Country leadership: highlights of interviews with the Ministers of Health of Bangladesh, India, Malawi and Nigeria
Bangladesh has consistently and substantially increased its health budget over the past few years, and is scaling up programmes in health and health-enhancing sectors, such as education, gender equality and empowerment, water, sanitation, hygiene and nutrition. For instance, it plans to: increase access to its 18000 primary health-care clinics; increase antenatal and postnatal care coverage; increase the number of “family planning mobile workers”; provide free education, meals and stipends to encourage girls to remain in secondary school; empower women and attain gender parity in the workspace and in politics; increase efforts to lower the current stunting prevalence rate of 38% in children by reaching over 25 million children per year; and ensure no one is left behind by implementing legal reforms, including on child marriage.
India is focusing on improving universal health coverage, with an emphasis on maternal, newborn, child and adolescent health. It has therefore increased its annual health budget by 26%. The Prime Minister of India recently announced the Pradhan Mantri Surakshit Matritva Abhiyan initiative, popularly referred to as “I pledge for 9”. This invites the private sector to provide free antenatal services on the ninth day of every month to pregnant women, especially those living in underserved, semi-urban, poor and rural areas. In three months this initiative reached 3.2 million women.
Malawi has made progress in improving the health and well-being of its women, children and adolescents by combining targeted interventions with a more holistic health system approach. Malawi sees country ownership as a critical driver of sustainable progress. The Ministry of Health is working on a number of initiatives to ensure high-quality outputs and deliverables, and is strengthening government structures to better monitor indicators, including the number of women who give birth, the number of women using contraceptives and survival rates of children.
Nigeria has developed a model for universal health coverage that aims to cater to the needs of everyone, leaving no one behind. The government has defined a package of basic health-care services, including tailored interventions addressing the unique needs of children, adolescents, women and men, regardless of location. These bold aspirations are not without their challenges owing to the sheer volume of need. For example, domestic resource mobilization, community ownership and accountability are needed to improve the health and well-being of women, children and adolescents. In line with this approach, the Ministry of Health is strengthening its engagement with civil society, monitoring and evaluation, quality of care, and data reporting lines, in order to initiate evidence-based programmes at the grassroots level and then implement them nationally.