATEGY AND PLAN OF ACTION FOR

CHILD HEALTH AND DEVELOPMENT�STRATEGIC ALLIANCES FOR COLLABORATION

WITH UNICEF AND UNFPA �SUPPORT COUNTRY EFFORTS IN ECD

( HEALTH COMPONENT) 0-3 YEARS