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U.S. Government Funding for Women and Family Health

The U.S. government has a long history of supporting efforts to improve the health of women and families around the world. While many U.S. programs address women and family health generally, several are focused on them directly, including: maternal and child health (MCH), which includes immunization activities; family planning and reproductive health (FP/RH); and nutrition.1 The accompanying papers examine U.S funding for each of these sectors. They look at funding trends over time, the top country recipients of aid, the share of funding provided to the sector within the larger U.S. global health funding portfolio, and the role of the U.S. as a donor in the context of overall donor support. Among the key findings are the following:
  • Combined U.S. funding for these sectors has risen somewhat in recent years, increasing from $1.9 billion in FY10 to $2.0 billion in FY16 ($180 million or 10%). This increase has been driven almost entirely by funding for maternal and child health programs (which rose by $271 million or 29%). Funding for the other two sectors has fluctuated and even decreased in some years, with funding for FP/RH declining over the period (a decrease of $108 million or 15%). The President’s budget request for FY17 includes a 5% increase for these sectors combined, most of which would go to MCH programs (See Figure 1).
Figure 1: U.S. Global MCH, FP/RH, and Nutrition Funding, FY 2010-FY 2017 Request

Figure 1: U.S. Global MCH, FP/RH, and Nutrition Funding, FY 2010-FY 2017 Request

  • U.S. funding for these sectors represents a relatively small share of the U.S. global health budget, which has been dominated by funding for disease-specific efforts – primarily PEPFAR and the Global Fund – over the last decade. In FY16, the three sectors accounted for 20% of the global health budget (see Figure 2). Funding for MCH was 12%, the third largest program after PEFPAR and the Global Fund. A significant share of funding for MCH is directed at immunization activities (at least 42% in FY16). Funding for FP/RH in FY16 was 6% of U.S. global health funding, and nutrition was 2%.
Figure 2: Funding for MCH, FP/RH, and Nutrition as a Share of U.S. Global Health Budget, FY 2016

Figure 2: Funding for MCH, FP/RH, and Nutrition as a Share of U.S. Global Health Budget, FY 2016

  • Most of the U.S. effort in these sectors is bilateral, with funding provided directly to countries or regions. Still, over time, an increasing share has been provided multilaterally, rising from 14% in FY10 to 20% in FY16. Most of this has been driven by the MCH portfolio, which channeled 30% of funds multilaterally in FY16 to GAVI and UNICEF. FP/RH funding included 5% for multilateral efforts through UNFPA. All nutrition funding was provided through bilateral channels. (see Figure 3).
Figure 3: Bilateral & Multilateral Funding Shares for U.S. Global MCH, FP/RH, and Nutrition Programs, FY 2016

Figure 3: Bilateral & Multilateral Funding Shares for U.S. Global MCH, FP/RH, and Nutrition Programs, FY 2016

  • Within each sector, the U.S. government has increasingly focused its funding on a subset of “priority countries” which represent those with the most severe health needs. For example, both the maternal and child health and family planning and reproductive health programs focus on 24 priority countries, which account for 76% and 70% of funding, respectively.
  • The U.S. is the largest donor to these sectors in the world,2 though no single donor provides the majority of funding in any of the three sectors.

Taken together, these papers show that funding for these three sectors has, overall, remained relatively flat over the past several years, though funding for MCH programs has grown as a priority. Combined, the sectors account for just a fifth of the U.S. global health budget. Still, it is important to note that funding for these three sectors alone does not fully capture U.S. support for activities that address women and family health; other programs, including PEPFAR and the President’s Malaria Initiative, indirectly support such activities, though their focus is not on women and family health per se. Ultimately, as the largest donor to each area in the world, future funding by the United States stands to have a significant impact in the field.

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