This is an average of the three domain scores below.
The U.S. Government received a 79 (C+) with transparency and an 83 (B) without transparency for the Maternal and Child Health (MCH) domain across all actors in 2022. Though global MCH efforts were meaningfully included in the National Strategy on Gender Equity and Equality, MCH was omitted from some whole-of-government actions as well as key agency-level actions from both the Department of State and the United States Agency for International Development (USAID). This omission reinforced the siloed nature of global health programs and did not support the implementation of integrated programming based in evidence and human rights. In most instances, agency-level actions were gender accommodating as they reinforced a gender binary and did not use inclusive language such as “pregnant and breastfeeding persons,” which excluded the experiences of all people who can become pregnant. All actors received low to moderate transparency scores for actions graded in the MCH domain. The continued lack of funding information for the Department of Health and Human Services (HHS) global MCH efforts and low scores for appropriate use of funds by USAID and the Department of State also negatively affected the overall MCH domain grade in 2022.
The White House received an 87 (B+) with transparency and an 88 (B+) without transparency in the Maternal and Child Health (MCH) domain in 2022. The White House requested adequate funding for global MCH programs within USAID, UNIFEM (now UN Women), and the United Nations Children’s Emergency Fund (UNICEF). Generally, actions graded in this domain meaningfully referenced global MCH programs, which supported the ability of global health assistance to promote SRHR in the MCH domain. The White House demonstrated a moderate level of transparency within MCH policies and a moderate level of transparency for the availability of funding information in the MCH domain.
Congress received a 94 (A) with transparency and a 96 (A+) without transparency in the Maternal and Child Health (MCH) domain in 2022. Congress appropriated adequate levels of funding for the United Nations Children’s Emergency Fund (UNICEF), UNIFEM (now UN Women), and global MCH programs implemented by the United States Agency for International Development (USAID). Congress demonstrated a moderate level of transparency with regard to actions and high transparency of funding information related to MCH globally in 2022.
The Department of State received a 36 (F) with transparency and a 43 (F) without transparency in the MCH domain in 2022. This domain grade was raised by the PEPFAR Five Year Plan, as well as the updated PrEP Ring FAQs, which were both responsive to need, based in evidence, and aligned with human rights principles. However, subsequent edits to the Five Year Plan did not promote SRHR, and were not based in evidence or responsive to need, and thus negatively impacted the MCH score. This domain grade was low because the actions did not include data or information about activities within MCH programs, which reinforced the siloed nature of global health programs, negatively affected transparency, and hindered SRHR. In the budget evaluation, the Department of State allocated MCH funds somewhat in accordance with country-level maternal mortality, which moderately promoted SRHR. Transparency was relatively low across actions but moderately high with regard to budget data in the MCH domain.
USAID received a 75 (C) with transparency and a 79 (C+) without transparency in the MCH domain in 2022. This domain grade was raised by efforts such as the Maternal and Child Health and Nutrition Technical Roadmap 2030, which outlined a sustainable, cross-sectoral strategy to promote global MCH that was based in evidence and responsive to need. The domain grade was decreased slightly because of the omission of MCH in the USAID Climate Strategy 2022-2030, which moderately hindered SRHR. Overall, transparency was low for many actions graded in this domain because USAID did not indicate which content was updated in 2022. USAID had a high level of transparency for funding data but did not disburse MCH funding that was responsive to need, which decreased this actor’s grade in this domain.
HHS received a 60 (D-) with transparency and a 69 (D+) without transparency in the Maternal and Child Health (MCH) domain in 2022. The Global Health Equity Strategy and the CDC Core Health Equity Science and Intervention Strategy moderately supported SRHR. The newly released HHS strategic plan for FY 2022-2026 and the General Terms and Conditions for Research and Non-Research neither promoted nor hindered SRHR in this domain because it was unclear as written whether these actions were relevant to the global MCH programs. The National Strategy for Combating Multi-Drug Resistant Tuberculosis moderately hindered SRHR as it did not mention the sex disaggregation of data despite the fact that gender is a key aspect that informs tuberculosis intervention strategies. Funding data for global MCH efforts implemented by HHS were not publicly available at the time of grading, which contributed to the low transparency grade in the MCH domain.