Introduction to H4 Initiative
Background and Objectives
The Millennium Development Goal 5 (MDG5), aimed at improving maternal health, is the goal least likely to be met in particular in sub-Saharan Africa and South Asia. Every single day, more than 1,500 women die from complications caused by pregnancy and childbirth and for every woman who dies, 20 more suffer disabilities.
With five years more to go until 2015, WHO, UNFPA, UNICEF and the World Bank have come together to strengthen their collaboration to support countries in their efforts to improve maternal health and reduce newborn mortality and thus achieve MDGs 5 and 4. This coordinated and harmonized support and the targeted cooperation with partners at global and national levels is expected to leverage positive developments in 60 countries that are currently not on track to achieve the Millennium Development Goals. Building on each agency's respective country-specific strengths and capacities, the four organizations will initially focus on the 25 countries with very high maternal mortality and expand to cover all the 60 low performing countries.
Although the four organizations have been working collaboratively for many years, this initiative will specifically work to accelerate action on maternal and newborn health according to the principles articulated in Paris Declaration and the Accra Agenda for Action. Specifically, the four organizations will jointly support the development, costing and financing of maternal and newborn health activities integral to the national health plans and will build on global and regional initiatives such as the International Health Partnership, the Harmonization for Health in Africa, the Maternal Mortality Campaign, the Partnership for Maternal, Newborn and Child Health, the Countdown to 2015 to ensure a harmonized support based on the organizational goals and expertise. The H4 will also place great importance on rigorously monitoring and documenting the process of in-country support, and will actively communicate results.
The four organizations will work:
- To promote investment in cost effective interventions and efficient health services including skilled health workers, emergency obstetric care and family planning in order to provide quality care to all women before, during and after pregnancy and childbirth.
- To support initiatives to increase access to quality care in health facilities for example by reducing out-of pocket payments for women and their families, creating an insurance scheme or improving the emergency transport system.
 25 High Burden Priority Countries: Afghanistan, Angola, Bangladesh, Benin, Burkina Faso, Burundi, Cambodia, Cote d'Ivoire, Djibouti, DRC, Eritrea, Ethiopia, Ghana, Guyana, Haiti, India (very high MMR states), Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mozambique, Nepal, Niger, Nigeria, Pakistan, Rwanda, Senegal, Sierra Leone, Sudan, Swaziland, Tanzania, Uganda, Vietnam, Zambia, Zimbabwe