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Note on costing and tracking investments

Posted by sdennis on 16 Feb 2011 at 19:20 GMT

Many thanks to the authors for a thorough and useful article. And this research also shows exactly how much work goes into the biannual Countdown reports. I have a few notes to respond to and build on points made in your article.

1. The OECD DAC CRS database may not have an MNCH category, but maternal health interventions are clearly included in the purpose code for Reproductive Health Care (13020). The purpose code is defined as, “Promotion of reproductive health; prenatal and postnatal care including delivery; prevention and treatment of infertility; prevention and management of consequences of abortion; safe motherhood activities.” Perhaps the definition should be updated to include more maternal health interventions, but the category is there. For advocacy and accountability purposes, funding for maternal health and child health interventions should be tracked separately wherever possible.
2. Thank you for pointing out that investments in family planning are crucial to improving maternal health, and will be tracking in the 2012 Countdown report. Investments in family planning are also part of the PMNCH $30 billion estimate, and therefore need to be included to more accurately compare disbursements to funding needs.
3. Regarding the $30 billion estimate, our research shows that the PMNCH/WHO estimate for family planning + maternal health is on the lower end of a spectrum of current estimates. For a comparison of cost estimates for reproductive health including maternal health, see Dennis and Mutunga (2009) “Funding Common Ground: Cost Estimates for International Reproductive Health.” In addition to the WHO and World Bank numbers, our analysis includes two other commonly cited estimates, one by The Guttmacher Institute and UNFPA cited by the present article, and another by UNFPA alone.
4. The authors are correct in stressing the importance of including health systems strengthening (HSS) costs as part of the overall investment need to improve maternal and child health. But the question of how HSS costs are applied to different themes is difficult to address. In “Funding Common Ground,” we roughly standardized cost estimates that present direct and HSS costs separately by allocating HSS costs to direct costs proportionally.

Thank you again for a very informative piece of work.

No competing interests declared.