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Estimates of aid for reproductive, maternal, newborn, and child health: findings from application of the Muskoka2 method, 2002–17

Dingle, A.; Schäferhoff, M.; Borghi, J. et al. The Lancet (2020) CC

Background Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017. Methods Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators. Findings After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million). Interpretation Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention. Funding Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health. more

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Quality, Equity, Dignity. The network to improve quality of care for maternal, newborn and child health

World Health Organization WHO; UNICEF; et al. (2018) C_WHO

Strategic Objectives

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Training and Evaluation of Community Health Workers (CHWs): Towards Improving Maternal and Newborn Survival in an Urban Setting in KwaZulu-Natal, South Africa

Thoko Ndaba1, Myra Taylor, Musawenkosi Mabaso The Open Public Health Journal (2019) C1

CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at home immediately after discharge from health care c... more

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Resettlement Policy Framework For Uganda Reproductive, Maternal, Neonatal, and Child Health Improvement Project
recommended

Ministry of Health Uganda (2016) C1

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Integrating HIV, hepatitis B and syphilis screening and treatment through the Reproductive, Maternal, Newborn and Child Health platform to reach global elimination targets

J. Woodring; H.d Sobel; Y. Takashima; et al. World Health Organization (Western Pacific Region) (2017) C_WHO

WPSAR Vol 8, No 4, 2017 | doi: 10.5365/wpsar.2017.8.3.005 DOI: http://dx.doi.org/10.5365/wpsar.v8i4.564

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Nepal: Health Sector Strategy Health Sector Strategy for Addressing Maternal Undernutrition 2013-2017 (Nepali Version)
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Governement of Nepal, Ministry of Health and Population, Department of Health Services (2013) C1

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Epilepsy mhGAP Training of Health-care Providers Training manual Supporting material

World Health Organization WHO (2019) C_WHO

mhGAP Training Manual for the mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings – version 2.0 (for field testing)

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Child and adolescent mental and behavioural disorders mhGAP. Training of Health-care Providers and Training manual Supporting material

World Health Organization WHO (2010) C_WHO

Training of Health-care Providers and Training manual Supporting material

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Intimate Partner Violence (IPV) in Zambia: Sociodemographic Determinants and Association with Use of Maternal Health Care

Simona, Simona J., Mazuba Muchindu, and Harriet Ntalasha ICF International (2015) C2

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Health Facility and Health Worker Baseline Assessment for Reproductive, Maternal, Neonatal, Child Health and Nutrition Services

Millennium Development Goal Acceleration Initiative Government of Zambia (2015) CC

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Building Accountable Community Level Commodity Supply Systems Responsive to Reproductive, Maternal, Newborn, Child and Adolescent Health Needs in Uganda

Ministry of Health, Republic of Uganda (2016) C1

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The Associations between Nutrition, Stress, Infection, and Inflammation and Maternal Health and Pregnancy Outcomes in Rural Malawi

Ashorn, P.; B. Poelman, K.G. Dewey, et al. Fanta Project; USAID (2017) C1

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Strengthening the capacity of community health workers to deliver care for sexual, reproductive, maternal, newborn, child and adolescent health

World Health Organization (WHO); H4+, UNFPA; et al. World Health Organization (WHO); H4+, UNFPA; et al. (2015) C_WHO

Technical brief by the H4+ (UNAIDS, UNFPA, UNICEF, UN Women, WHO and the World Bank)

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A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno Distr

Wroe, E.B.; Nhlema, B.; Dunbar, E.L. et al. BMJ Global Health (2021) CC

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan... more

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Fostereing a Stronger Community-to-Facility Link to increase maternal and newborn health and nutrition

Micronutrient Initiative (2016) C1

Case Study

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Essential care and practice mhGAP Training of Health-care Providers. Training manual and supporting material

World Health Organization (WHO) (2015) C_WHO

Key messages include Effective communication skills should be used for everyone seeking health care, including people with MNS conditions and their carers; Effective communication skills enable health-care providers to build rapport and trust with people as well as enabling health-care providers to... more

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Other significant mental health complaints: mhGAP Training of Health-care Providers and training manual, supporting material
recommended

World Health Organization (WHO) WHO (2015) C_WHO

Common presentations of other significant mental health complaints include: depressed mood, irritability, anxiety, stress, extreme tiredness, unexplained physical complaints. Other significant mental health complaints are frequently seen in non-specialized health settings, but are often treated inap... more

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Disorders due to substance use - mhGAP Training of Health-care Providers Training manual Supporting material

World Health Organization (2019) C_WHO

Accessed: 21.03.2019

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Tracking aid for global health goals: a systematic comparison of four approaches applied to reproductive, maternal, newborn, and child health

Pitt C.; Grollman C.; Martinez-Alvarez M. et al The Lancet (2018) CC

Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health (RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and the Organisation for Economic Co-operation and Development (OECD) policy marker. We... more

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Antibiotic resistance – undoing progress in maternal and child health

ReAct (2018) C2

Antibiotic resistant bacteria are spreading at an alarming rate and some bacterial infections may once again be untreatable. Antibiotic resistance (ABR), conservatively calculated, causes more than 500 000 deaths every year. This number is projected to rise dramatically if radical actions are not ta... more

Resettlement Policy Framework For Uganda Reproductive, Maternal, Neonatal, and Child Health Improvement Project recommended

Nepal: Health Sector Strategy Health Sector Strategy for Addressing Maternal Undernutrition 2013-2017 (Nepali Version) recommended

Other significant mental health complaints: mhGAP Training of Health-care Providers and training manual, supporting material recommended

Resettlement Policy Framework For Uganda Reproductive, Maternal, Neonatal, and Child Health Improvement Project
recommended

Nepal: Health Sector Strategy Health Sector Strategy for Addressing Maternal Undernutrition 2013-2017 (Nepali Version)
recommended

Other significant mental health complaints: mhGAP Training of Health-care Providers and training manual, supporting material
recommended