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Implementing Canada's commitments under the Muskoka Initiative
Canada has committed $1.1 billion in new funding between 2010 and 2015 under the Muskoka Initiative, and will maintain existing program spending on maternal, newborn and child health at $1.75 billion over five years – for a total contribution of $2.85 billion. As of September 2011, the Government of Canada has announced almost $800 million in Muskoka Initiative funding for 51 projects in 26 countries in Africa, the Americas and Asia.
Canada places accountability at the core of its international development efforts and has worked closely with its partners to develop a framework to measure progress, track results and ensure that funding helps partner countries achieve a sustainable reduction in maternal and child mortality rates. In May 2011, the United Nations Commission on Information and Accountability for Women’s and Children’s Health – co-chaired by Prime Minister Harper and President Jakaya Kikwete of Tanzania – released an advance copy of the report entitled Keeping Promises, Measuring Results, which made 10 recommendations for practical measures to better the lives of women and children in developing countries.
Since the launch of the Muskoka Initiative in June 2010, Canada has taken decisive actions with its maternal, newborn and child health partners to achieve sustainable and meaningful results for mothers and children in developing countries. The Government of Canada is now delivering programs under the Muskoka Initiative in 10 partner countries with high maternal and child mortality. Projects in Afghanistan, Bangladesh, Ethiopia, Haiti, Malawi, Mali, Mozambique, Nigeria, Southern Sudan and Tanzania focus on improving community health care services, reducing the burden of illnesses and diseases among women and children and improving nutrition.
Afghanistan
Working with the World Bank, Canada is supporting Afghanistan's Ministry of Public Health in delivering basic health services. The work focuses on increasing access to and use of health services for women and children in underserved areas. It will train community health practitioners; pay for supplies, equipment and other costs associated with running health care facilities; strengthen the Ministry’s ability to manage, monitor and evaluate the national health system; and improve the referral system between community care and hospital care.
Under the Muskoka Initiative, Canada is contributing $15 million from 2011 to 2014 to this project.
Bangladesh
New programming in Bangladesh contributes to the Joint Government of Bangladesh-UN Maternal and Neonatal Health Initiatives that are working to increase the quality and quantity of health services for mothers and newborn children.
Working at the local level in districts and communities, Canadian assistance will focus on poor and marginalized populations to provide training and information for mothers about harmful health practices and the need to use and demand better services; technical assistance and support to improve local level planning to develop better services; and training to improve the skills of doctors, nurses and other community-based health personnel.
Canada’s Muskoka Initiative is contributing $20 million from 2011-2016.
Ethiopia
Canada’s programming in Ethiopia builds on its longstanding support to the Ethiopian government’s efforts to forge a better future by improving the health and nutrition of mothers and their children, as well as food security.
Working with UNICEF, Canada will improve the nutrition and health of 3 million pregnant and nursing women and their children in Ethiopia. Funding will help train and equip more than 4,000 community health care workers so that they can screen and treat malnutrition in children and provide supplements such as Vitamin A and iron, which are essential to the health of children and mothers. Efforts will also help caregivers provide their children with the right foods at the right time and ensure access to clean water for 125,000 people.
Canada is contributing $50 million from 2011 to 2016 to maternal, newborn and child health work in Ethiopia.
Haiti
Haiti is the poorest country in the Americas. Canada’s investment in the country will improve health services and increase access to lifesaving health care for mothers and children. Canadian support will also allow the government of Haiti to rebuild basic infrastructure that was destroyed or damaged in the 2010 earthquake, as well as to build new health infrastructure.
Canada is supporting an innovative Pan-American Health Organization project that provides free basic health services to 3 million people, including women, newborns and children under the age of five. The project will run for 18 months between 2011 and 2012.
Canada is working with the United Nations Population Fund to reconstruct Haiti’s National School of Midwifery and 10 new maternity clinics. The two year project (2011-2013) will offer a full range of maternal and neonatal services, such as basic emergency obstetrical and neonatal care, family planning, the prevention and testing of HIV/AIDS, and services for the victims of sexual violence.
Canada has also increased its commitment to the construction of the new tier II Hôpital de la Providence in Gonaives by adding a 30-bed maternity ward, a 35-bed pediatric ward, and a waiting home for pregnant women. The project has begun, and the construction is expected to take place over the next two years, as part of a larger commitment from 2011 to 2014.
Canada is also supporting the Centre de coopération internationale en santé et développements in improving maternal, newborn and child health services in Artibonite by rehabilitating infrastructure and equipping and training staff at nine maternity clinics and seven community health centres. The project will run over five years from 2011 to 2016.
Canada is contributing $50 million over five years to these new projects in Haiti, $40 million of which originates from new funding under the Muskoka Initiative.
Mali
Canada’s investment will help reduce maternal, newborn, and child mortality, prevent and address diseases affecting maternal and child health, and improve the nutrition of mothers and children by 2016, including:
- 80 percent of the villages within four districts will have established a sustainable transport strategy to extend the referral/evacuation system for pregnant women and newborns to the village level;
- 179,600 malnourished and at-risk children will benefit from the food aid for nutritional recovery project; and,
- 238 health care workers and 400 women’s groups and community liaison workers will be trained in the detection of malnutrition.
Canada is providing $94 million from 2010-2015. Of that total, $77 million stems from the Muskoka Initiative commitment and the remainder is from ongoing CIDA health funding to Mali.
Mozambique
Canada has a longstanding commitment in support of the Mozambique government’s efforts to build a better future for children and youth. New programming in Mozambique is aligned with the country’s National Integrated Plan for Achieving the Millennium Development Goals 4 and 5. It will address the leading causes of maternal, newborn, and under-five child mortality by providing mothers and children with access to comprehensive and integrated health services. By supporting the National Integrated Plan, Canada will help Mozambique:
- improve and upgrade access to local health centres;
- ensure sufficient supplies of essential medicines;
- train health care workers;
- increase programs to prevent and treat infectious diseases; and,
- improve nutrition along a continuum of care, from pre-pregnancy, through pregnancy, childbirth, and the early days and years of life.
By 2015, Canada’s funding is expected to help the Mozambique Ministry of Health deliver lifesaving HIV treatment to 38,000 young children, and treat 94,000 pregnant women in order to prevent new HIV infections in their children.
Canadian aid helped UNICEF conduct a national vaccination campaign in May-June 2011, as part of national public health efforts in collaboration with the Mozambique Ministry of Health. The campaign provided the measles vaccine to 2.8 million children and a dose of Vitamin A and de-worming tablets to over 3 million children.
Under the Muskoka Initiative, Canada is contributing over $128.1 million between 2010 and 2015 in support of maternal, newborn, and child health Initiatives in Mozambique.
Nigeria
Through a new program in support of the Muskoka Initiative, Canada will:
- help the Nigerian government provide universal coverage of integrated maternal, newborn, and child health services at the community level;
- help increase the capacity of doctors, nurses, midwives, and community health extension workers to deliver high-impact and cost-effective maternal and child health interventions; and,
- help increase women’s ability to ask for quality gender-sensitive primary health care services.
Canada’s Muskoka Initiative contribution to Nigeria is $21 million from 2011-2015.
South Sudan
With Canada’s support, through its first Muskoka Initiative project in South Sudan, 24-hour comprehensive emergency obstetric and neonatal care hospitals will be established in at least eight hospitals, benefitting approximately 150,000 women and children.
Canada is contributing $19.4 million from the Muskoka Initiative over five years, beginning in 2011.
Tanzania
Canada will provide support to the Government of Tanzania to immunize 24 million children and pregnant women, provide 4 million women with antenatal and delivery care, help protect 2 million pregnant women from malaria, and reach a further 300,000 pregnant women to prevent mother-to-child transmission of HIV. Canada’s contribution will also support improvements in infrastructure, equipment and training related to prenatal, delivery and postnatal care. This includes providing greater access to upgraded health centers, training health care workers in emergency obstetrics, maternal, newborn and child health and nutrition projects and providing greater access to family planning and vaccinations.
Canada’s Muskoka Initiative contribution is $122.6 million between 2011 and 2015 to achieve these goals.
Partnership with Canadians
Muskoka Initiative Partnership Program—Canada has been a leader in drawing global attention to maternal, newborn, and child health issues. As part of that leadership, the Government of Canada is working to mobilize Canadian partners to make a difference. Under the Muskoka Initiative Partnership Program, projects from Canadian organizations will be undertaken to achieve concrete development results that will reduce maternal, newborn, and child mortality over the next five years. Twenty-eight projects approved in 2011 will focus on at least one of the three key paths: strengthening health services at the community level, improving nutrition, and reducing leading diseases and illnesses.
Canada has committed $82 million ($75 million under the Muskoka Initiative and $7 million from ongoing CIDA funding) between 2010 and 2015 to the Muskoka Initiative Partnership Program.
Multilateral Projects
Canada is also committed to programs with multilateral partners, allowing projects and interventions to reach beyond the 10 identified partner countries, where there is the potential of delivering global results.
Renewed Efforts Against Child Hunger (REACH) — This project will help reduce child hunger and under-nutrition: it specifically targets the 1,000-day window of opportunity (pregnancy to age two), after which the effects of under-nutrition are largely irreversible. As part of the Scaling-Up Nutrition global movement, REACH will build government and national capacity to effectively increase nutrition interventions, improve health and reduce mortality rates of the most disadvantaged women and children. It will work through multiple sectors, linking child under-nutrition, food security and health care. Over the next three years, there will be a substantial increase in the delivery of basic nutrition services in select countries. This could avert an estimated 2 million cases of anemia and associated complications in pregnant women, prevent approximately 225,000 deaths due to severe malnutrition, and, over the longer term, reduce stunting in an estimated 2 to 3.5 million children under the age of three.
REACH is a United Nations interagency team, jointly established by the World Food Programme (WFP), the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO) and the Food and Agriculture Organization (FAO).
Canada’s Muskoka Initiative contribution is $15 million between 2011 and 2014.
The GAVI Alliance — The GAVI Alliance is working to distribute new and underused vaccines. With contributions from Canada and other donors, the GAVI Alliance is working to immunize 250 million children thereby preventing four million deaths; accelerate action against the two biggest killers of children, pneumonia and diarrhea, through accelerating the introduction of the necessary vaccines (pneumococcal and rotavirus vaccines); and control deadly meningitis epidemics through the introduction of a new vaccine against meningitis A in countries in the sub-Saharan African Meningitis Belt.
Canada is providing $65 million in new funding between 2011 and 2016. Of that total, $50 million originates from the Muskoka Initiative commitment and the remainder is from ongoing CIDA health funding.
The Global Fund to Fight AIDS, Tuberculosis and Malaria — The Global Fund is an international financing mechanism that supports developing country-led, large-scale prevention, treatment and care programs for AIDS, tuberculosis and malaria. Since its inception in 2002, the Global Fund is estimated to have saved 6.5 million lives, most notably through the delivery of HIV treatment to 3 million people, the treatment of 7.7 million people for tuberculosis, and the provision of 160 million bed-nets to prevent malaria.
Canada recently increased its three-year pledge to the Global Fund from $450 million to $540 million in the coming three years, between 2011 and 2013. Of the $90 million increase, 46 percent ($41.4 million) will help achieve the goals of the Muskoka Initiative.
Health 4 Initiative — The Health 4 (H4) Initiative is a collaborative mechanism established by the United Nations Population Fund (UNFPA), UNICEF, the World Health Organization (WHO) and the World Bank to improve coordinated support to national maternal and newborn health programs. In addition to its work with H4 members in the targeted countries, the Government of Canada provided funding to the H4 Initiative to support joint work among member agencies to scale up quality health services. The projects will conduct needs assessments to identify the bottlenecks that prevent improvement of maternal and newborn health in developing countries and recommend how to reduce the barriers.
The H4 Initiative works with developing country governments to support development of performance-based, costed national reproductive, maternal, newborn and child health plans. It addresses the urgent need for skilled health workers and removes financial barriers to health care service access for the poorest people. As part of this initiative, the H4 will tackle the root causes of maternal mortality and morbidity, as well as strengthen monitoring and evaluation systems informing countries and donors of what is working and assess the impact of their shared effort.
Canada’s contribution to the H4 Initiative is $50 million between 2011 and 2016.
The Micronutrient Initiative — The Micronutrient Initiative delivers essential life-saving vitamins and minerals to women and children globally. Through Canada’s contribution, the Micronutrient Initiative will deliver Vitamin A to 8 million children annually in sub-Saharan African countries and save the lives of 150,000 children over the next five years; distribute iron and folic acid supplements to 3.8 million pregnant women, avoiding anemia at term for 500,000 of them; provide community-based treatment of severe acute malnutrition to 200,000 children annually by 2015; and, prevent an estimated 17,000 maternal and newborn deaths through integrated health and nutritional interventions.
Canada has committed $75 million over the period of 2011 to 2015 towards the work of the Micronutrient Initiative.
Building on Strong Foundations: The Government of Canada’s Ongoing Commitment to Mothers and Children
As part of the Muskoka Initiative, Canada committed to maintaining its current levels of funding for maternal, newborn and child health. This amounts to $1.75 billion over the five years between 2010 and 2015. With approximately $350 million in ongoing MNCH spending in 2009-2010, Canada’s assistance has helped:- provide a full set of vaccinations to over 80 percent of children in targeted rural areas of Bolivia;
- provide 71 percent of pregnant women in targeted rural areas of Bolivia with at least four prenatal consultations (up from percent in 2008);
- establish, with the government of Mali, community health care centers in rural areas and increase by 58 percent the proportion of people living within five kilometers of a functional centre; and
- raise the vaccination rate in Ethiopia against diphtheria, whooping cough and tetanus to 82 percent of all children, as compared to 73 percent in 2008.
Canada is delivering on its 2006 commitment of $450 million over 10 years to the Africa Health Systems Initiative (AHSI), which supports country-led efforts to strengthen health systems across the continent.
Through the AHSI, the Government of Canada works in several African countries including Mali, Mozambique, Tanzania and Zambia, to support the implementation of their national health sector strategic plans. The AHSI focuses on helping to mobilize and deploy additional African health care workers to expand the reach of basic health care services to the most vulnerable.
A key part of the AHSI is the Canadian-led Catalytic Initiative to Save a Million Lives (CI), a multi-donor initiative launched by Prime Minister Harper in 2007. To date, Canada’s contribution to the CI has resulted in:
- more than 20,000 front-line health workers trained to provide essential life-saving health care services to pregnant women and children under five in vulnerable, hard-to-reach communities in select sub-Saharan African countries;
- over 890,000 long-lasting insecticide-treated bed nets distributed to pregnant women and children under five in Mozambique;
- over 120,000 treatments for malaria being delivered to children in Ghana; and,
- the distribution to health posts of over 9,000 packages of high impact interventions for children and pregnant women in Ethiopia.
