The United States continues to be the largest bilateral donor in the field of global maternal and child health (MCH) —especially child health—and has expanded its investment in this area under the Obama administration. Increasingly, the United States has become a leading voice in the vibrant global movement to end preventable maternal and child death.

 

Over the past 25 years there has been a nearly 50 percent decline in the number of maternal and child deaths worldwide. Directly linking this progress to U.S. investments, however, is difficult, given the proliferation of global actors involved, the fact that data systems to track health outcomes are inadequate, and measurement of progress in maternal and child health is complicated by the inability to determine whether particular interventions are responsible for success or if overall improvements in social and economic conditions have contributed.

 

And despite recent progress in reducing maternal and child mortality, there is still tremendous work to be done to improve the overall health and livelihoods of the world’s mothers and children. Political will and financial resources have not sufficiently matched stated priorities, and there has been debate on what constitute the key issues within the MCH field. For many decades, the programmatic emphasis was on reducing child mortality. Only in the past few years has revitalizing stalled progress on reducing rates of maternal death attracted attention; the related challenge of newborn survival has emerged even more recently. Looking ahead, achieving greater and more sustained impact will require reaching the most vulnerable women and children: those living in remote areas, conflict zones, and humanitarian assistance settings.

 

For the next administration to truly move the needle on maternal and child health, greater innovation in programming and collaborations will be required. The United States should intensify its efforts in several priority areas:

  • Scale up success:The U.S. government is strongly positioned to leverage existing tools, knowledge, and experience to scale up the U.S. Agency for International Development’s (USAID) high-impact, evidence-based interventions. Scaling up what works will deliver much better results than simply trying to do more.

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  • Integrate by creating a more holistic approach: Scale-up of programs and strengthening of existing systems create new opportunities for program integration. The U.S. government can be the pioneer in developing integrated models for global health that streamline MCH into other essential development activities.
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  • Reinforce efforts to reach the most vulnerable: Sixty percent of maternal deaths in the world occur in 10 countries, 9 of which are currently in a state of conflict or emerging from conflict. Women and girls who live in refugee camps or are escaping war in their home countries are more susceptible to sexual assault, forced marriage, and unsafe abortions. Unless the administration devotes more resources to the hardest-to-reach mothers and children, it risks a slowdown in progress.
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  • Address roadblocks and prepare for new challenges: “Going the last mile” to eradicate preventable maternal and child deaths will entail a sharper focus on removing the roadblocks to progress and expanding proven, low-cost solutions. The incoming administration has multiple opportunities to build on the United States’ track record of success in many areas.
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  • Initiate and sustain public-private partnerships focused on maternal and child health, such as Saving Mothers, Giving Life (SMGL), drawing on expertise from multiple sectors to support countries’ efforts to improve women’s and children’s access to high-quality health services.

 

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