Development Assistance for Health: A Focus on Maternal and Child Health Funding from 1990 to 2015

Development assistance for health (DAH) grew to unprecedented highs since the establishment of the Millennium Development Goals (MDGs) in 2000. After fifteen years, the MDGs will culminate and will be succeeded by the Sustainable Development Goals (SDGs) as the future global targets. In preparation for these new objectives, this study attempts to understand how the MDGs catalyzed funding specifically for two of the health focused goals. MDG four calls for the global community to reduce the under-five mortality by two-thirds between 1990 and 2015. Goal five calls for a reduction of maternal mortality by three-quarters, over the same time period.

We extract data from the Institute for Health Metrics and Evaluation’s forthcoming Financing Global Health 2015 report. This report systematically tracks development assistance for health (DAH) from 1990 to 2015, splitting DAH into more than 20 health focus areas and drawing data from all major international development agencies. Budget documents and project descriptions are used to track donors’ priorities and categorize investments. The sources of the funds, primary channels of delivery, and country recipients of DAH are reported. Since 2000, $372.3 billion have been disbursed from donors to low- and middle-income countries. Of these funds, $36.6 billion (9.8%) and $62.4 billion (16.8%) were focused toward improving maternal and child health, as called out by MDGs 4 and 5. The decade after the signing of the MDGs, we observe DAH grow 11.3% per year. However, since 2010, we observe only a 1.4% annualized growth rate. Development assistance for maternal and child health, grew at an annualized rate of 2.8% and 8.8% the decade after 2000, both under-pacing the over growth in DAH. Over the last five years, we see both maternal and child health programs outpacing overall DAH, with 3.8% and 7.1% annualized growth, respectively. On average, countries poised to reach the child health MGD received more child health focused development assistance per capita than those countries not expected to reach the goal. Maternal health efforts do not have such straight forward results, with seemingly no obvious divide in funding for countries achieving or not achieving the maternal health goal. Understanding where the global community has achieved the targets set forth at the beginning of the millennium, and how the associated monetary response differed across those targets, can provide a strong foothold to begin the effort to reach the next round of global targets.