Canada Reportedly Ready to Spend $1 Billion to Cut Maternal Mortality: How To Use the Money Well

We hope that the G-20 members will call upon donors and recipients to experiment with the application of incentives and outcome-based development assistance to increase aid effectiveness.
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This is a joint post with Katherine Douglas

The Canadian press reports :

(Ottawa is) telling other G8 countries that Canada is willing to put about $1 billion toward maternal and child health -- as long as other countries ante up too... The Canadian cash will likely target poor countries with the worst records of maternal and child mortality and malnutrition.

The news follows Canadian PM Stephen Harper's January announcement that improving maternal and child health would be his country's signature initiative. Canada is hosting twin summits, the G-8, in Muskoka, north of Toronto, on June 25-26, and the G-20 in Toronto, on June 26-27. The United States is already on board: maternal and child health are key components of the Obama Administration's Global Health Initiative (GHI), which calls for an increase in global health funding to $63 billion over the next six years. Of this, $12 billion would be allocated to maternal and child health, family planning, and neglected tropical diseases. The money is potentially good news. Between 343,000 and 500,000 women die needlessly each year from complications during pregnancy or childbirth. Millennium Development Goal Five, which calls for sharp reductions in the maternal mortality, has seen the least progress of all the MDGs. In 2008, almost 80 percent of all maternal deaths occurred in 21 countries, and nearly half were concentrated in only six countries (India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of the Congo). These maternal deaths are an avoidable tragedy where rapid progress should be possible.

Turning the money into fewer maternal deaths will require tapping the power of incentives wherever possible. One way to do this is to offer incremental payments for progress towards a shared goal -- such as increases in the number of attended births, or even for the registration of births, since this would increase the likelihood that health providers identify and maintain contact with pregnant women. CGD's proposal for Cash on Delivery or COD Aid is one promising approach. My colleagues and I have explored the possible application to maternal mortality here and here.

The upcoming G-8 and G-20 summits in Canada represent a critical window of opportunity for development. The Canadian government's admirable commitment to champion aid effectiveness, maternal and child health, and the MDGs at the G-8 should not end there. We hope that the G-20 members will call upon aid donors and recipients to experiment much more with the application of incentives and pragmatic, outcome-based development assistance to increase aid effectiveness.

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