Attachments
Introduction
In 2010, the United Kingdom (UK) Government Department for International Development (DFID) announced their ‘Framework for results for reproductive, maternal and newborn health (RMNH)’ which included several ambitious goals in relation to reproductive, maternal and newborn health including saving 250,000 newborn and 50,000 maternal lives by 2015 (1). DFID simultaneously committed to measuring its achievements in reaching these goals.
DFID supports health progress in developing countries through a number of different aid modalities. These include direct budget support to the government (general funds or health funds), bilateral/multi-donor programs, regional programs, support to multilateral organizations (such as UNFPA and GAVI) and program partnership arrangements (PPA) with civil society organizations.
Currently, there are no easy cost-effective methods available to directly measure the lives saved from the wide variety of types of health programs and funding streams. The most accurate method would be to directly measure mortality through before and after surveillance in the area where each individual program is implemented. However, this is time consuming, expensive and not feasible for all projects, especially those working at the national level or through budget support. There is also the possibility of double-counting the lives saved when programs overlap in place or time or over-ascribing impact to DFID programming when other programs exist in the area. In addition, measurement of maternal mortality at adequate precision to see statistically significant differences requires a very large population (100,000 or more pregnant women) that few programs reach.
Alternatively, child mortality rates or maternal mortality ratios can be collected through existing national surveys. They are limited in that most priority countries will not have such surveys at the exact points in time (2010 and 2015) that are necessary to estimate these impacts for the DFID results framework. In addition, these surveys are unable to adequately identify DFID programming impacts separately from non-health and non-DFID activities.