ArticlesCountdown to 2015: assessment of donor assistance to maternal, newborn, and child health between 2003 and 2006
Introduction
Although there exists a lack of clarity on what constitutes an adequate target of aid disbursement to improve maternal, newborn, and child health to acceptable levels, evidence broadly points towards a substantial funding gap between what is needed to meet Millennium Development Goal (MDG) targets and what is currently invested in developing countries.1, 2, 3 To ensure that sufficient resources become available, donors will need to play their part in providing additional funding to support national governments in meeting agreed targets. Monitoring of aid disbursements to maternal, newborn, and child health to those countries with the greatest need is an important part of the process to assess progress and promote donor accountability.
We have previously developed and tested a method of tracking official development assistance in support of maternal, newborn, and child health-related interventions and services to recipient countries.4 Our findings suggested that levels of official development assistance were broadly inadequate to make a substantial contribution towards filling the funding gap. This work also provided some indication that donor spending could be better targeted to countries with the greatest health needs, since the data showed substantial variation in per beneficiary donor assistance between priority countries.
Here, we update estimates of official development assistance to maternal, newborn, and child health to include the years 2005 and 2006, which allows us to undertake a more extensive analysis of trends over time. Specifically, we examine whether there has been a sustained increase in official development assistance to maternal, newborn, and child health and hence whether donors are living up to their promises to support countries to achieve MDG targets. Additionally, the determinants of aid allocations to developing countries are explored to elucidate the direction and intensity of financial flows to maternal, newborn, and child health. This study is part of the Countdown initiative, a collaborative effort that aims to support countries in meeting their commitments to global goals through monitoring mechanisms and effective use of information collected.
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Methods
We analysed and coded the complete aid activities database for the years 2005 and 2006 with methods described previously.4 We included all 22 donor countries and the European Union represented in the Development Assistance Committee of the Organisation for Economic Co-operation and Development (OECD). Additionally, we included the World Bank, UNICEF, the GAVI Alliance, and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) as multilateral development organisations or global
Results
The volume of aid to maternal, newborn, and child health-related activities amounted to US$2935 million in 2005 and $3482 million in 2006 (table 2), representing just 3% of gross development assistance disbursements.7 As in previous years, child health expenditure accounted for more than two-thirds of all official development assistance for these activities. Bilateral donors accounted for almost two-thirds of total aid to maternal, newborn, and child health (table 2). Together, the GAVI
Discussion
The volume of official development assistance to maternal, newborn, and child health rose from $2119 million in 2003 to $3482 million in 2006, with increases of 63% for child health and 66% for maternal and newborn health. There was improved targeting to the 68 priority countries, with an almost doubling of disbursement per beneficiary. Both multilateral agencies and bilateral donors increased their contribution between 2003 and 2006 on average by 57%, whereas disbursements from global health
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2015, The Lancet Global HealthCitation Excerpt :Agreement is needed as to which agency should take the lead. The results shown in this paper are subject to the same limitations with regard to the methods that have been acknowledged previously.12–15 The first challenge relates to separating funding to R*, maternal and newborn health, and child health, as well as the programme components therein.