.png?sfvrsn=6d0e27cd_1 "Partnership for Change - v7 (1)")
In a moment marked by shrinking civic space, reduced development assistance, geopolitical instability, and intensifying attacks on gender equality, the Partnership for Maternal, Newborn and Child Health (PMNCH) convened a global policy dialogue on the State of Accountability for Women’s, Children’s, and Adolescents’ Health (WCAH). The dialogue brought together leading voices from civil society, academia, and public institutions to examine how to move from commitments on paper to accountability that delivers real-world results.
The discussion was opened by PMNCH Executive Director Rajat Khosla, who framed the current moment as a profound structural shift for global health governance. The dialogue examined how traditional accountability mechanisms are coming under growing strain as multilateral institutions weaken and national priorities shift. Across regions, women’s, children’s, and adolescents’ health risks are being deprioritized within shrinking health budgets, while progress on sexual and reproductive health and rights (SRHR) faces mounting political pushback.
The conversation featured expert reflections from Fadekemi Akinfaderin (Chief Global Advocacy Officer, Fòs Feminista), Paul Hunt (Emeritus Professor, Essex Law School), Naomi Hossain (Global Research Professor; Director SOAS Development for Transformation Centre, SOAS University of London), Elizabeth Mason (Professor, LSHTM, former Co-Chair, Independent Accountability Panel (IAP)), Landry Tsague (Director of Primary Health Care, Africa CDC), Asha George (South African Research Chair in Health Systems, Complexity and Social Change School of Public Health, University of the Western Cape, South Africa), Walter Flores (Research Professor, Accountability Research Centre, SIS, American University; Research Associate, Centre for the Study of Equity and Governance in Health Systems, Guatemala), and Sofia Gruskin (Distinguished Professor of Population, Public Health Sciences & Law, Institute on Inequalities in Global Health, USC).
Speakers emphasized the growing importance of people-powered accountability rooted in community engagement, rights literacy, and civic participation. The dialogue highlighted that meaningful accountability is not sustained by technical frameworks alone, but by the ability of communities to understand their rights, participate in governance, and safely demand better services.
Participants also explored the limits of technocratic and digital-first accountability systems. While data platforms and artificial intelligence offer new ways to track commitments, these tools do not by themselves generate accountability. Many grievance redress mechanisms remain inaccessible to marginalized communities and rarely lead to meaningful reform without organized civil society support.
The dialogue further addressed accountability in crisis settings, underscoring how essential services for women, children, and adolescents can rapidly fall off national and global agendas during pandemics, conflicts, and humanitarian emergencies. The need for permanent, well-financed accountability architecture capable of withstanding political and economic shocks emerged as a key priority.
From a financing and governance perspective, the conversation emphasized that accountability must also extend to domestic resource mobilization and public financial management. With declining donor support across many regions, particularly in Africa, national ownership and efficient use of public resources were identified as foundational to sustaining WCAH gains.
Power, ideology, and community trust were also central themes. The dialogue drew attention to the impact of unsafe working conditions for frontline health workers on service quality and accountability, as well as the role of long-term, community-led accountability as a form of countervailing power that can strengthen health governance from the local level upward.
The discussion concluded with a shared recognition that accountability today is unfolding in a deeply political context shaped by democratic backsliding, attacks on rights, and widening inequities. As global systems undergo profound transformation, traditional approaches to accountability alone will no longer be sufficient to protect the health and rights of women, children, and adolescents.
Watch the full recording