Sustainable health financing is a foundational element of a strong health system and one of the six WHO building blocks for health systems strengthening. It is critical for ensuring equitable access to maternal, newborn, and child health (MNCH) services, reducing financial barriers, and ultimately improving health outcomes. Without adequate and reliable funding, health systems are unable to provide lifesaving interventions, leading to preventable maternal and child morbidity and mortality.

A strong health financing system includes key components such as revenue collection, pooling of funds, purchasing of services, service delivery, governance, sustainability, and equity. These elements must be effectively managed and integrated to ensure that resources are mobilized, allocated efficiently, and reach the populations most in need – especially women and children.

Governments must prioritize domestic investment in MNCH through national budgets, health insurance schemes, and strategic purchasing. At the same time, public-private partnerships, donor funding, and innovative financing mechanisms – such as micro-contributions, market-based financial instruments, and results-based financing – are essential to bridge resource gaps and support long-term sustainability.

Financial protection strategies, including universal health coverage (UHC), voucher programs, and targeted subsidies, are crucial for reducing out-of-pocket costs and ensuring that no woman or child is denied care due to financial constraints. Transparent budgeting, tracking, and accountability mechanisms are also critical to ensure that available resources are used effectively and equitably.

This section of the toolkit provides practical guidance for strengthening MNCH financing, with a focus on advocating for increased investment, adopting cost-effective approaches, and building sustainable systems that ensure high-quality care reaches every mother and child.

What Are the Benefits of Financing MNCH Interventions

What’s the Evidence?

Evidence shows that investing in MNCH significantly reduces mortality and improves health outcomes, making advocacy for health financing in low- and middle-income countries critical. According to the World Health Organization (WHO), approximately 810 women die daily from preventable causes related to pregnancy and childbirth, with the vast majority of these deaths occurring in LMICs (WHO, 2021). Similarly, nearly 5 million children under five die annually, largely from preventable diseases (UNICEF, 2021). This underscores the urgent need for increased health financing.

Countries that have prioritized MNCH financing show positive results. For instance, Rwanda’s investments in maternal and child health have contributed to a reduction in maternal mortality by over 60% since 2000 (World Bank, 2019). Studies also demonstrate that every $1 invested in maternal and child health services yields a $10 return in economic and social benefits, illustrating the high return on investment (Lancet, 2018).

Moreover, evidence from countries with strong health financing mechanisms, such as Thailand, shows that universal health coverage with government funding and strong health systems leads to better health outcomes and reduced inequality (World Health Report, 2010).

Advocacy efforts have successfully led to increased funding in TCI-supported countries for their family planning and AYSRH programs, resulting in improved quality of care, expanded service coverage, and impact in uptake of modern contraception.

Financial contributions committed by TCI-supported local governments compared with what they actually spent for family planning and AYSRH from September 2017 to December 2024. An average of 62% has been spent across all six hubs.

Key Indicators

• Commitment: Percentage of local government budget allocated to maternal, neonatal, and child health services.
• Coverage of Services: Percentage of women and children accessing essential MNCH services (e.g., antenatal care, skilled birth attendance, immunization).
• Domestic Resource Mobilization/Sustainability: Percentage of health financing sourced domestically (through taxes, facility-based financing, social health insurance, etc.).
• Innovative Financing: Percentage of health financing for MNCH sourced from innovative financing mechanisms, such as social impact bonds, public-private partnerships, or impact investing.