Equity of resource flows for reproductive, maternal, newborn, and child health: are those most in need being left behind?

19 February 2020Achieving the ambitious aim of “leaving no woman, no child, no adolescent behind” in the push towards universal health coverage and the Sustainable Development Goals (SDGs) requires adequate resources, that are distributed fairly. The international community must focus on countries and populations within them with the highest needs. Both external donors and country governments must be held accountable for their contributions towards reproductive, maternal, newborn and child health (RMNCH).


In response to a request by donors and other stakeholders, Dr. Melisa Martinez-Alvarez and colleagues developed a novel method for tracking aid for RMNCH – Muskoka2 – that allows timely, transparent and granular analysis. The team applied this method to track donor aid for RMNCH and found a 10% jump in funding from 2016 to 2017, the most recent year for which data is available. Child health (46%) and reproductive and sexual health (34%) received much higher proportions of total funds than maternal and newborn health (19%).

The team also assessed the equity or fairness of funding for RMNCH across low- and middle-income countries. The Muskoka2 method was to examine donor aid and used data on domestic government financing from the World Health Organization. The study concluded that equity has improved; however, more and better targeted funding is needed to ensure the poorest are not left behind. It also highlighted the important gaps in data and methods requiring investment.

Dr. Martinez-Alvarez, Senior Scientist at the MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine said, “Although equity of external funding for reproductive, maternal, newborn and child health has improved in recent years, the scope still exists for donors and country governments to improve the amount and targeting of their funds in order to improve equity”.

The study was done in partnership with the London School of Hygiene & Tropical Medicine, Countdown to 2030, Partnership for Maternal, Newborn & Child Health, Open Consultants, and the University of Nigeria.