Maternal Mortality in India
USAID and its partner organizations implemented the development impact Utkrisht bond in February 2018. Many believe this is an innovative and cost-effective solution to end preventable maternal and child deaths in India.

The Utkrisht bond is targeted to assist the State of Rajasthan, where 80,000 babies die annually from inadequate medical care. But proponents hope the model can be used throughout India, which accounts for 20 percent of maternal and child deaths globally.

The development impact bond was announced in November of 2017 by USAID Administrator Mark Green at the Global Entrepreneurship Summit in India. It is expected to provide 600,000 women with improved healthcare access and potentially save 10,000 moms and newborns.

The bond works as a public-private partnership. Investors grant providers of maternal care with upfront capital. Then, outcome funders pay back the investors their principal plus a return if pre-agreed metrics are achieved. The investor, in this case, is the UBS Optimus Foundation, which has committed about $3 million. The organization works with philanthropists to bring sustainable benefits to vulnerable children.

Up to 440 private health facilities will then be operated with assistance from Population Services International (PSI) and the Hindustan Latex Family Planning Promotion Trust (HLFPPT), which also are co-investors providing 20 percent of the required capital. PSI is a global health nonprofit and the HLFPPT is an Indian nonprofit that works with maternal care.

In order to maximize success, private facilities are the focus of the Utkrisht bond. They host more than 25 percent of institutional deliveries in Rajasthan and are used by women of all socioeconomic backgrounds, yet little has been done to improve their quality of care.

USAID and Merck for Mothers, a nonprofit with the goal to end maternal mortality, have each committed up to $4.5 million that will be paid if the heath facilities meet accreditation standards. This is a highly cost-effective method to save lives according to World Health Organization standards, which is particularly exciting to USAID.

“The pay for success approach ensures appropriate stewardship of U.S. taxpayer dollars, while unlocking both private capital and government resources for health,” USAID states.

While this is the first development impact bond targeted toward health, the future of the Utkrisht bond looks promising. If it is successful, more initiatives can be implemented that involve private-public cooperation and effective use of taxpayer money to save the lives of many women and children around the world.

– Sean Newhouse

Photo: Flickr

Reach Every Mother and Child Act
On the African continent, women are 47 times more likely to die from preventable complications during childbirth than they are in the United States. That amounts to approximately 800 women dying a day in developing nations. Mothers are not the only vulnerable ones. Each day, an estimated 17,000 children under the age of five will also die from treatable conditions.

Delaware’s Senator Chris Coons and Maine’s Senator Susan Collins hope to dramatically shrink and ultimately eliminate these statistics. In July 2015, the senators introduced the Reach Every Mother and Child Act of 2015 in order to increase the amount of U.S. aid being directed toward ending these tragic and preventable deaths. The bill establishes a framework to implement the existing tools and focus necessary for winning the battle against preventable mother and child deaths.

The bill calls for a strategic and attainable 10-year plan to succeed in ending preventable maternal, newborn and child deaths by 2035. This includes the creation of a permanent Maternal and Child Survival Coordinator at the United States Agency for International Development (USAID) who will be responsible for implementing the 10-year plan and to confirm that resources and interventions are being effectively utilized in target nations.

The U.S. government will also create a financing framework that will allow the use of U.S. funds to leverage additional funds from nongovernmental organizations, partner countries and international organizations.

While introducing the bill in their floor speeches, Senators Coons and Collins both stressed that the Reach Every Mother and Child Act is not a bolt-from-the-blue or a handout.

“Investing in maternal and child health in developing countries is an investment in the future, and I look forward to working with my colleagues to help all mothers and children around the globe get the health care they deserve,” said Senator Coons.

Acting USAID Administrator Alfonso Lenhardt echoed Coons’ sentiment. “As children survive and thrive, parents are choosing to have smaller families,” said Lenhardt, “unleashing a virtuous cycle of progress and prosperity.”

USAID recently released a new report showing that previous efforts to improve the survival rates of mothers, newborns and children under the age of five have already saved 2.5 million children and 200,000 mothers since 2008. This demonstrates substantial evidence that the new act will be successful.

“There are simple, proven and cost-effective interventions that we know will work if we can reach the mothers and children who need them to survive,” said Senator Collins. The Reach Every Mother and Child Act, if passed, is anticipated to improve the health of millions of impoverished and at-risk mothers and children.

World Vision’s Director of Government Relations Lisa Bos is particularly excited about the bill, praising Senators Collins and Coons for championing the bill. “The goal of ending preventable maternal and child deaths is achievable, but it will take renewed commitment, coordination and resources,” said Bos. “This bill builds on the progress we’ve made and is critical for ensuring we reach every mother and child. We hope every Member of the Senate will support this legislation.”

Claire Colby

Sources: Senate, USAID, World Vision