Maternal and Child Health

FY2018 Funding Recommendation:  
$900 million

 

Funding History

       Enacted   

       House/Senate FY2017 Request  

       InterAction's FY2018 Recommendation


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Justification

 Key Facts

  • Each year, 5.9 million children under the age of five die from mostly preventable causes such as pneumonia, prematurity, malnutrition, diarrhea, and malaria, and from complications during labor and delivery.

  • Globally, about 45% of under-five deaths are attributable to undernutrition. Nearly half (45%) of under-five deaths are babies who die within the first month – one million of those deaths occur on the first day of life.

  • Approximately every two minutes, a woman dies from pregnancy or childbirth-related complications (a total of approximately 303,000 women in 2015). Ninety-nine percent of these women live in developing countries.

  • New vaccines such as the rotavirus and pneumococcal vaccines that are supported by Gavi, the Vaccine Alliance, drive down deadly diarrhea and pneumonia – both leading killers of kids in the developing world. Since started in 2002 Gavi has supported poor countries to immunize over half a billion children, which saves over 7 million lives.

Each year, USAID interventions help save the lives of more than 6 million children under the age of five 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, and helps fulfil existing 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.

The good news: MCH interventions are working. Since 2009, child mortality has declined an average of 4% each year in the 25 priority countries where USAID focused its maternal and child health programs. In these same countries, maternal deaths declined an average of 3.5% each year – faster than the global average.

Since 2014, USAID has sharpened 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. Under this strategy USAID targets the most high-impact interventions toward the specific health concerns of each of its 25 priority countries. 

While great strides have been made to increase maternal, newborn, and child health, much work still needs to be done. Each day, over 16,000 children under five years of age will die of preventable and treatable conditions such as prematurity, pneumonia and diarrhea – with malnutrition being the underlying cause in 45% of those deaths. Newborn deaths are a growing proportion of child mortality with 1 million children dying on the day they are born. Strengthening and investing in care during labor, birth and the first day and week of life, as supported by the Every Newborn action plan, are critical to reach this vulnerable population and to drive down newborn deaths and stillbirths. In addition, children who are surviving, may not be thriving. UNICEF has suggested that in areas where child mortality declines, child disability prevalence is unlikely to do so at the same rate and may stay the same or even increase.  Identification of birth impairments and developmental delays are not commonplace within health sector practice.

InterAction recommends an FY2018 funding level of no less than $900 million for the MCH account, including $290 million for Gavi, the Vaccine Alliance. This would continue current lifesaving interventions, fulfill U.S. commitments to Gavi-supported vaccines and the global plan for polio eradication, and bolster new research and development to advance the U.S. commitment to end preventable child and maternal deaths.

Success Story

The Right Skills and Tools Save Lives in Indonesia

When Hamriani, a young woman from Indonesia, was 38 weeks pregnant, she awoke in the middle of the night with a throbbing headache and contractions. Her husband took her to Kampili health center in a borrowed car. The midwives on duty found signs of pre-eclampsia, a potentially fatal pregnancy-related condition that is the second leading cause of maternal deaths in Indonesia. Each year, more than 10,000 women die in Indonesia due to complications from pregnancy and childbirth such as pre-eclampsia.

Hamriani was lucky. That same day, the USAID-supported and Jhpiego-led Expanding Maternal and Neonatal Survival (EMAS) program had just completed training the health center’s midwives in managing severe pre-eclampsia cases. With the skills fresh in their mind, the staff quickly divided into three color-coded teams: red, green, and yellow. The green team contacted the obstetrician, the red team administered the medication, and the yellow team monitored Hamriani’s condition and calmed her. An hour later Hamriani gave birth to a healthy baby and her condition was stable. She had survived pre-eclampsia.

The EMAS program is working in 30 districts and cities, including 150 hospitals and 300 health centers, to help improve health outcomes for mothers and newborns and reduce maternal and newborn deaths.

With confident and well-prepared midwives, nurses, and health facilities – like the ones who came together to save Hamriani’s life – more mothers and their babies can survive and thrive.  

Photo: Syane Luntungan/Jhpiego

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