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Publication Years
1131
2525
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Category
2025
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Toolboxes
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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
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method was requested to produce accurate, predictable, transparent, and up-to-date estimates that could 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.
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Infectious disease epidemics pose a threat to reproductive, maternal, newborn and child health (RMNCH) both directly—by worsening women’s and children’s
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health outcomes—and indirectly—by reducing their access to services.1–4 Greater investment is therefore needed to mitigate the negative effects of COVID-19 and avoid a reversal of recent gains in RMNCH coverage and outcomes.1 However, COVID-19 has reduced household and government budgets,5 and there are concerns about the extent to which resources have been diverted away from RMNCH.
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Background:Tracking aid fl ows helps to hold donors accountable and to compare the allocation of resources in relation to health need. With the use of data reported by donors in 2015, we provided estimates of offi cial development assistance and gr
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ants from the Bill & Melinda Gates Foundation (collectively termed ODA+) to reproductive, maternal, newborn, and child health for 2013 and complete trends in reproductive, maternal, newborn, and child health support for the period 2003–13. Methods: We coded and analysed fi nancial disbursements to reproductive, maternal, newborn, and child health to all recipient countries from all donors reporting to the creditor reporting system database for the year 2013. We also revisited disbursement records for the years 2003–08 and coded disbursements relating to reproductive and sexual health activities resulting in the Countdown dataset for 2003–13. We matched this dataset to the 2015 creditor reporting system dataset and coded any unmatched creditor reporting system records. We analysed trends in ODA+ to reproductive, maternal, newborn, and child health for the period 2003–13, trends in donor contributions, disbursements to recipient countries, and targeting to need.
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We created a dataset to generate estimates of donor-reported ‘official development assistance’ and private grants (ODA+) to reproductive, maternal, newborn and child health (RMNCH) by donor, rec
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ipient country and activity type over the period 2003–2013. We collected disbursement information from the Organisation for Economic Co-operation and Development Creditor Reporting System (CRS) in January 2015. All 2.1 million records across all sectors were coded based on donor name, project title, short and long descriptions, and CRS code describing the purpose of the disbursement. We classified records according to the degree to which they would promote attainment of Millennium Development Goals 4 and 5 (reproductive and sexual health, maternal and newborn health, and child health). We also classified records according to whether they supported prenatal and neonatal health (PNH). The dataset includes project funding as well as allocating shares of general budget support, health sector support and basket funding. The data can be used to analyse resource flows to RMNCH or to other purposes or beneficiaries of ODA+.
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not i
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mprove outcomes, if funds are delivered in ways that undermine countries’ public financial management systems and incur high transaction costs for project implementation
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This provisional Facilitator's Kit provides a complete framework for a 3-day training on Community Preparedness for Reproductive Health and Gender. The goal is to build community capacity to prepar
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e and respond to risks and inequities faced by women and girls during emergencies.
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This summary highlights the experiences, results and actions from the implementation of the Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages in Botswana. The tool – develo
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ped by IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW and Young Positives in 2009 – supports national assessments of the bi-directional linkages between sexual and reproductive health (SRH) and HIV at the policy, systems and services levels. Each country that has rolled out the tool has gathered and generated information that will help to determine priorities and shape national plans and frameworks for scaling up and intensifying linkages. Country experiences and best practices will also inform regional and global agendas.
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