MCH investments have proven to be “best buys” for the United States. Since 1990, for instance, this support has helped to cut the global rate of child and maternal mortality in half, making it possible for the United States to commit to a future goal of fully preventing child and maternal deaths.
Within the MCH account, the United States invests its resources bilaterally through multiple U.S. agencies, as well as multilaterally, through organizations such as Gavi. The United States also contributes key technical leadership and support through other mechanisms, such as the Sanitation and Water for All partnership and World Health Organization (WHO). These collective efforts have saved millions of lives while driving down health costs and, at the same time, scaling up to help in other areas, such as reducing newborn deaths and improving immunization rates.
USAID serves as the lead implementing agency in the U.S. for maternal and child survival, providing reportable benchmarks for the U.S. commitment to save the lives of 15 million children and nearly 600,000 women by 2020. In the past 10 years, USAID has helped save the lives of more than 5 million children and 200,000 women. USAID outlines a roadmap for success in its Acting on the Call initiative, which supports the scale-up of high-impact, evidence-based approaches for driving down the leading killers of mothers and children. Its investments help to ensure access to high-quality antenatal, labor, delivery, and postpartum care; provide nutrition for children and for women who are pregnant or recently gave birth; deliver lifesaving vaccines; save newborns from severe infections; protect young children from the risks of diarrhea, pneumonia, and malaria; support the healthy timing and spacing of births through voluntary family planning that protects both women and children; and address comorbidities, including HIV, malaria, and tuberculosis. Statistical modeling has demonstrated that, if a 25% cut to USAID MCH programming was to be enacted, 20.5 million mothers and children would fall out of reach for maternal and child survival programs each year — and an estimated 2 million lives that could have benefited from USAID help from 2018 to 2019 would be lost.
Alongside USAID programmatic efforts, the agency has also pioneered other methods for improving MCH and global health — including through the Saving Lives at Birth grand challenge, an initiative of the U.S. Global Development Lab and the Center for Accelerating Innovation and Impact. These efforts mobilize some of the world’s brightest thinkers, researchers, and entrepreneurs to innovate solutions for health, development, and maternal and newborn survival, benefiting many communities and saving the lives of millions. To strengthen systems of care, USAID also engages health-professional associations and trains frontline health workers to properly manage pregnancy, delivery, and complications for women and newborns.
USAID efforts are complemented by CDC activities, which provide scientific and technical assistance to strengthen health systems and workforces, and involve immunization programs such as the Measles & Rubella Initiative. Another close partner is the National Institutes of Health (NIH), which supports basic and applied research for issues critical to MCH, such as the causes of complicated pregnancies and deliveries. Additionally, U.S. funding for UNICEF supports the procurement and delivery of critical child-health commodities in developing countries.
U.S. commitments to Gavi are also key in driving down vaccine-preventable deaths globally. Two of the leading killers of children are pneumonia and diarrhea, yet both can be averted by highly effective vaccines that prevent pneumococcal infections or severe bouts of rotavirus, which causes deadly diarrhea. U.S. contributions to the Gavi five‑year strategy are expected to help immunize 300 million children against these threats and save over 6 million lives.
As seen with recent outbreaks and pandemics, the need for increased investments in MCH has never been greater. Continued U.S. support and leadership, with the help of bilateral partnerships and multilateral stakeholders, can prioritize the lifesaving interventions, effective programming, and evidence-based reporting necessary to continue progress.