Research Article: Financing Maternal and Child Health—What Are the Limitations in Estimating Donor Flows and Resource Needs?

Date Published: July 6, 2010

Publisher: Public Library of Science

Author(s): Marco Schäferhoff, Christina Schrade, Gavin Yamey

Abstract: Marco Schäferhoff and colleagues critique funding estimates for the maternal and child health Millennium Development Goals, and make recommendations for improving the tracking of financing flows and estimating the costs of scaling up interventions for mothers and children.

Partial Text: The crisis of avoidable maternal, newborn, and child deaths in developing countries is currently a major focus for the global health community (Box 1), and it will be one of the leading issues discussed at the September 2010 Summit on the Millennium Development Goals (MDGs) [1]–[3]. Many countries are off track to reach the 2015 child and maternal health MDGs (MDGs 4 and 5), and additional donor assistance will be needed to help countries get back on track.

The key source of data for estimating official development assistance (ODA) to MNCH is the Countdown to 2015 Initiative ( Countdown is a collaborative network of organizations that monitors coverage levels for interventions proven to reduce maternal, newborn, and child mortality. It published its first two reports in 2005 and 2008 (, and two articles in The Lancet in 2006 and 2008, that include the MNCH financing estimates (covering the years 2003–2006) [4],[5]. Its third report, available at, covers financing flows up to 2007.

There are several limitations in the estimates of funding flows to MNCH in Countdown’s first two studies [4],[5]. These limitations also apply to the estimates in the June 2010 report—Countdown has not been able to address these limitations in its third report (Countdown member, personal communication). Some, but not all, of these limitations have been acknowledged by Countdown [4].

Below, we offer a set of policy recommendations to overcome weaknesses in tracking MNCH financing flows and in estimating the MNCH “price tag.”

Important strategic decisions must be made to accelerate progress toward MDGs 4 and 5. Reliable estimates on the currently available financial resources and the funding gap are a critical precondition for sound decision making and for directing investments.