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Roselyne Sachiti Features Editor
Only a few days remain before the Millennium Development Goals deadline arrives. In most African countries progress has been good in some areas and quite bad in others. Simply progress can be described as a half glass full, half glass empty scenario.

In Zimbabwe, there have been substantial achievements towards MDGs 4 and 5 (to reduce child mortality and improve maternal health).

Family planning has also to some extent played a pivotal role in reducing unwanted pregnancies and helped in child spacing thereby also reducing maternal and newborn deaths.

It also increases educational and economic opportunities for women and leads to healthier families and communities.

But, while some countries have made strides, child and maternal deaths both increased globally by around 50 percent, and contraceptive prevalence increased from 55 percent to 63 percent.

Despite these advances, every year, 6.6 million children under five years of age die (44 percent as newborns) and 289 000 maternal deaths occur, all from mainly preventable causes, according to the “Success Factors for Women’s and Children’s Health” Partnership for Maternal and Newborn and Child Health report.

Progress varies widely across countries even where levels of income are similar.

Some low-income countries are accelerating progress towards MDGs 4 and 5.

For African nations, understanding what works in accelerating progress to reduce maternal and child mortality is important to support countries achieve the MDGs and to inform post 2015 strategies.

But what has been the barrier to achieving goals 4 and 5?

What did those who have succeeded do and how with almost similar resources when others have clearly struggled to make progress?

How can instruments such as the Maputo Plan of Action (MPOA) play a role in acceleration of MDGs?

In September 2006, ministers of health and delegates from 48 African countries met in Maputo, Mozambique, where they agreed unanimously that the right to health is under serious threat in Africa, and that poor sexual and reproductive health is a leading killer.

To address this problem, they adopted a plan of action to ensure universal access to comprehensive sexual and reproductive health (SRH) services on the continent. The plan recommends a number of measures.

These include integrating HIV/AIDS services into sexual and reproductive health and rights; promoting family planning as a crucial factor in attaining the Millennium Development Goals; supporting the sexual and reproductive health needs of adolescents and young people as a key SRH component; addressing unsafe abortions through family planning; delivering quality and affordable health services to promote safe motherhood, child survival, and maternal, newborn and child health.

Other measures include the adoption of strategies that would ensure reproductive health commodity security.

In most countries the MPOA was tied with the MDGs programming as most targets were similar.

Zimbabwe is a signatory to MPOA and has made commitments to Family Planning 2020 (FP2020).

And, just a few weeks back African civil society organisations raised many questions at a MPOA Experts review meeting and CSO validation meeting in Nairobi, Kenya.

Over 120 participants from 37 countries representing the sub-regions of Africa attended the meeting.

And their challenges were almost similar.

According to discussions at the meeting, some of the challenges that have resulted in the MPOA moving at a snail’s pace include the lack of effective implementation of existing laws, policies by governments, traditional and customary law still prevail -over-weighting the legislation, communication of SRHR not adequate – literacy levels, cultural practices, level of development with regards to health services among others.

There has also been lack of ownership from policy makers addressing SRHR which is not a priority in budgeting.

International Planned Parenthood Federation Africa Region director Mr Lucien Kouassi Kouakou said at inception, the MPOA deliberately set out to guide countries in planning and programming for MDG 4, 5 as well as 6.

However, he said, challenges of Sexual Reproductive Health Rights remain a major barrier to development in Africa.

“The MPOA shall come to close in 2015; and a new version of this instrument is under consideration.

“The comprehensive review of Maputo implementation and achievements is therefore very important as it will inform the policy direction on SRHR post 2015,” he said.

He said the AU member states, SRHR experts and CSOs across Africa have been part of the Maputo review over the last six months and over.

“We have to ensure that our unified voice communicates the solutions that we want our African leaders to embrace as we move beyond 2015,” he said.

Collated findings of the universal CSOs evaluation on MPOA were shared during the meeting.

“Most importantly, this meeting provided a platform upon which we can make further recommendations that can contribute towards a final comprehensive report to the AU Commissions; and successively we are looking at strategising and making a strong CSO statement to our African leaders in SRHR positioning in Africa is key if we are to enjoy the possibility of a demographic dividend,” he said.

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