Maternal and Child Health
FY2016 Funding Recommendation:
President's FY2016 Request
InterAction's FY2016 Recommendation
Each year, USAID interventions help save the lives of more than 6 million children under the age of 5 and reduce maternal deaths from pregnancy-related causes. These initiatives range from prenatal care and preventing maternal deaths during childbirth, to pediatric immunizations and other child-survival interventions.
MCH funding supports cost-effective interventions like vaccines and nutritional supplements, and trains health workers on basic prevention, treatment, and management of threats such as malaria, diarrhea, pneumonia, prematurity and stillbirth, birth complications, and all forms of malnutrition. Scaling up these programs is necessary to end child and maternal mortality. MCH funding also supports the research and development, introduction, and scale-up of new tools and solutions needed to improve maternal and child health. MCH funding fulfills U.S. commitments to the Global Polio Eradication Initiative and to Gavi, the Vaccine Alliance to increase access to new and underutilized vaccines for developing countries.
These interventions are working. From 1990 to 2011, child mortality declined an average of 4% each year in the countries where USAID focused its maternal and child health programs. In these same 24 focus countries, maternal deaths declined an average of 5% each year, faster than the global average.
At a June 2012 summit, global health experts showed that it is possible for every country to end preventable child deaths in a generation. Since then, 177 countries, including the United States, have signed the “A Promise Renewed” pledge to reduce child mortality to 20 or fewer deaths per 1,000 live births in every country by 2035, and to end preventable maternal deaths. Those pledges have led several developing country governments to develop and launch high-impact strategies to reach the 2035 goals.
Most recently, in June 2014, USAID announced a strategy to sharpen its programming for maternal and child health in an effort to reach the global goal of preventing the deaths of 15 million children and 600,000 mothers by 2020. USAID plans to target the most high-impact interventions toward the specific health concerns of each of its priority countries.
InterAction recommends an FY2016 funding level of $850 million for the MCH account, including $235 million for Gavi. This would provide lifesaving interventions, including Gavi-supported vaccines, to advance the U.S. commitment to end preventable child and maternal deaths.
More than 700,000 women served by MCHIP efforts to prevent after-birth bleeding
With her labor pains intensifying, Epiphanie Nyirankurikiyimana began the 3-hour walk to the health facility closest to her Rwandan village. But the baby would not wait. Nyirankurikiyimana gave birth on the side of the road assisted by community health worker Immaculee Bampoyineza, who had agreed to accompany her to the health facility. Nyirankurikiyimana started bleeding excessively – a not uncommon event in the developing world, where postpartum hemorrhage (PPH) is the leading cause of maternal deaths.
In Rwanda alone, 45% of maternal deaths are attributed to postpartum hemorrhage.
But Bampoyineza had been trained to deal with just this situation through the Maternal and Child Health Integrated Program (MCHIP), USAID’s flagship program to improve maternal and child health worldwide, which is led by Jhpiego. She gave Nyirankurikiyimana three tablets of misoprostol, a drug that is highly effective at preventing women from bleeding to death.
In Rwanda and 12 other African and Asian countries, MCHIP has trained community health workers to educate pregnant women on preparation of a birth plan, the importance of giving birth in a health facility, the danger signs of life-threatening complications, and how to use a uterotonic medicine (such as misoprostol) to prevent postpartum hemorrhage. As of June 2013, more than 700,000 women giving birth have received lifesaving medicine to prevent postpartum hemorrhage, thanks to USAID/MCHIP-supported programs.
Since the birth of her daughter, Nyirankurikiyimana has been teaching other mothers in her village about the importance of preparing in advance for childbirth and taking misoprostol immediately after the birth if delivering outside a health facility. “I still remember the tragic day when we lost my neighbor, who died during childbirth from excessive bleeding,” she said. “I wish the drug had been available in our village to save her life.”
Photo Credit: Jhpiego