An Essential Accountability Tool

With a focus on MDGs 4 and 5, Countdown to 2015 set out to promote accountability from governments and development partners by compiling, publishing, and reporting on critical data that indicate country progress — or lack of progress — in providing equitable coverage of effective health interventions and in improving maternal, newborn, and child survival. CD2015 reported on information that is reliable, comparable across countries and time, nationally representative, clear and comprehensible by policy makers and program managers, and available regularly in most Countdown priority countries. Countdown’s reports and country profiles are tools used by all international and country level stakeholders to advocate for action on maternal, newborn, and child health and to hold governments accountable for fulfilling their commitments. To learn more about how Countdown to 2030 helps to monitor progress toward the Sustainable Development Goals, click here.

Countdown and the Continuum of Care

When Countdown began in 2005, its mission was to take stock of, and to hold countries and their partners accountable for, progress in preventing the deaths of newborns and children. In subsequent years, ground-breaking articles and commentaries published in The Lancet and other journals, as well as in WHO’s 2005 report, Make every mother and child count, helped to focus a new level of international attention on the overriding importance of the continuum of care for maternal, newborn, and child health (MNCH). The continuum of care for MNCH is based on a recognition of the tight interlinkages between maternal, newborn and child health and includes two dimensions, time (from pre-pregnancy through pregnancy, childbirth, and the early days and years of life) and location (home, community and health facility).

Countdown’s focus was broadened for its 2008 Report and conference to encompass the MNCH continuum of care, and effective maternal and reproductive health interventions were added to the list of interventions that it tracks. Since then, Countdown’s data, analysis, and messaging have emphasized and highlighted the importance of countries providing and ensuring equitable coverage for essential interventions across the continuum.

CD2015 Guiding Principles

Five guiding principles were established under Countdown to 2015. These principle, slightly evolved, and continue in the work of Countdown to 2030.

1. Focus on coverage of interventions proven to reduce mortality
2. Focus on equity of intervention coverage
3. Build on existing goals and monitoring efforts to accelerate progress toward achievement of the millennium development goals
4. Promote effective interventions
5. Maintain a country and regional orientation

CD2015 Structure and Governance

The governance and management structure of CD2015 was based on a partnership model that sought to optimize:

• Countdown’s ability to deliver on its work plan, which is prepared annually and reviewed by a Steering Committee, and serve a key accountability function at global, regional and national levels including strengthening country capacity to use data to track progress and make course corrections.
• Funding flows that ensure independent operations, keep the transaction costs low, and minimize the burden of “compounding” overheads.
• The research undertaken during CD2015 was conducted by 4 Technical Working Groups TWG) – Coverage, Equity, Health Systems and Policies, and Financial Flows. All of the technical working groups consisted of researchers in partner institutions around the world, which allowed CD2015 to achieve independence from any single institutional agenda.
• The coordination and high quality of the technical outputs through the operations of a Scientific Review Group that oversees and provides guidance to the Profile Development Team and 4 TWG.
• Broad stakeholder input through a Coordinating Committee that included representation from all institutions that review and endorse Countdown to 2015 annual reports and demonstrate support for Countdown’s mission.

CD2015 Key Achievements

Countdown to 2015 was launched in 2005, and was hailed for its substantial contributions to monitoring the progress toward achieving the Millennium Development Goals. At the heart of Countdown to 2015’s work were country-level Countdown profiles, which presented in one place the best and most recent available data to enable an assessment of a country’s progress in expanding coverage across the continuum of care for women’s and children’s health.

These profiles were produced in conjunction with global-level Countdown Reports. CD2015 published seven of these global reports – the final Countdown to 2015 Report was launched at the Global Maternal Newborn Health Conference in Mexico City in October 2015.

Additional key CD2015 achievements were:

• Driving consensus around priority interventions and key coverage and outcome indicators for reproductive, maternal, newborn, and child health (RMNCH)
• Performing pioneering analyses of equity in coverage of essential health interventions, of policy and health system reforms needed at the country level, and of global financial flows for RMNCH
• Taking on a central accountability role for follow-up to the UN Secretary-General’s 2010 Global Strategy for Women’s and Children’s Health
• Partnering with the Inter-Parliamentary Union (IPU) to mobilize and engage Parliamentarians in taking action and demanding accountability for progress on maternal and child health and policy-making at the national level
• Producing a series of more than 60 peer-reviewed scientific publications to disseminate Countdown’s findings to a broad, global medical and scientific audience
• Holding successful international conferences in 2005, 2008, and 2010 that brought together researchers, policy makers, program managers, donors, and advocates from around the world
• Providing technical and financial support for a series of in-depth country case studies focused on high-burden countries, which sought to analyze, understand, and explain how progress was achieved and to strengthen country capacity to analyze evidence for action.