The Power of Peer-to-Peer Dialogue at the Annual Exemplars World Health Assembly Ministerial Dinner: Dr. Niranjan Bose

At the 77th World Health Assembly (WHA) in Geneva, Switzerland, Exemplars in Global Health (EGH) and the Gates Foundation co-hosted its third annual ministerial dinner. This year, EGH and the Gates Foundation were honored to host nine African countries and leadership from across partner organizations for a dialogue focused on how countries are accelerating progress for maternal, newborn, and child health (MNCH).

Exemplars in Global Health’s Managing Director, Niranjan Bose, PhD, shares his thoughts on the dinner, WHA 2024, and the importance of strengthening health systems to improve outcomes.

Why did EGH want to bring ministries of health together on the topic of maternal, newborn, and child health at WHA?

Bose: Over the last few decades, the world has made incredible progress in protecting the lives of women and children. Millions more women and babies are surviving and thriving after childbirth. Researchers have learned more about the health of mothers and babies over the past 10 years than they did in the century before.

Unfortunately, progress on maternal and newborn health has stalled in recent years. At this year’s WHA, country governments signaled the urgent need to reverse this trend by passing a landmark resolution focused on speeding up progress to reduce maternal, newborn, and child mortality.

With member states making MNCH a priority at WHA, we decided to focus our annual ministerial dinner on the theme of “Strengthening Health Systems to Maximize Life-Saving Innovations for MNCH.”

We know strong health systems and new innovations in health can help us save more lives. Our goal at WHA was to create an opportunity for ministers of health and leaders from their ministries to share and discuss interventions, best practices, and partnerships that are working in their countries to make gains on health systems strengthening and MNCH outcomes.

EGH is built around the belief that learning from countries’ public health successes can help others catalyze progress. That’s why this type of peer-to-peer dialogue led by ministries is at the core of EGH’s mission – and our annual WHA engagement.

What did EGH learn from the countries who participated in the ministerial dialogue?

Bose: We heard from leaders across the African continent, including the Ministers of Health of Nigeria, Senegal, and Mali and representatives from Ghana, The Gambia, Sierra Leone, Ethiopia, Benin, and Liberia.

Despite the unique economic, political, and cultural environment in each country, the message from all was clear: reducing child, newborn, and maternal mortality requires a strong health system, especially a strong primary health care system.

The similarities in their priorities were resounding. We heard repeatedly about strengthening the health workforce, expanding access to care, collecting more and better data, improving women’s empowerment, and introducing innovative MNCH products and tools.

Each leader also delved into unique approaches to MNCH they were implementing.

In many countries, governments are focusing on making the quality health care women and children need more readily available. H.E. Dr. Muhammad Pate, Nigeria’s Minister of Health, shared that the country has “put in resources to provide insurance coverage for women to access skilled birth attendants and to attend the facilities that have comprehensive emergency operations capabilities,” as affordability is a major barrier. In Benin, there is a program to incentivize health care professionals with scholarships to work in underserved areas in the north of the country.

The Minister of Health and Social Action in Senegal, H.E. Dr. Ibrahima Sy, highlighted the impact of programs that offer complementary MNCH services. Senegal has long prioritized family planning, which not only empowers women to make decisions about their reproductive health but saves women’s lives by helping them safely space their pregnancies or wait until they are ready to become pregnant.

Other leaders emphasized investments in sectors beyond health. Dr. Enagnon Pétas Akogbeto, Benin’s Ministry of Health Cabinet Director, and H.E. Dr. Col Assa Badiallo Touré, Mali’s Minister of Health and Social Development, called out the need to invest in girls’ education if countries want to improve maternal and newborn health.

I left the evening feeling inspired by the possibility of so many innovative solutions and the deep commitment to keeping women and children healthy.

Many of the ministries spoke about the importance of strengthening their primary health care (PHC) systems. EGH is soon to publish new research from five countries that stand out because of their success in PHC. Can you share some of the key drivers of success identified in EGH’s analysis?

Bose: During the dinner, it was also heartening to hear ministries reiterate many of the key drivers of success in PHC and maternal and newborn mortality that we’re seeing from EGH’s research on these topics.

From research in Primary Health Care and Neonatal and Maternal Mortality, some common patterns about high performing health systems emerge.

High-performing countries started with strong foundations for financing and governance. This includes reforms to empower local autonomy for planning while maintaining some key functions centrally. Countries then systematically expanded access to care through a variety of means, including access to family planning methods, and key components of maternal and newborn health such as institutional delivery and postnatal care.

Countries built on these reforms to ensure consistent, high-quality service delivery focused on improving performance management, accountability, and quality.

Exemplar countries have also used innovative strategies to reach underserved populations, such as rural, poor, or migrant populations that are typically hard to track through existing routine health systems.

EGH’s country narratives from Peru and Zambia, two Exemplars in Primary Health Care, are available now and research from Rwanda, Ghana, and Bangladesh will be published soon. Four narratives from Exemplar countries in Neonatal and Maternal mortality are available, with narratives from Morocco, Nepal, and Niger publishing later this year.

What was the impact of the ministerial dialogue and how do you hope to continue engaging with ministries of health?

Bose: The dinner facilitated a dialogue about successful approaches to improving MNCH outcomes in different country contexts. Our hope is that the conversation helped countries learn from one another and adapt what’s working in peer countries to inform their own programs and policies.

It was also a chance for leadership from partner organizations such as WHO, PMNCH, UNITAID, WAHO, and USAID to hear what countries are prioritizing. Our aim was for this country-driven dialogue to lead to new collaborations between countries and partners to accelerate progress on women’s, children’s, and newborns’ health.

We also deepened our existing partnerships with Exemplar countries, like Senegal. As an Exemplar in six EGH topic areas, Senegal is a leader in strong political commitment and effective stakeholder coordination. We were honored to meet with our partners from Senegal’s Ministry of Health and Social Action, with whom we are working on multi-topic projects from an anemia prevention strategy to health facility mapping.

Is there anything else you’d like to share about how the World Health Assembly can support Exemplars in Global Health’s mission?

Bose: With Ministries of Health and leaders from multilateral and funding organizations gathering in Geneva, the World Health Assembly is a unique opportunity for countries to share knowledge and build on each other’s public health successes, and for organizations to learn and support health sector priorities. At future WHAs, alongside our partners, we look forward to continuing to highlight the extraordinary successes of positive outliers in health and foster dialogues that better support countries to improve the health of people everywhere.