There have been huge increases in donor funding to aid maternal, newborn, and child health in recent years, with a near-doubling of funding per child in the 68 Countdown priority countries. However, funding fell in some of these countries, and work needs to be done to stabilise funding flows to allow governments to make long term commitments to health improvements. These are the conclusions of authors of an Article in this week's Countdown Special Edition of The Lancet.
To track donor assistance to maternal, newborn, and child health-related activities is necessary to assess progress towards MDGs 4 and 5 and to foster donor accountability. Anne Mills and Giulia Greco, London School of Hygiene and Tropical Medicine, UK, and colleagues, analysed aid in these areas between 2003 and 2006.
They found that donor disbursements increased from US$2119 million in 2003 to $3482 million in 2006; funding for child health increased by 63% and for maternal and newborn health by 66%. In the 68 priority countries, child-related disbursements increased from a mean of $4 per child in 2003 to $7 per child in 2006; and those for maternal and neonatal health increased from $7 per livebirth in 2003 to $12 per livebirth in 2006. Of the 68 countries, 52 countries saw increases in official development assistance (ODA) to child health per child between 2003 and 2006, by an average 200% per country. 50 also saw ODA to maternal and newborn health per livebirth rise, on average by 400% per country. The countries that saw falls in ODA in these areas included Brazil, Congo, Ghana, and Burundi.
Furthermore, countries with higher under-five mortality received more official developmental assistance per child, but official development assistance did not seem to be well targeted towards countries with the greatest maternal health needs. In terms of actual donation size, the four countries which gave the largest donations in 2006 were World Bank ($725 million), USA ($692 million), Global Fund ($327 million) and UK ($325 million). Only France, Greece and Italy have substantially reduced their donations in these areas in recent years.
The authors also comment on the volatile and variable nature of disbursements. They say: "This volatility makes effective planning and provision of appropriate levels of funding for various strategic priorities difficult for developing countries…Donors to maternal, newborn, and child health need to not only to provide long-term commitments but also to coordinate themselves collectively such that funding at the country level does not fluctuate excessively year-on-year."
They conclude: "This study demonstrates the value of year on year analysis of donor assistance to maternal, newborn, and child health. These analyses, for example, show that although expenditure is increasing, it is still far from sufficient. Despite the Paris Declaration on Aid Effectiveness, the great bulk of disbursements are still through projects rather than sector or budget support. Analyses, such as those presented here, must continue to be done so that donor commitments can be monitored and assessed to make sure that the most needy countries are benefiting."
Professor Anne Mills, London School of Hygiene and Tropical Medicine, UK T) +44 (0) 20 7927 2354 E) anne.mills@lshtm.ac.uk (not attending press conference)
Giulia Greco London School of Hygiene and Tropical Medicine, UK T) +44 (0)20 7927 2262 E) +44 (0)7896 365971 E) giulia.greco@lshtm.acuk (attending press conference)
Journal
The Lancet