INTRODUCTION
The Partnership for Maternal, Newborn & Child Health is a new global health partnership, launched in Delhi in September 2005 to accelerate efforts towards achieving Millennium Development Goals (MDGs) 4 and 5. This new partnership is the result of a merger of three existing partnerships: the Partnership for Safe Motherhood and Newborn Health (2003 by WHO), the Child Survival Partnership (2004 by UNICEF NY) and the Healthy Newborn Partnership (2000 by SCF USA). This was as a result of various recommendations and reports, including the World health report 2005. Also the report of the UN Millennium task Force on Child and maternal health, the Lancet Neonatal Survival series (April 2005).

The Partnership aim is to intensify and harmonize national, regional and global action to improve maternal, newborn and child health. Among expected benefits of the partnership are to bring maternal, newborn and child health together-under the continuum of care and services; accelerate action at all levels-via involvement of all stakeholders at all levels and promote accountability through optimal support in monitoring and evaluation by the Partnership.

The Partnership
·         joins together the maternal, newborn and child health communities, encouraging unified and effective approaches that promise greater progress than in the past.
·         is made up of a broad constituency of more than 80 members representing partner countries, UN and multilateral agencies, nongovernmental organizations including faith based, health professional associations, bilateral donors and foundations, and academic and research institutions.
·         Provides a forum through which members can combine their strengths and implement solutions that no one partner could achieve alone.
·         supports country-led efforts towards universal coverage of essential interventions for maternal, newborn and child health.
CONCEPTUAL FRAMEWORK
The concept of the continuum of care has two dimensions
1.  The Dimension of Time linking across the times of care giving
Connecting care giving across the Continuum for maternal, newborn and child health-linking across the care giving from adolescence and pre-pregnancy-pregnancy-birth-postpartum (maternal health) and postnatal (neonatal &infancy -infancy-childhood.
2.  Place-between homes, the community and health facilities with linkages between various levels (outreach services)
Promoting health home based practices, promoting demand for quality services and care seeking behaviors at the family level, increasing access to quality health care services at both primary and referral levels. Promotion of interventions that empower women, families and communities so that there is shared responsibility for pregnancy and child birth and care.
The partnership aim is to achieve universal coverage of interventions throughout the continuum of care reflecting cross cutting issues-gender, human rights, education, nutrition, family planning, access to affordable-safe services. This ensures that all components of the health systems are addressed. Certain principles will govern interventions as follows:
·         Priority will be in high mortality countries and at the time of pregnancy, delivery and infancy.
·         There is common understanding that there is no single intervention that can address the problems of MNCH
·         Focus for intervention will be national level
·         Each national programme should be tailored to the needs and realities of national and sub-national settings, employing a rational mix of quality health facility and outreach interventions, and aim at scaling up.
The concept of Continuum of care will also address the broader context and contributing factors such as socio-cultural and economic issues that influence the health factors. These include issues around gender equity and women empowerment, education status, employment and incomes, access to basic services, legal and judicial systems; to be addressed mostly through linkages to such relevant programmes.
GOALS AND PRIORITIES OF THE PARTNERSHIP
The major goal of the partnership is to enable nations achieve the MDG 4 &5.
The priorities are expressed in areas around which the partnership has formed 4 groups which support countries:
·         Country Support - actively promoting improved partner coordination in countries and supporting the creation, implementation and evaluation of a single national plan.
·         Advocacy raising the profile of maternal, newborn and child health on political agendas and advocating for increased resources - financial and other.
·         Effective interventions promoting the assessment, scaling up, and delivery of evidence-based, cost-effective interventions, with a focus on reducing inequities in access to care.
·         Accountability through strengthened Monitoring and evaluation assessing progress by holding stakeholders at all levels accountable in meeting their financial and policy commitments.
GOVERNANCE OF THE PARTNERSHIP
The partnership is an alliance of all stakeholders-governments, UN agencies, bilateral organizations, international organizations, donors foundations, civil society, academia, etc, of those committed to support the partnership in any way on the short or long term. IBFAN is among the 80 members currently registered, while the criteria for membership are being finalized.
The partnership will be coordinated from Geneva by a secretariat under Dr. Francisco Songane. The secretariat is supported by a steering committee of about 20 people formed by representatives (senior advisors) of the 4 working groups. Steering Committee members serve on a 2-year rotation basis (with the option to be re-elected for a second term). Then there are the 4 working groups with core 20 persons each. In all these, a balance is maintained between the different continuum elements and the constituency members (donor countries, partner countries, academia, civil society, Prof Associations, multilateral organizations) as well as geographical distribution. Membership of the partnership is open but will be further specified by the Steering Committee, but the criteria will include commitment to the partnership and be active in at least one area of the partnership.
IBFAN as a member currently belongs to the NGO constituency and the COUNTRY SUPPORT working group. Other constituencies were represented in most of the working groups because they had more members participating. For instance the working groups for advocacy and effective interventions would also have been very relevant to us. It was unfortunate that we did not have other IBFANers at the meeting apart from the organizers in Tanzania who did not have time to sit in the WG or constituency group work. Groups such as The White Ribbon had people in all groups. At the global level, all members have the right to be informed and be involved in working group activities but this is done by invitation of the steering committee or by the chair of the working group.
At the national level, members are co-opted by the national leadership.
We were informed that the Partnership is not a Fund. All funding will be directed to countries from the donors after recommendations from the Steering Committee of the Partnership. The focal point for the work of the working groups is mostly governments at the country level. Support to countries will be directed through the 4 technical working groups based on country demands.
OBJECTIVES OF THE TANZANIA FORUM
The Forum serves a regular annual global platform for the Partnership, for the renewal of commitment, global high level advocacy and an opportunity for achieving broader consensus on issues. The Tanzania Forum was of a similar nature. Its major objectives were to:

• update all stakeholders and bring them up to date with the happenings since 2005.
• finalise and endorse TOR for the different constituencies and the 4 Technical Working Groups, and
• endorse the 10 year plan.

All of these documents will be finalized by the Secretariat and the Steering Committee; and be shared with members at large, as well as be posted on the Partnership website.
Highlights of the Forum
1. General proceedings
About 300 delegate members gathered from around the world to attend the Partners’ Forum in Dar es Salaam, Tanzania from 17-20 April, 2007. This was the first-ever assembly of The Partnership for Maternal, Newborn & Child Health which was hosted by the government of Tanzania.
Among the dignitaries that opened the forum were: His Excellency Edward Lowassa- Tanzania Prime Minister who represented the President of the Republic, Ministers of Health from Mozambique, Malawi and Tanzania; Mr. Kul Gautan-Deputy Executive Director of UNICEF, Ms. Daisy Mafubela-Assistant Director General of the WHO, Dr. Francisco Songane-Director of the Partnership (WHO), Dr. Tore Godal-special Advisor to the Prime Minister of Norway who also pledged for support to Tanzania, Nigeria, Pakistan and India; Dr. Getrude Mongella, -President of the Africa Union Parliament and Goodwill Ambassador for the Partnership, and the UN Resident Representative- Oscar Fernandez Taranco. Fortunately this time the meeting was not graced by representatives of the private sector.
Some highlights of the Forum included: the opening ceremony, where the Prime Minister of Tanzania, the Rt Hon. Edward Lowassa called on other governments to give a greater priority to health and MNCH issues; the unveiling of The Partnership’s Ten-Year Strategy and governance discussions which brought the six constituency groups and four working groups together face-to-face for the first time; discussions and presentations from several countries on The Partnership’s role in countries; the presentation of a plan initiated by the Prime Minister of Norway, the Rt. Hon. Jens Stoltenberg — Global Business Plan to increase global awareness and commitment to MDGs 4&5. Tanzania also launched its MNCH initiatives.
On the first day there was a good overview of The Partnership, coupled with an overview of the Ten year strategy and the Conceptual Institutional framework. This was followed by the work of the Working groups and different constituencies.
2. Constituency issues
Some of the issues and challenges identified by the members of the Constituency groups (also in the website):

• Clarification of the role of regional bodies with The Partnership;
• Open up greater advocacy opportunities to NGO’s in the south;
• The need to build more alliances;
• The need to create a database for the sharing of information across and within constituency groups;
• Focus attention on how to strengthen health systems in general.

Some of the main themes repeated during the discussions included:
Continuum of care: The need to integrate health care services directed at mothers and their vulnerable children and babies, and to advocate for the delivery of quality health care services throughout the life-cycle. To ensure sustainability, maternal, newborn, and child health needs be better integrated into primary health care strategies.
Harmonization and coordination of efforts: The development of one message and clearly defined action plans to avoid the duplication of efforts in the field.
Increased funding for maternal, newborn and child health: Despite increased funding for health recently, maternal, newborn and child health is still grossly under-funded and a central objective of the Partnership must be to raise awareness of and political commitment to improving global maternal, newborn, and child health.
Creating greater demand for services: Strides in generating a paradigm shift at the community level from acceptance of high rates of maternal and newborn deaths as normal to intolerance need to be made.
Human resources training and management: The need to train and retain health care workers.
3. Some details of the NGO Constituency
Co-Chairs: Anne Tinker (Save the Children USA), Ann Starrs (Family Care
International)
Rapporteur: Afsana Kaosar (BRAC Bangladesh
These will also serve on the Steering Committee.
Three major issues became contentious.

• Consensual agreement on a transparent voting process for the 4th open NGO position on the Steering Committee to be reflected in a revised ToR (agenda item #3). (full report on website)
  

-In relation to the criteria for the 4th NGO position on the Steering Committee, the following conclusions were reached:
a. The Criteria for Nomination: The individual nominated must be either, i.) Based in an NGO in Sub-Saharan Africa (including regional Sub-Saharan African NGOs) or, ii.) From an international NGO with multi-country presence in Sub-Saharan Africa.
b. The Election Process: Nominations will be solicited and submitted electronically. The nominations must include a brief profile of the candidate stating the candidate qualifications for serving on the Steering Committee. This profile must also contain a description of the candidate institutional affiliation.
Action: The nomination and election process will be completed via an electronic email-based process (based on the participant list) within two months of the Forum (by June 20th).
In order to maintain institutional memory on the Steering Committee, only 2 of the 4 NGO representatives on the Steering Committee will rotate off at a time. Steering Committee membership (and membership in The Partnership) is considered organizational, meaning that members represent their
respective institutions and constituencies (and must specify when they are contributing personal views to discussions). Anne Tinker also clarified that the NGO representative on the Steering Committee is required to donate 5-10% of his/her work time to Steering. Committee activities are without financial compensation, although travel costs to any face-to face meetings will be covered. 2-3 Steering Committee meetings are held per year, and Steering Committee members are also expected to attend general Forum conferences.

• Suggestions for strengthening the NGO contribution to the Partnership work plan (agenda item #4).
  

-Agreed that mandate and structure of The Partnership calls for strong participation of the NGO sector-hence need for mechanisms for broader NGO participation in all areas of Partnership.
-Because the NGO constituency represents the largest and most diverse grouping of members, it can make significant contributions to Partnership work.
-Participants agreed that the NGO constituency has a range of skills and considerable technical expertise to help push the work of The Partnership forward. They also stressed that this constituency has the added advantages of flexibility, being rooted in communities, being able to push for accountability, and the ability to play a strong advocacy role.
NGO were equally divided into the different working groups to have sufficient representation of NGO in each group. IBFAN joined working for country support which was mostly donors.

• Revisions to the NGO call to action draft (agenda item #6)
  

The different NGOs made revision of the Call to Action. This will be finalized by the secretariat of the NGO be circulated. It was agreed that the draft NGO call for action document will be revised and re-circulated to members. Earlier Lida and I had made comments to it and these were acknowledged.
4. Deliberations of the Working Groups
During the afternoon plenary session on the 18th, several summary points were made:

1. The efforts of the Working Groups must be ‘catalytic’ and value-added.
2. The Working Groups are divided according to topical area. Although separate entities, the Groups must communicate with one another to develop a coordinated and common approach when assisting countries.
3. The Working Groups, and particularly the Country Support Working Group, must foster a 2-way structure of interaction with countries, and their activities must be rooted in Ministries of Health. Working Groups should encourage countries to identify their own service gaps and resource needs, and partners to develop ‘country clusters’ which will give advice to countries and help conduct ‘mapping exercises’.
4. Members wanted the work of The Partnership to include countries in all geographic locations, while still having the 60 highest burden countries prioritized for assistance.
5. Although the Gates grant presents an opportunity to prove the value-added quality of The Partnership, members wanted to ensure transparency in the process and that The Partnership continue in its modus operandi of not funding countries directly.

Conclusions of Working Group discussions

1. All four interim working groups were able to endorse their agendas with modifications and become official Partnership Working Groups. These will be printed on-line as available.
2. Elected co-chairs and chairs will revise existing ToRs and circulate updated versions to working group members via email lists.
3. The composition of working groups was explained, comprised of: the open, at-large membership; and selected core members, with greater responsibilities and time commitments.
4. Suggestions were made for developing a governance process by which Partnership members could re-assign the topical area of working groups (i.e. instituting a time-limit for working groups).
5. All working groups agreed upon setting up communication channels via The Partnership web-site. These communication channels will facilitate communication within and between working groups.
6. Each group established its own democratic and transparent voting process, and chairs and co-chairs were duly elected. These election processes will be reviewed in the Steering Committee meeting.

5. Major elements of the 10 year plan
  

 

1. Ensure MNCH is core element in national development plans
2. Mobilize resource and advocate for government commitment
3. Align resources and actions for partnership activities
4. Catalyze implementation at scale up of actions at the national level
5. Strengthen national health systems
6. Improve equity in coverage
7. Increase demand for MNCH at the national level
8. Monitor for progress

IBFAN needs to work closely with the Parnership to anchor its issues within it and thereby contribute to the MDG 4&5.