A new report published in The Lancet reveals that Official Development Assistance(ODA) in support of maternal, newborn and child health (MNCH) programs increased in 2007 and 2008, yet concerns persist over how countries are prioritized. ODA for MNCH programs increased from $4.7 billion in 2007 to $5.4 billion in 2008 for all developing countries, with Countdown priority countries receiving 71.6% of MNCH aid in 2007, and 75.6% in 2008. Increased flows of ODA are in large part due to the efforts emerging from the Accra Agenda for Action and the Paris Declaration on Aid Effectiveness, which also called for a larger proportion of MNCH ODA to be disbursed as grants, not loans.
Several donors have significantly scaled up aid, and MNCH aid in particular. The GAVI Alliance and the Global Fund together have increased their aid by a factor of nearly five from 2003 to 2008. The USA and the UK are the largest bilateral donors to MNCH aid. The World Bank is the largest multilateral donor, with UNFPA in a very close second place. However, the World Bank’s aid to MNCH programs in particular are lower in 2007 and 2008 than in previous years.
Integrated health-care projects, including primary health care, hospitals and health systems strengthening activities accounted for 30.6% of all project-based MNCH funding in 2008. Malaria and HIV-related programs accounted for 20.4%, though this number greatly varied from country to country. The only project type with a decreased value from 2003-2008 was the Integrated Management of Childhood Illness.
While ODA is designed to provide aid to countries most in need, this was found to not always be the case. For example, Niger and Chad have some of the highest rates of maternal mortality, yet they consistently received less ODA for maternal and newborn health per live birth than many other countries with lower mortality and greater resources. While increased aid should be celebrated, it is critical that prioritization is also analyzed and that needed adjustments are made to reach MDG 5.