The ‘Leveraging SSC to scale-up work on maternal and child health’ webinar took place on 10 October 2019. The event was organised by the Community of Practice on South-South Cooperation for Children (CoP-SSC4C), a joint initiative by UNICEF, IPC-IG and the UNOSSC. The webinar showcased experiences from different countries using South-South cooperation and partnerships to share knowledge and technical expertise in maternal and child health and nutrition.
The session was moderated by Dr. Kunihiko Chris Hirabayashi (Regional Adviser, Health and HIV, East Asia and Pacific Regional Office, UNICEF), who was joined by speakers Dr. Cao Yingjie (International Health Exchange & Cooperation Centre, IHECC), Dr. Lily Wang (International Cooperation, Hunan Children's Hospital, China), Ms. Yasmin Wakimoto and Mr. Bruno Magalhães (WFP Centre of Excellence against Hunger, Brazil) and Dr. Alyssa Sharkey (Senior Health Specialist, Health section, UNICEF NYHQ).
Experiences and Solutions from China in delivering technical assistance and capacity for countries in the Global South
China has experienced severe changes on maternal and child health (MCH). The country’s indicators in the field have improved significantly, contributing to the global achievements of the MDGs, being rated as a high-performance country for MCH by the World Health Organization (WHO). On the other hand, the world, specially developing countries, face serious challenges on MCH when taking into consideration the 2030 SDGs goals.
The International Health Exchange & Cooperation Centre (IHECC) is an independent legal institution for private international exchange and cooperation in the field of medicine and health. The Centre has actively participated in the field of MCH, conducting training courses public welfare projects, and foreign aid medical innovation projects of maternal and children’s health. Some of these innovative projects can be seen on table below:
Based on the experiences listed above, the Centre, under the guidance of the National Health Committee (NHC), is currently working on two programmes in partnership with UNICEF:
- Belt and Road MCH training hub project is based on health exchange and cooperation guidance. The project is planned for five years and aims to promote the exchange of skills and experiences in South-South cooperation. It focuses, especially, on the promotion of technical exchanges and sharing of experiences on maternal and child health between China and countries along the Belt and Road. Its objectives are to establish a flagship cooperation and exchange platform, creating a training network to design standardised training courses and curriculum, while strengthening the capacity of the Chinese Partner agencies.
- South-South Cooperation (SSC) Fund for MCH projects is being developed and has not been implemented yet.
The training hub proposed by the Belt and Road MCH project is based around a specific structure for project implementation:
South-South cooperation experiences: Hunan Children’s Hospital
The Hunan Children’s Hospital (HCH) in China has accumulated positive experiences in the field of SSC. The international affairs department of the HCH has released a foreign aid training programme on MCH and pediatrics, working with Chinese doctors and nurses and in cooperation with local institutions on the partner countries. The department is responsible for foreign aid training and projects, and for organising projects with other countries, namely the ‘Children’s Health Collaboration Alliance for Developing Countries’ and the ‘International Academic Research Cooperation Platform’.
Several trainings have already been conducted:
The trainings have been conducted on Asia, Africa and the Pacific. The runs with the most participants have been Sierra Leone, Bangladesh, Zambia, South Sudan, and Sri Lanka, which count with follow-up visits, to monitor the development of alumni.
The course follows a demand-driven design, tailoring the curriculum to ensure that it is relevant to participants and presents pertinent information to their specific country case. At the end of the course, a training effectiveness evaluation is conducted to investigate if the course has been able to prepare professionals to actively transform the health scenario in their countries. Despite the challenges in implementing these steps, mainly in financing, the programme aims to progressively contribute to capacity-building, following a cooperation approach:
School feeding as a platform for health promotion
School feeding programmes can be tailored to become entry points for health interventions. The World Food Programme (WFP) usually perceives school feeding under a multisectoral approach – meaning that these policies not only provide food, but also serve as an umbrella programme, a safety net initiative that can contribute to other sectors:
The World Food Programme (WFP) considers school feeding programmes crucial for the first 8000 days of human development, being able to address children’s hidden hunger and diseases, enabling better eating habits, and promoting health access, using schools as entry points. WFP works mostly on capacity strengthening, considering it key for food assistance connected to health promotion. In this sense, capacity strengthening can provide for institutional development and individual development:
- Institutional development: Refers to policies, legal instruments, and strategies that can organise and address health components within a school feeding program
- Individual development: Training on how we are going to apply and use policies and legal instruments within the school feeding programs – training teachers in topics related to food and nutrition for children
Thusly, by sharing country experiences through South-South cooperation, it is possible to enhance both the governmental capacity and improve nutrition in schools, and possibly in children’s households, as a result of the nutritional education children received in school.
National School Feeding Programme (PNAE): The Brazilian experience
The WFP’s Centre of Excellence against Hunger, created in 2011, provides technical assistance in food nutrition and security, and school feeding, in addition to sharing and promoting the Brazilian experience in the struggle against hunger. In 2003, the Brazilian government launched the ‘Zero Hunger’ strategy, an integrated initiative composed by a series of programmes. The strategy was based around four main axes:
- Access to Food
- Strengthening Smallholder Farming
- Income Generation
- Multisectoral Coordination and Civil Society Participation
Many of the most notorious Brazilian social protection programmes are part of the first axis, such as the conditional cash transfer programme, Bolsa Família, and the National School Feeding Programme (PNAE).
The country’s National School Feeding Programme provides universal coverage, reaching over 42 million children, being designed to function in a nutrition-sensitive approach. This entails in contributing to at least 30% of children’s daily nutritional needs, with plans that are conceived by nutritionists and are adapted to regional eating habits, enabling the consumption of locally produced goods. Additionally, following a homegrown school-feeding model, schools purchase their food from local producers. The programme’s success can be attributed to specific elements, namely:
- Strong legal and policy basis
- Sustainable and continuous financing
- Multisectoral coordination
- Universality and regional sensitivity
- Civil society participation
In this scope, the National School Feeding Programme has contributed to nutrition through three main axes:
National School Meals and Nutrition Strategy: the Kenyan experience
Kenya is a middle-income country and counts with an efficient and well-structured school feeding programme. Part of the programme’s success lies on its legal embedment, and its integration not only with the educational sector, but also with agricultural and health sectors. This school feeding programme is over thirty years old, having been run by the WFP country office until 2009, when a transitional period began, lasting until 2018.
The Kenyan school feeding programme, which is entirely funded by the government, follows the homegrown school meals model, ensuring that the food distributed to children is locally sourced and fresh, contributing to the health and nutrition aspects of the programme. The strategy that structures it was inspired by the Brazilian experience in design and purpose, aiming to promote nutritional education and better eating habits.
South-South cooperation has assisted in updating the programme, mainly in combining healthcare approaches in a field that has been centered around the education sector:
Improved Maternal, Newborn, Child and Adolescent Health in South Asia through South 2 South Collaborative for Health
Despite some recent important achievements in the reduction of child mortality in South Asia, countries in the region still face significant challenges, presenting some of the highest mortality rates in the world, representing one third of all deaths to children globally.
Since 2013, UNICEF’s Regional Office for South Asia (ROSA), supported country-based colleagues to participate in learning opportunities for capacity strengthening around priority topics concerning newborn, child and adolescent health. In 2015 the South 2 South Collaborative for Health was formalised in partnership with Sri Lanka’s country office, focused on knowledge-sharing in health interventions, mainly through trainings and courses.
The aim of the initiative was to address health systems challenges by building on good practices from South Asian countries and enhancing collaboration and exchanges of knowledge among professionals working in the field of maternal, newborn, child and adolescent health (MNCAH).
The South 2 South approach counts with the participation of a variety of institutions to improve learning, strengthen skills, and foster self-reliance in countries by enhancing their ability to find country specific solutions to health problems corresponding to their own aspirations, values and needs.
The webinar was closed with an enriching Q&A session, which can be accessed here.