Governments and their influence on women's and children's health in low and middle income countries

Many countries have made substantial progress towards achieving Millennium Development Goals (MDGs) 4 and 5-to reduce child mortality and improve maternal health. Governments have a key leadership role to play in this process by setting strategic policies and priorities, implementing and monitoring national plans in the health system and related sectors, and fostering research and evidence-based innovation. Drawing upon a recent study: Success Factors for Women's and Children's Health that analyzed why some countries achieved faster progress than other comparable countries [1], this chapter examines the experience of four low-income countries: Bangladesh, Rwanda, Tanzania and Uganda. Two of these countries (Bangladesh and Rwanda) were among the ten countries designated as "fast track" countries in the above study. The Tanzania story features the role that health systems research has played in this country's health development. The Uganda story includes an account of the "Healthy Child Uganda" initiative and the influence it has had on national health policies and practices. The chapter also examines the contribution of two high-income countries to the global effort. They are Canada with the announcement in 2010 by prime minister Harper of the "Muskoka Initiative" on maternal, newborn, and child health, and Norway with its special interest in improving global child health, declared by prime minister Stoltenberg in 2007. Some reflections on the experience of both groups of countries are presented. Then building on the lessons learned from these national "stories", the synthesis highlights key government strategies that appear to be most effective in improving maternal and child health around the world.