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UNFPA Partnership Catalyst

PMNCH's Research and Evidence Work

PMNCH-W-01PMNCHWorkingAudience: Both4,578 words

EXECUTIVE SUMMARY

PMNCH occupies a specific and underappreciated position in the global health knowledge architecture: the translation layer between primary research and policy action. It conducts no original research, funds no primary studies, and publishes no clinical trial data. What it does is commission and produce systematic evidence syntheses, policy briefs, and knowledge brokering services that translate complex research findings into accessible, policy-relevant formats for its diverse membership — governments, NGOs, health professionals, donors, and civil society. This niche role is genuinely valuable and would be difficult for any single implementing agency to replicate, because those agencies have institutional interests that shape how they present evidence. PMNCH's relative distance from implementation gives it a degree of independence in evidence presentation.

The "What Works for Women and Children" series is the centrepiece of PMNCH's knowledge function. It is a systematically reviewed, evidence-graded synthesis of intervention effectiveness in MNCH/SRHR topic areas, produced in partnership with academic institutions and published in accessible formats alongside peer-reviewed companion papers. The series is of genuine quality — methodologically sound, accessible, and policy-relevant. Its limitations are those inherent to its design: it is only as good as the underlying evidence, and in many priority areas (GBV prevention, adolescent health, community health worker programmes in complex fragile settings), the evidence base is thin. The series is also necessarily incomplete in coverage — it cannot address all relevant topics, and updating existing volumes is resource-intensive.

Beyond the flagship series, PMNCH's knowledge function includes the annual EWEC Progress Reports (which combine epidemiological data with self-reported commitment progress), policy briefs, working group publications, and — importantly — knowledge brokering through its partner network. The brokering function is the least visible but potentially most valuable part of the knowledge work: PMNCH connects research producers (academic institutions, WHO technical programmes) with policy consumers (government delegations, NGO advocacy teams, donors) through its network, events, and working groups. This brokering role is structurally distinct from UNFPA's evidence work, which primarily evaluates its own programmes, and from WHO's technical guidance function, which produces normative standards.

For researchers, PMNCH's knowledge products should be understood as high-quality secondary sources — useful starting points for evidence synthesis, but requiring triangulation with primary evidence from Cochrane, WHO guidelines, and country-level evaluations. The What Works series in particular has been cited in peer-reviewed literature and has contributed to framing evidence debates around specific intervention categories. However, the series' policy orientation means it prioritises accessibility over technical completeness, and researchers using it should access the full systematic review methodology and underlying data sources rather than relying solely on the summary publications.


KEY FACTS

  1. PMNCH does not conduct primary research. All PMNCH knowledge products are evidence syntheses or translations of existing research.
  2. The "What Works for Women and Children" series is PMNCH's flagship knowledge product — systematically reviewed, evidence-graded, publicly available free of charge.
  3. Topics addressed in the What Works series include (but are not limited to): stillbirth prevention and care, adolescent health interventions, skilled birth attendance, maternal nutrition, community health workers, health systems strengthening, sexual violence prevention, newborn care, and family planning.
  4. Each What Works volume is produced in partnership with academic institutions and published alongside a peer-reviewed companion paper in academic journals.
  5. The series uses evidence grading frameworks (typically GRADE-compatible) to classify intervention evidence by strength and direction of effect.
  6. PMNCH is a co-publisher of Countdown to 2030, the leading academic tracking initiative for MNCH/SRHR intervention coverage; Countdown papers are published in the Lancet and other major journals.
  7. PMNCH annual EWEC Progress Reports include updated global data on MNCH/SRHR indicators drawn from WHO, UNICEF, UNFPA, and Countdown data sources.
  8. Policy briefs are produced to align with specific advocacy moments — ahead of Partner Forums, UNGA health events, and G7/G20 Health Minister meetings.
  9. PMNCH knowledge products are policy-oriented, not academic — they prioritise accessibility and decision-relevance over technical completeness.
  10. PMNCH's knowledge brokering function — connecting research to policy through its partner network — is consistently identified by member organisations as one of PMNCH's most valuable functions.
  11. WHO hosting gives PMNCH privileged access to WHO technical processes; PMNCH knowledge products can inform WHO guideline development, though they do not carry the normative authority of WHO guidelines.
  12. PMNCH's knowledge work under the 2021–2025 strategy has expanded to include evidence on digital health approaches, climate-MNCH intersections, and financing innovation.
  13. The evidence base in several PMNCH priority areas is thin: GBV prevention in LMICs, comprehensive sexuality education impact, and adolescent mental health have limited high-quality evidence.
  14. PMNCH knowledge products are not substitutes for country-specific technical guidance — they address global evidence patterns, not country-level programme design questions.
  15. Working group publications produced by PMNCH's thematic working groups are variable in quality and depend on the expertise of member organisations engaged.
  16. All PMNCH knowledge products are available on the PMNCH website (who.int/pmnch) without paywall or registration.

BACKGROUND AND CONTEXT

The Knowledge Gap PMNCH Was Designed to Address

When PMNCH was established in 2005, the global MNCH/SRHR field faced a specific knowledge problem: there was substantial research evidence about which interventions worked, but this evidence was not accessible to the people making decisions about health systems, policies, and programmes. Academic journals were paywalled. Systematic reviews required specialist training to interpret. WHO guidelines were authoritative but slow to produce and sometimes difficult to translate into policy implications.

The gap PMNCH's knowledge function was designed to fill was not the gap between unknowing and knowing — it was the gap between knowing and deciding. Decision-makers in health ministries, donor agencies, and NGOs needed the evidence translated into accessible, decision-relevant formats. PMNCH positioned itself as the translation layer.

This positioning was credible for two reasons. First, PMNCH's multi-stakeholder membership included both research institutions (who could vouch for the quality of the synthesis) and policy actors (who could identify what questions decision-makers actually needed answered). Second, PMNCH's distance from implementation gave it a degree of independence — it was not translating evidence to justify its own programmes, but to inform the field broadly.

Relationship to WHO Technical Guidance

The relationship between PMNCH's knowledge products and WHO's normative guidance function requires careful clarification. WHO produces clinical guidelines — normative standards based on systematic evidence review using the GRADE methodology, approved by WHO guideline development groups, and intended to inform clinical practice and health system policy globally. These guidelines carry WHO's normative authority.

PMNCH's knowledge products are not WHO guidelines. They do not carry normative authority, they do not go through WHO's guideline development process, and they are explicitly advocacy-oriented rather than normative in intent. The What Works series uses systematic review methodology and evidence grading, but it does so to inform advocacy and policy rather than to set clinical standards.

The WHO hosting relationship does create a privileged connection, however. PMNCH's evidence work can and does inform WHO's guideline development processes — if PMNCH's What Works review identifies an evidence gap or a strong signal about a specific intervention, this can prompt WHO to accelerate its own guideline development in that area. Conversely, new WHO guidelines inform PMNCH's evidence synthesis — when WHO updates its recommendations on antenatal care, skilled birth attendance, or contraception, PMNCH's knowledge products are updated to reflect the new normative framework.


ORGANISATIONAL DETAIL

How Knowledge Products Are Commissioned and Produced

The What Works series and other major knowledge products follow a structured commissioning process:

Topic selection: Topics are selected by the PMNCH secretariat in consultation with the Board and relevant working groups. Selection criteria include: policy relevance (is this a live question in current global health debates?), evidence state (is there sufficient primary evidence to synthesise meaningfully?), and advocacy utility (does the topic align with PMNCH's current strategic priorities?). This means the series is not a comprehensive evidence map — it is a strategic selection driven by policy timing and advocacy needs.

Partner commissioning: PMNCH commissions academic institutions or research networks to conduct the systematic review. Institutions that have produced What Works volumes include the London School of Hygiene and Tropical Medicine, the International Center for Research on Women, Harvard T.H. Chan School of Public Health, Johns Hopkins Bloomberg School of Public Health, and others. The commissioning model gives PMNCH access to high-quality academic expertise without maintaining a large in-house research team.

Review methodology: Commissioned reviews use systematic review methodology — structured literature searches, inclusion/exclusion criteria, quality assessment of individual studies, and evidence synthesis. Evidence grading (typically GRADE or a compatible framework) rates the strength of evidence for each intervention or finding. The methodology is described in each publication, allowing readers to assess the approach.

Publication formats: Each What Works volume is published in two formats: a full technical report (typically 50–100 pages) for specialist readers, and a summary policy brief (typically 8–12 pages) for decision-makers. Academic companion papers — authored by the commissioned researchers and submitted to peer-reviewed journals — provide the detailed methodology and results for the research community.

Update cycles: What Works volumes are not updated on a fixed cycle. Updates are triggered by significant new evidence (a major new trial, a new Cochrane review covering the same topic, or significant policy changes in the area). The lack of a systematic update cycle is a limitation — some volumes become outdated without a clear mechanism for revision.

Working Group Knowledge Function

PMNCH's thematic working groups produce knowledge outputs alongside their advocacy and networking functions. Working group publications typically include: comparative case studies of programme approaches in different countries, rapid evidence scans on specific emerging questions, and advocacy-oriented evidence summaries for specific policy audiences (e.g., finance ministry officials, parliamentary committees).

Working group publications are more variable in quality than What Works volumes because they depend heavily on which member organisations are actively engaged. Working groups with strong academic institution participation tend to produce higher-quality knowledge outputs. Working groups primarily composed of NGO practitioners tend to produce more operational case study material, which has different value (practical learning) but lower methodological rigour.

The Countdown to 2030 Partnership

The Countdown to 2030 collaboration is PMNCH's most important formal research partnership. Countdown is an academic-led initiative that tracks coverage of essential interventions for women's, children's, and adolescents' health in high-burden countries. It produces country profiles for 81 countries showing coverage levels for key indicators (antenatal care, skilled birth attendance, immunisation, family planning, wasting treatment, etc.) alongside equity breakdowns.

PMNCH's role in Countdown is co-publishing and convening, not analysis. The academic work is conducted by a network of country teams led by research institutions (including LSHTM, Johns Hopkins, University of Toronto, and country-based partners). PMNCH's contribution is: hosting the Countdown secretariat functions, convening the Countdown partner meetings, and integrating Countdown data into PMNCH's own advocacy and knowledge products.

The Countdown partnership gives PMNCH access to regularly updated, country-specific, peer-reviewed epidemiological data that significantly strengthens the evidence base of its publications and advocacy. It also anchors PMNCH in the academic global health community in a way that its own publications alone — which are policy-oriented rather than peer-reviewed primary research — would not achieve.


KNOWLEDGE PRODUCTS AND OUTPUTS

Full Assessment of the What Works Series by Evidence Area

A structured assessment of evidence quality by area covered in the What Works series:

Strong evidence areas (multiple RCTs, systematic reviews, consistent effect direction):

Moderate evidence areas (some RCTs, systematic reviews with limitations, mixed evidence):

Weak evidence areas (observational studies, small trials, inconsistent evidence):

PMNCH's What Works volumes are transparent about evidence quality in weak areas — they acknowledge where evidence is limited rather than overstating findings. This transparency is a genuine quality marker but also means that some volumes provide limited policy guidance precisely because the evidence does not support strong recommendations.

EWEC Progress Reports: Content and Quality Analysis

The annual EWEC Progress Reports have evolved significantly since their introduction in 2011. Early reports (2011–2013) were primarily commitment inventories — lists of who had committed what, with limited progress analysis. More recent reports (2018–present) have become more analytically sophisticated, incorporating:

The most valuable sections of recent Progress Reports for decision-makers are typically: the global indicator dashboard (concise, annually updated, sourced from WHO/UNICEF/UNFPA data), the thematic analysis sections (synthesising broader evidence around a specific advocacy priority), and the country spotlights (case studies of progress that can inform advocacy and programme design).

The least reliable sections are the commitment-progress tables and aggregate commitment statistics. These reflect self-reported data from commitment holders and are subject to the selection and optimism biases described in PMNCH-W-02. Sophisticated readers treat these sections as stakeholder self-assessments rather than as independent evaluation findings.

Policy Briefs: Utility Assessment by Audience

For government health ministry officials: PMNCH policy briefs are most useful when they address specific policy decisions — financing allocation choices, service delivery model selection, or regulatory decisions. The strongest briefs include explicit decision-trees or policy option analyses. Weaker briefs are more descriptive and less decision-focused.

For donor agency programme officers: Policy briefs on emerging evidence areas (digital health, climate-MNCH) provide useful orientation when programme officers are designing new funding streams. Briefs translating Countdown data into financing priority arguments are particularly useful for bilateral aid budget submissions.

For NGO advocacy staff: Policy briefs provide citable, accessible evidence summaries for advocacy materials. The credibility of PMNCH as source — associated with WHO, produced in collaboration with academic institutions — adds authority to NGO advocacy claims.

For parliamentary staff: PMNCH produces some briefs specifically targeted at parliamentarians and parliamentary health committees. These are typically the most accessible in format and the most oriented toward domestic policy decisions rather than global health architecture.


THE ACCOUNTABILITY FUNCTION: WHAT IT DELIVERS AND WHERE IT FALLS SHORT

The EWEC Progress Reports function as the knowledge backbone of PMNCH's accountability mechanism. For a full analysis of the accountability function, see PMNCH-W-02. From a knowledge perspective:

Where the knowledge-accountability connection works well: When a commitment is specific and measurable (e.g., "train 500 midwives"), and when the progress report documents training data that can be cross-referenced against external data sources (e.g., national workforce registries, MoH training records), the knowledge function strengthens the accountability function. The credibility of the evidence supports the credibility of the accountability claim.

Where the connection breaks down: When commitments are vague, when progress data is not cross-referenceable with external sources, or when the evidence base for expected outcomes is weak, the knowledge function cannot compensate for accountability mechanism weaknesses. A commitment to "improve maternal health outcomes" backed by weak self-reported progress data and an uncertain evidence base for the specific interventions being used provides no meaningful accountability.

The gap between PMNCH's evidence work and its accountability work is wider than the organisation typically acknowledges. Closing it would require: more rigorous commitment acceptance criteria anchored to the evidence base (only accepting commitments to deliver evidence-based interventions); more systematic outcome tracking alongside input/output tracking; and independent verification for a sample of commitments. This would require substantially more resources and would reduce the volume of commitments registered, which creates political disincentives within the partnership.


FUNDING, SCALE AND RESOURCES

PMNCH's knowledge function is funded primarily from the secretariat budget, supplemented by specific grants from donors for particular knowledge products. The Countdown collaboration is funded through a combination of PMNCH secretariat contributions and separate grants from UK/FCDO, Gates Foundation, and other sources.

The What Works series commissioning costs are substantial — a full systematic review and associated publication process typically costs USD 200,000–500,000 per volume depending on scope and complexity. At a production rate of 2–4 volumes per year, the series requires USD 400,000–2 million per year in commissioning costs, a significant fraction of PMNCH's knowledge budget.

Policy briefs are lower cost but require sustained secretariat capacity for editing, design, targeting, and dissemination — a function that is difficult to capture in volume counts but represents real resource allocation.


KEY DEBATES AND CONTESTED QUESTIONS

Should PMNCH invest in primary research to fill evidence gaps? A persistent question in PMNCH governance is whether the synthesis model is adequate, or whether PMNCH should fund primary research in areas where the evidence base is weak. The argument for primary research investment: PMNCH's advocacy is constrained by evidence gaps, and the partnership has the convening capacity to coordinate multi-country research at scale. The argument against: primary research is expensive, slow, and well beyond PMNCH's current capacity; it risks duplicating what research funders (Wellcome, Gates, NIH, MRC) already do; and it would require a fundamentally different organisational model.

The consensus — reflected in the 2021–2025 strategy — is to maintain the synthesis model while advocating more aggressively for research funders to prioritise evidence-gap areas. This is a reasonable compromise but leaves PMNCH vulnerable to advocacy on topics where the evidence base remains thin.

Does PMNCH's policy orientation compromise rigour? Some academic critics have argued that PMNCH's knowledge products sacrifice methodological rigour for accessibility and advocacy utility. The argument: selecting topics for policy relevance rather than evidence completeness creates a biased evidence portfolio; grading evidence for policy audiences rather than academic peers can oversimplify; and the dual role of evidence producer and advocate creates incentives to present evidence favourably.

PMNCH's response — reflected in the commissioning of independent academic institutions for What Works reviews and the use of GRADE-compatible methodology — is a reasonable mitigation. But the tension is structural: advocacy organisations that produce their own evidence are always at risk of confirmation bias.

Is knowledge brokering a sufficiently rigorous PMNCH function? Knowledge brokering — connecting research to policy through the partner network — is consistently valued by partners but is the least measurable aspect of PMNCH's knowledge function. Internal evaluations have found it valuable; academic researchers cannot systematically study it because it happens through relationships, events, and informal conversations that are not documented. For funders, this creates a question: is supporting a large network for knowledge brokering value for money when the outcomes are diffuse and unmeasurable?


COMPARISON WITH OTHER GLOBAL HEALTH PLATFORMS

PMNCH vs. WHO Technical Guidance Function: WHO produces normative standards through a rigorous, institutionally governed process. PMNCH produces advocacy-oriented evidence syntheses through a more flexible, faster process. The two functions are complementary: PMNCH's syntheses can inform WHO guidelines; WHO guidelines inform PMNCH's advocacy. Neither substitutes for the other.

PMNCH vs. Cochrane Collaboration: Cochrane produces systematic reviews that are the gold standard for evidence quality in many clinical areas, including MNCH. PMNCH draws on Cochrane reviews as its evidence sources but makes them accessible to non-specialist audiences. The two are complementary; PMNCH does not compete with Cochrane.

PMNCH vs. UNFPA Evidence Work: UNFPA's Independent Evaluation Office produces rigorous evaluations of UNFPA's own programme approaches and country programmes. These provide different information than PMNCH's What Works reviews: UNFPA evaluations tell you what specific UNFPA programme approaches produce in specific contexts; PMNCH reviews tell you what the global evidence shows about intervention categories. Both are useful; neither substitutes for the other.

PMNCH vs. Results for Development / Global Health Evidence Initiatives: Several organisations (R4D, USAID's Evidence-Based Approaches Centre, etc.) work in the research-to-policy translation space. PMNCH's advantage is its coalition breadth — its knowledge products reach a wider and more diverse audience because they are produced by and for a multi-stakeholder partnership. The limitation is that PMNCH's knowledge function is one element of a broader organisational mandate, not the sole focus.

PMNCH vs. Global Burden of Disease (IHME): IHME's Global Burden of Disease study provides the most comprehensive global epidemiological database for MNCH/SRHR outcomes. PMNCH uses GBD data in its knowledge products. The comparison illustrates PMNCH's positioning: IHME provides the underlying data; PMNCH translates it into policy implications.


IMPLICATIONS BY AUDIENCE

For Practitioners and Programme Staff

The What Works series is the PMNCH knowledge product most directly useful to practitioners. When designing or evaluating a programme in a specific area (e.g., community midwifery, adolescent SRH services, nutrition in pregnancy), the relevant What Works volume provides a rapid, credible overview of what the global evidence shows. Use it to:

Note the limitations: What Works volumes address global evidence patterns, not country-specific conditions. Local health system capacity, community preferences, infrastructure, and policy context all affect how global evidence translates into local practice. PMNCH's knowledge products are the starting point, not the ending point, for programme design.

For the most current country-specific data, use Countdown to 2030 (country profiles) and WHO Global Health Observatory data. PMNCH's Progress Reports and What Works series provide context; Countdown provides the country-level numbers.

For Decision-Makers and Funders

The knowledge function should be assessed by funders on two dimensions: (1) the quality of what PMNCH produces, and (2) the reach and influence of what PMNCH produces.

On quality: the What Works series is methodologically sound, uses academic commissioning and peer review, and is transparent about evidence limitations. The Countdown co-publishing adds academic credibility. Policy briefs are variable in quality.

On reach and influence: PMNCH's publications reach a wide and diverse audience because of the partnership's membership. However, demonstrating that publications have influenced specific policy decisions is methodologically difficult. Available internal evaluations suggest high satisfaction among partner organisations with PMNCH's knowledge products, but this is satisfaction data, not impact data.

Funders should ask: what would the global MNCH/SRHR policy community's knowledge landscape look like without PMNCH's synthesis function? The likely answer — more fragmented, less accessible, less connected to the advocacy and accountability processes — suggests the function has real value. Quantifying that value remains a challenge.

For Researchers

PMNCH's knowledge products are most useful to researchers as secondary sources — credible evidence syntheses that provide rapid orientation in a specific area. The What Works series is citable and methodologically described, making it appropriate to reference in academic literature. The Countdown to 2030 publications are primary academic outputs (peer-reviewed, authored by named researchers) and should be used and cited as such.

For researchers examining PMNCH's knowledge function itself, interesting questions include:

The self-reported progress data in EWEC Progress Reports requires careful methodological handling for research use. Appropriate uses include: longitudinal analysis of commitment-making behaviour, analysis of commitment quality across commitment types, and qualitative analysis of accountability claim framing. Inappropriate uses include: using PMNCH progress data as a proxy for programme effectiveness or health outcome achievement.


CURRENT STATUS AND FUTURE DIRECTIONS

PMNCH's knowledge function is expanding in three directions under the 2021–2025 strategy:

Digital health: New What Works content on digital health interventions for MNCH/SRHR is being produced, responding to the explosion of digital health initiatives post-COVID. The evidence base is growing but remains immature — many digital health interventions lack rigorous outcome evaluations.

Climate and MNCH: PMNCH is producing evidence briefs on the health impacts of climate change on MNCH outcomes — heat stress and pregnancy, climate-induced food insecurity and maternal nutrition, displacement and MNCH access. The evidence base here is thin; PMNCH's products are largely evidence mapping rather than evidence synthesis.

Financing evidence: The innovation theme in the 2021–2025 strategy has prompted knowledge work on innovative financing mechanisms for MNCH/SRHR — development impact bonds, blended finance, private sector partnerships. This is an area of active policy interest but limited evidence on effectiveness.

For the 2026–2030 strategy period, PMNCH's knowledge function will need to address the growing evidence base on health systems disruption (post-COVID), the climate-MNCH evidence agenda, and the role of community-driven accountability in MNCH/SRHR — an area where the evidence is emerging from LMICs in ways that challenge the traditional global-to-local knowledge flow model.


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