Domain Score Overview

The U.S. Government received an 86 (B) with transparency and an 89 (B+) without transparency for HIV and AIDS across all actors in 2019. This grade reflected the continued commitment of the President’s Emergency Plan for AIDS Relief (PEPFAR) to implement programs that are evidence-based, responsive to need, and gender accommodating and Congress’s commitment to appropriating adequate funding for HIV and AIDS. Similar to past years, the implementation of the PLGHA policy by relevant actors harmed SRHR within this domain. Furthermore, HIV and AIDS continued to be omitted from key reporting documents across actors, including USAID’s annual Acting on the Call report. Low transparency of policy documents from USAID in this domain also contributed to the overall lower grade. In spite of these negative actions, however, the domain grade for HIV and AIDS-related funding and policies remained higher than the grades of the other domains across actors.

The U.S. Government received a 68 (D+) with transparency and a 71 (C-) without transparency for Maternal and Child Health across all actors in 2019. This grade stemmed from a low budget request by the White House and gender-blind language across policy documents that reinforced the traditional gender binary with regard to maternal and child health programs. The U.S. government also omitted specific references to maternal and child health programming in the PLGHA policy documents and guidance, which indicates that the U.S. government did not consider the unique impact of the implementation of the PLGHA policy on maternal and child health programs. The grade was positively impacted by the continued issuance of USAID’s reports like Acting on the Call and USAID’s revision of ADS Chapter 212 that are based in evidence. Low transparency regarding USAID’s maternal and child health policies and maternal and child health funding by HHS also contributed to this grade.

The U.S. Government received a 61 (D-) with transparency and a 64 (D) without transparency for Family Planning across all actors in 2019. This grade reflected the continued harm to SRHR by the implementation of the PLGHA policy and the harm to SRHR caused by omitting family planning from key global health documents concerning women and girls by various actors. Similar to 2018, this grade was also harmed by insufficient family planning funding, the defunding of the United Nations Population Fund (UNFPA) due to an unsubstantiated Kemp-Kasten amendment violation in FY 2019, low transparency of policies by USAID, and family planning spending by USAID that was not responsive to need.