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Partnerships for Women's Health

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Partnerships for Women's Health The United Nations University was established as a subsidiary organ of the United Nations by General Assembly resolution 2951 (XXVII) of 11 December 1972. It functions as an international community of scholars engaged in research, postgraduate training and the dis- semination of knowledge to address the pressing global problems of human survival, development and welfare that are the concern of the United Nations and its agencies. Its activities are devoted to advanc- ing knowledge for human security and development and are focused on issues of peace and governance and environment and sustainable development. The University operates through a worldwide network of research and training centres and programmes, and its planning and coordinating centre in Tokyo. Partnerships for women’s health Partnerships for women’s health Striving for best practice within the UN Global Compact EDITED BY MARTINA TIMMERMANN AND MONIKA KRUESMANN © United Nations University, 2009 The views expressed in this publication are those of the authors and do not necessarily reflect the views of the United Nations University. United Nations University Press United Nations University, 53-70, Jingumae 5-chome, Shibuya-ku, Tokyo 150-8925, Japan Tel: +81-3-5467-1212 Fax: +81-3-3406-7345 E-mail: [email protected] general enquiries: [email protected] http://www.unu.edu United Nations University Office at the United Nations, New York 2 United Nations Plaza, Room DC2-2062, New York, NY 10017, USA Tel: +1-212-963-6387 Fax: +1-212-371-9454 E-mail: [email protected] United Nations University Press is the publishing division of the United Nations University. Cover design by Curtis Christophersen Printed in the United States of America ISBN 978-92-808-1185-8 Library of Congress Cataloging-in-Publication Data Partnerships for women’s health : striving for best practice within the UN Global Compact / edited by Martina Timmermann and Monika Kruesmann. p. ; cm. Includes bibliographical references and index. ISBN 978-9280811858 (pbk.) 1. Women—Health and hygiene. 2. Women—Health and hygiene—India. 3. Global Compact. I. Timmermann, Martina. II. Kruesmann, Monika. [DNLM: 1. Global Compact. 2. Women’s Health. 3. Developing Countries. 4. International Cooperation. WA 309 P273 2009] RA564.85.P367 2009 362.1082—dc22 2009041596 CONTENTS Figures. ix Tables . xi Boxes . xiii Contributors . xv Foreword by Mary Robinson ............................ xxi Acknowledgements ............................... xxvii Introduction: Women’s health through PPP within the UN Global Compact – At the nexus of business, ethics and human rights. 1 Martina Timmermann PART A: CONTEXTUAL FRAME OF REFERENCE . 29 Section I: MDGs, human rights, the UN Global Compact and public private partnerships. 31 1 Improving maternal health in Asia and Africa: Challenges and opportunities . 33 Moazzam Ali 2 Poverty, health and the human right to the highest attainable standard of health . 63 Paul Hunt and Judith Bueno de Mesquita 3 Partnering in support of the right to health: What role for business? . 85 Klaus M. Leisinger vi Contents 4 The challenge of equal financial access to the best available health care: Bringing in the private sector. 105 Günter Neubauer and Iris J. Driessle 5 The United Nations Global Compact: Seeking to embrace diversity . 121 Monika Kruesmann 6 Small and medium-sized enterprises: Their role in achieving the Millennium Development Goals . 137 Kai Bethke and Manuela Bösendorfer Section II: Women’s health needs and health care in India. 153 7 The health situation of women in India: Policies and programmes . 155 Suneeta Mittal and Arvind Mathur 8 India’s medical system. 185 Nirmal Kumar Ganguly and Malabika Roy 9 Health PPPs in India: Stepping stones for improving women’s reproductive health care?. 217 Rama V. Baru and Madhurima Nundy 10 Pro-poor capacity-building in India’s women’s health sector . 247 Arabinda Ghosh PART B: A CASE STUDY IN INDIA. 273 11 Introduction to the case study: The Women’s Health Initiative – A trilateral partnership within the framework of the UN Global Compact . 275 Martina Timmermann Contents vii 12 KARL STORZ’s WHI goals and expectations . 293 Sybill Storz 13 The German PPP Programme: A viable way to improve women’s health in India?. 301 Nicolaus von der Goltz 14 GTZ’s goals and expectations for the WHI public private partnership from a development cooperation point of view. 317 Diana Kraft and Jörg Hartmann 15 The WHI: Management perspectives from the private and the public partners in the field. 327 Peter Laser and Anu Chopra 16 The WHI: Perspectives from private and public medical doctors in the Endoscopy Training Centres. 337 A. Kurian Joseph and Alka Kriplani 17 The economic logic of the Women’s Health Initiative as a business model for poverty alleviation. 355 Christina Gradl 18 A PPP for women’s health and human rights in India: Striving for best practice within the framework of the UN Global Compact. 385 Martina Timmermann and Monika Kruesmann PART C: CONCLUSION. 419 19 PPPs for women’s health and human rights beyond India: Probing new standards and methodologies . 421 Martina Timmermann and Monika Kruesmann viii Contents APPENDICES . 435 A UNU Workshop I: Programme and participants . 437 B UNU Workshop II: Programme and participants. 443 C Paul Hunt’s 2008 Preliminary Mission Report on India. 449 FIGURES 0.1 The Ten UN GC principles . 14 0.2 The WHI at the interface of challenges of global concern. 20 4.1 Public private partnership. 113 6.1 Mapping corporate social responsibility: Issues and stakeholders. 144 7.1 Distribution of modern contraceptive methods, 2005–2006. 160 7.2 Causes of maternal mortality in India. 162 7.3 Distribution of births by type of medical attention at delivery, 2006. 163 7.4 Ratio of public to private expenditure on health in major states . 177 8.1 Share of public and private sector delivery. 195 8.2 Approaches of the National Rural Health Mission . 198 8.3 Structure of the NRHM. 200 8.4 Indian government ministries undertaking research with health components . 212 9.1 Pathways of partnerships . 225 10.1 Similar income, different Human Development Index. 250 10.2 Multidirectional relationships between poverty, ill health and illiteracy . 251 10.3 Present scenario of selected RCH programmes’ performance and female literacy . 262 10A.1 Women experiencing delivery complications . 267 10A.2 Female literacy rate and total fertility rate. 267 10A.3 Total fertility rate and maternal mortality rate. 268 10A.4 Female literacy rate and mean age at marriage for girls . 268 10A.5 Mean age at marriage for girls and safe delivery . 269 11.1 WHI partnership structure. 278 11.2 Monitoring, reporting and evaluation. 283 11.3 WHI internal structure. 284 x Figures 14.1 WHI – functional impact chain. 321 17.1 Set-up of the WHI. 357 17.2 Change in the burden of disease in India: Estimates and projections, 1990 and 2020. 362 17.3 Hospitalised Indians falling into poverty as a result of medical costs, 1995/96. 363 17.4 The WHI ecosystem. 366 17.5 Public and private sector shares in service delivery for those above and below the poverty line: All India, 1995/96. 370 18.1 Blueprint for a best practice PPP within the UN Global Compact. 388 TABLES 4.1 Advantages and disadvantages of public private partnerships. 114 7.1 The financing of health care in India: Health expenditure by financing source . 176 8.1 Population norms for rural health centres. 189 8.2 Public sector health care infrastructure. 191 8.3 Growth of voluntary hospitals and beds . 196 8.4 Socio-economic differences in health: Selected indicators . 207 9.1 Collaboration between government and the private sector in family planning and reproductive and child health programmes in India. 220 9.2 Forms and designs of health PPPs in India. 226 10A.1 Poverty measured by people living on less than US$1 a day . 266 11.1 The difference between outcome monitoring and outcome evaluation. 286 18.1 Number of doctors trained and patients treated at each ETC. 390 BOXES 9.1 Some ethical concerns. 238 CONTRIBUTORS Moazzam Ali, a physician by training, is currently assistant profes- sor at the Department of Global Health Policy, Institute of Inter- national Health at the Graduate School of Medicine, University of Tokyo, from where he also received his doctorate in public health. Prof. Ali has also earned master’s degrees in public health and in business administration. Rama V. Baru, Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, is an expert on health policy, international health, privatisation of health services and in- equalities in health. Prof. Baru is the author of Private Health Care in India: Social Characteristics and Trends (Sage), the regional editor of South Asia for Global Social Policy (Sage), and an acclaimed advisor to the Government of India, the WHO, and the Indian Council for Medical Research. Kai Bethke has been UNIDO’s regional director for Mexico, Cen- tral America and the Caribbean since November 2007. He joined UNIDO in 2000 as head of both the public private partnership and corporate social responsibility (CSR) Programmes, which support small and medium-sized enterprises (SMEs) in developing countries through fostering cooperation with large buyers from the economic sector. Manuela Bösendorfer is working as a consultant at UNIDO in Vienna, Austria. Judith Bueno de Mesquita is currently a part-time teacher in the School of Law at Essex University. From 2001–2008 she was a senior research officer in the Human Rights Centre, in support of the mandate of the UN Special Rapporteur on the right to the highest attainable standard of health, Paul Hunt. Anu Chopra holds Masters degrees in Business Administration and Sociology. She worked with GTZ for nearly two decades. Cur- rently Ms.
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