Just a couple of months after a group of bipartisan senators introduced the Reach Every Mother and Child Act of 2015, four House Representatives—David Reichert (R-WA), Betty McCollum (D-MN), Barbara Lee (D-CA), and Michael McCaul (R-TX)—extended arms across the aisle to co-sponsor companion legislation (H.R. 3706).
Both bills aim to bolster United States efforts to end preventable maternal, newborn, and child deaths globally by: scaling-up evidenced based interventions; designing, implementing, monitoring and evaluating programs to increase accountability; streamlining existing resources; and utilizing innovative public-private financing.
While the House version of the legislation echoes much of what comprises the Senate bill, there are two differences worth noting.
First, the House bill gives the Maternal and Child Survival Coordinator greater authority. As noted in a previous blog post, ideally the Maternal and Child Survival Coordinator would oversee all US investments in global maternal and child health, not just those made through USAID. And the House bill delivers: the Coordinator would have responsibility for assuring that all US government resources and activities designated for international maternal and child health and nutrition programs work together. In theory, this arrangement would give the Coordinator enough clout to ensure greater alignment and cooperation across US agencies with initiatives that impact women and child health. This is a big task, but one that, if executed effectively, could yield benefits. If each agency’s strategy and budgets aligned with their comparative advantages, we could very well see greater gains in maternal and child health in the countries where the US provides assistance.
Second, the House bill calls for the use of innovative public-private financing tools, but does not explicitly refer to development impact bonds (something we were excited to see included in the Senate version). That said, the House legislation provides additional flexibility, which could help US agencies explore results-based financing approaches like DIBs and determine if they offer a context-appropriate mechanism for leveraging public and private capital and management for maternal and child health interventions. Still, including a few more tangible examples in the text of what is meant by ‘innovative financing tools’ wouldn’t hurt.
Overall, we’re pleased to see both bills focus on outcome- and evidence-based approaches. However, careful consideration of what outcomes are measured will be needed. For instance, the use of maternal mortality rates as an indicator of progress has proven problematic due to measurement challenges, such as lack of statistical capacity which impacts accuracy and timeliness of critical data. And the presence of skilled delivery attendants at births has not always corresponded with positive health impacts.
While the very idea of reaching compromise in Washington these days feels like a pipe dream, we’ll take bipartisan support for the Reach Act in both the House and Senate as an encouraging sign.