Drive Better Governance and Stronger Collaboration for RMNCAH
ARMMA Plus builds a future where no woman, child, or adolescent is left behind.
CARMMA has, since its launch, upheld the belief that every maternal and child death matters and must be accounted for. This core principle has guided the African Union Commission (AUC) in strengthening accountability and fostering partnerships to advance reproductive, maternal, newborn, child, and adolescent health (RMNCAH) through the re-strenghned Campaign-CARMMA Plus.
The 2014 Luanda Declaration marked a turning point, with African Ministers of Health committing to end preventable maternal and child deaths by 2030. They called for the creation of an accountability mechanism to track progress and assess the implementation of health commitments.
In response to the 2019 evaluation of CARMMA (2009–2019), the AUC developed the Accountability Partnership Framework(APF). This framework builds on existing structures and partnerships to monitor progress using both qualitative and quantitative indicators aligned with international standards. It promotes transparency and enables stakeholders to measure how well commitments are being fulfilled.
Effective implementation also depends on strong partnerships. The Framework encourages collaboration across governments, regional economic communities (RECs), civil society, academia, and the private sector. Aligning partner support with national priorities helps deliver high-impact, coordinated interventions.
Through this approach, the AUC aims to hold all stakeholders including political leaders accountable for their roles in advancing RMNCAH goals, ensuring that actions are impactful, measurable, and sustainable.
SafeBirth Africa (SBA) is a joint programme implemented by Unitaid and UNFPA in partnership with African regional and national authorities, namely WAHO/ECOWAS, EAC, SADC, AUC, the Ministries of Health of Côte d’Ivoire, Madagascar, Nigeria, Uganda, Zambia, and professional associations. It aims to strengthen health systems in Africa and accelerate access to life-saving medicines that are widely used in wealthy countries to prevent women from dying from postpartum haemorrhage (PPH), in a significant drive to end preventable maternal deaths. SBA is part of the Team Europe Initiative on Sexual and Reproductive Health and Rights in Africa.
Co-funded by the European Union, the initiative will accelerate access to new and underused maternal health medicines in Côte d’Ivoire, Madagascar, Nigeria, Uganda and Zambia, improve PPH management and access to PPH commodities more widely across Africa through regional policy dialogue, strengthened regional pooled procurement mechanisms for maternal health medicines, knowledge sharing and South-South learning.
SBA seeks to overcome challenges by generating evidence, strengthening national capacity, and improving access to the best available life-saving commodities. Its three specific objectives are:
- Generate evidence on impact, feasibility, acceptability, and costing of priority PPH drugs and delivery models to accelerate country uptake, informing both global operational guidelines and country operational arrangements.
- Leverage regional and continental platforms to increase the policy, regulatory, financing and delivery capacity of the national health systems to roll out the use of new and underused quality-assured PPH commodities.
- Improve access to affordable quality-assured recommended commodities to prevent and treat PPH in Africa, especially through manufacturers in Africa, building on existing continental and regional initiatives including the African Continental Free Trade Area is a free trade area (AfCFTA).
Despite progress over the last decades, preventable maternal deaths remain extraordinarily high in the African region. In the 23 countries in the East and Southern Africa region, an estimated 58,053 maternal deaths occur annually, 159 deaths every day, accounting for 23.5 per cent of the total global annual maternal deaths. The region needs to greatly accelerate its rates of reduction if the target of 70 maternal deaths per 100,000 live births is to be achieved by 2030.
Start-With-Her, the UNFPA Strategy for Reproductive, Maternal and Newborn Health and Well-Being. The MNH fund is a multi-donor trust fund which is intended to catalyse and accelerate progress in improving the health of women and children.
In collaboration with partners, through the MNH fund, UNFPA deploys its convening power and evidence-based solutions to provide support to countries to address MNH challenges in a holistic manner and ensure that all women, girls, and newborns have access to the comprehensive care and quality services they need. This means strengthening quality health systems, improving access to supplies, innovation in emergency obstetric and newborn care service delivery, bolstering the midwifery workforce (State of Midwifery in ESA region 2024 report), promoting respectful care, strengthening Maternal and Perinatal Death Surveillance and Response (MPDSR), Obstetric fistula prevention and management and addressing perinatal mental health.
The UNFPA Supplies Partnership is UNFPA’s flagship global health initiative supporting 54 of the world’s lowest-income countries to strengthen health systems and expand access to sexual and reproductive health (SRH) commodities. With an annual budget of about US$185 million, it is the largest public sector supplier of contraceptives and life-saving maternal health medicines, drawing on UNFPA’s five decades of family planning expertise.
Operating across Africa, Asia, Latin America and the Caribbean, and the Pacific—where nearly two-thirds of countries face humanitarian or fragile contexts—the Partnership works with governments and partners to ensure equitable access to quality-assured SRH supplies. Each year, more than 20 million women benefit from stronger public health systems, with targeted support reaching underserved, rural, crisis-affected and marginalized populations, including adolescents and persons with disabilities.
The Partnership advances global commitments to the Sustainable Development Goals (SDGs), the ICPD Programme of Action and UNFPA’s Transformative Results by ending unmet need for family planning, reducing preventable maternal deaths and strengthening reproductive rights. It does so by:
- Procuring contraceptives and maternal health medicines;
Supporting governments to increase domestic financing through Compacts, a Match Fund, and the Bridge Fund; - Strengthening supply chains, policy and planning, and health worker capacity;
- Integrating SRH services into broader health and humanitarian responses.
Governance is participatory and inclusive, with a Steering Committee of donors, programme governments, civil society and partners providing strategic oversight. Subcommittees on strategy, finance and leadership ensure transparency, accountability and alignment with national priorities.
Beyond commodities, the Partnership acts as a catalyst for country-owned health system strengthening—supporting e-LMIS implementation, training thousands of health workers annually, promoting method mix expansion, and mobilizing sustainable domestic resources. By leveraging UNFPA’s global reach and trusted convening role, the Partnership enables coordinated, multi-sectoral responses, ensuring that investments deliver long-term impact even in the most complex and fragile settings.
About The Programme
The Safeguard Young People (SYP) programme, is a flagship initiative by the UNFPA East and Southern Africa Regional Office. It is aimed at empowering adolescents and young people between the ages of 10 to 24 to protect themselves from sexually transmitted infections, including HIV, early and unintended pregnancy, unsafe termination of pregnancy, gender-based violence, early marriage, and other harmful cultural practices. In addition, the programme equips young people with important life skills, building confidence, communication and decision-making abilities. Enables them to access education and opportunities to make their voice heard and influence decisions.
SYP adopts a cooperative approach, involving young people as partners, advisors, implementers, and beneficiaries at regional and country levels. Originally launched with eight participating countries, SYP expanded its reach to a further four countries and is now implemented in Angola, Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Tanzania, Zambia and Zimbabwe. The success of the programme is underpinned by robust financial support and influential partnerships. The Swiss Agency for Development and Cooperation and the Embassy of the Kingdom of the Netherlands. Endorsements from key stakeholders, including the African Union, the Southern Development Community (SADC), the East African Community (EAC), non-governmental agencies, and various United Nations entities ensure the programme’s sustained impact and growth.
Main areas of activity include:
- Policy: SYP has played a pivotal role in reshaping policies and legislation related to young people’s sexual and reproductive health and rights through strategic partnerships at continental, regional, and national levels.
- Youth leadership: The programme actively involves young people in policy-level engagements and equips young networks and their members with advocacy and leadership skills through capacity-building initiatives.
- Empowerment: Through comprehensive sexuality education (CSE), SYP provides life-saving, age-relevant, and scientifically accurate information to equipping young people to safeguard their health, develop health-promoting and gender-transformative attitudes, and acquire essential life skills.
- Services: SYP ensures equitable access to adolescent and youth-friendly health services (AYFHS) by training health care providers and promoting a standardized package of AYFHS for young people.
- Evidence, knowledge sharing, and South-South learning: SYP’s interventions are evidence-based, incorporating the latest research and proven methodologies. Documenting best practices and fostering South-South learning among participating countries to enhance the programme’s effectiveness and alignment with young people’s evolving needs.
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Re-Strengthened Campaign on Accelerated Reduction of Maternal Mortaility in Africa CARMMA Plus (2021-2030) Roadmap