2020 IAP Report: Caught in the COVID-19 storm

Abstract

Background:
The 2020 Independent Accountability Panel (IAP) report, Caught in the COVID-19 Storm: Women’s, Children’s and Adolescents’ Health in the Context of UHC and the SDGs, evaluates the global impact of the COVID-19 pandemic on health systems, accountability, and progress toward Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs).

Objective:
To examine how COVID-19 disrupted essential health services for women, children, and adolescents, assess accountability gaps within health systems, and propose a framework for strengthening governance, equity, and data-driven decision-making globally.

Methods:
The report synthesizes global health data, policy analyses, modeling studies, and country case studies from Ethiopia, Georgia, Guatemala, Kenya, and Papua New Guinea. It evaluates indicators related to maternal and child mortality, UHC service coverage, health financing, inequalities, governance, and accountability mechanisms.

Results:
The report demonstrates that COVID-19 significantly worsened pre-existing global inequities and disrupted reproductive, maternal, newborn, child, and adolescent health services. Major consequences included interruptions in immunization campaigns, shortages in sexual and reproductive health services, increased gender-based violence, rising child marriage risks, and worsening poverty. Modeling estimates projected substantial increases in maternal and child mortality in low- and middle-income countries. The report further identified major weaknesses in civil registration systems, health data infrastructure, governance transparency, and accountability processes. Countries with stronger investments in primary health care, multisectoral collaboration, data systems, and rights-based governance showed greater resilience and better health outcomes.

Conclusions:
The IAP concludes that accountability is fundamental to achieving UHC and SDG targets for women’s, children’s, and adolescents’ health. The report proposes a four-pillar accountability framework consisting of Commit, Justify, Implement, and Progress, emphasizing the institutionalization of monitoring, review, remedy, and action mechanisms. Key recommendations include investing in national data systems, embedding accountability functions into governance structures, and democratizing accountability by amplifying community voices and participation. Strengthening accountability systems is presented as essential for improving global health security, resilience, equity, and trust in public institutions during and beyond pandemics.