Donor Funding for Reproductive, Maternal, Newborn and Child Health Nears Us$14 Billion Annually

Abstract

Donor development aid for reproductive, maternal, newborn and child health worldwide more than tripled between 2003 and 2013, although it is unknown whether this marked increase translated into better outcomes, according to an analysis from the Countdown to 2015 project. (1) The amount of official development assistance funds plus grants from the Bill & Melinda Gates Foundation (collectively termed ODA+) to these health subsectors increased by 225% over the period--to nearly US$14 billion. Gains were greatest for child health, with the bulk going to immunization efforts, and for reproductive and sexual health, with the bulk going to HIV interventions. Correlation between amounts disbursed and country metrics of health need became stronger over the study period, a change that suggests better targeting of funding to level of need. For the study, investigators used the January 2015 download from the creditor reporting system of the Organisation for Economic Co-operation and Development, which included global financial disbursements through 2013. They used a predefined framework to code all projects over the 2003-2013 period on the basis of whether they were related to reproductive, maternal, newborn and child health; they also coded disbursements for 2003-2008 relating to reproductive and sexual health activities. The end result was a Countdown data set for 2003-2013, which was matched to the 2015 creditor reporting system data set. The investigators then analyzed trends in ODA+ for reproductive, maternal, newborn and child health for 2003-2013, trends in donor contributions and disbursements to recipient countries. They also calculated Spearman correlation coefficients between funds disbursed and selected metrics of health need to assess targeting. In 2013, a total of 147 countries and 17 regional entities received ODA+ disbursements. These disbursements were made by 64 donors reporting to the creditor reporting system and the Bill & Melinda Gates Foundation. Results of analyses show that ODA+ to the entire health sector in 2013 amounted to US$24 billion, or 15% of the total for that year--an increase from 10% in 2003. Disbursements specifically for reproductive, maternal, newborn and child health in 2013 amounted to almost US$14 billion. Some 48% of this amount--$6.8 billion-supported child health, 34% ($4.7 billion) supported reproductive and sexual health, and 18% ($2.5 billion) supported maternal and newborn health. Between 2003 and 2013, ODA+ for reproductive, maternal, newborn and child health increased by 225% overall; the increase was greatest for child health (286%), followed by reproductive and sexual health (194%) and maternal and newborn health (164%). Bilateral donors accounted for the largest share--59%--of all ODA+ for reproductive, maternal, newborn and child health in 2013; global health initiatives disbursed 23%, and multilateral aid agencies disbursed 13%. The leading donors for the period 2003-2013 were the United States (US$32 billion), the Global Fund (US$11 billion), the United Kingdom (US$7.3 billion) and the Global Alliance for Vaccines and Immunization (US$6.6 billion); these same donors were also the leaders in 2013. Throughout the study period, most ODA+ for reproductive, maternal, newborn and child health was concentrated in the 75 Countdown priority countries, where 95% of all maternal and child deaths occur. …