The document summarizes the US Global Health Initiative (GHI), which aims to invest $63 billion over six years to strengthen health systems and improve health outcomes in partner countries, with a focus on women, newborns and children. The GHI will work through coordination, integration, country ownership and health systems strengthening. It establishes targets to reduce mortality and prevalence of diseases like HIV/AIDS, tuberculosis, malaria and malnutrition by 2015. The GHI operational plan includes assessing country health plans, focusing US investments, and designating some countries for additional technical and financial support.

1. The U.S. Government’s Global Health Initiative “ We will not be successful in our efforts to end deaths from AIDS, malaria, and tuberculosis unless we do more to improve health systems around the world, focus our efforts on child and maternal health, and ensure that best practices drive the funding for these programs.”—President Obama, May 5, 2009

10. GHI Plus Country Selection and Funding

12. MNCH Integration Along the “Continuum of Care” MCH / FP / Nutrition HIV / Malaria Pre-pregnant Pregnant Labor & Delivery Post-Partum Care & FP Newborn, infant & child Family Planning, nutrition HIV prevention, counseling; VCT; Antenatal Care, nutrition VCT, HAART; IPTp, ITNs Obstetric Care PMTCT Mother: Post-partum F/U Care & Treatment ENC, immunization, prevention, sick NN/child care, nutrition CTX, testing, basic preventive package, ITNs, sick child care, RDTs, treatment

14. Bureau for Global Health Maternal Child Health Portfolio Review

15. What’s New?? Previous USG HSS Activities HSS under the GHI HSS defined by attribution from disease-specific programs HSS as a deliberative focus of USG health activities USG assistance programs designed through an element-driven lens Developing HSS objectives that are strategic activities for the country HSS Objectives articulated in element-driven terms Clear, measurable objectives for both shared and element-driven activities No common indicators, progress tracked on per activity basis A few, strategic HSS indicators will be aggregated across the GHI Unable to track USG HSS investments Development of better means to track HSS expenditures Difficult to establish linkages between HSS activities and health impact Conducting HSS implementation research that will help us to identify the linkages between the highest priority HSS activities and impact

16. Monitoring and Evaluation Plan: Rwanda As part of an investment in a comprehensive approach to reduce poverty and hunger, USG can assist Rwanda to reduce undernutrition for over 300,000 children, from a national prevalence of 52% to 30%. Core Indicators Baseline Target % of children underweight 20 15 % of children stunted 52 30 % of children wasted 5 2 % of women with BMI <18.5 9 6 % of women with anemia 33 22 % of Children with anemia 56 37 % of infants exclusively breastfed <6 months 38 60 % of children fed according to three Infant & Young Child Feeding Practices 37 60 % of children (6-59 months) supplemented with vitamin A twice a year 84 85 % of households consuming adequately iodized salt 88 90 Household Hunger Scale TBD TBD Women’s Dietary Diversity TBD TBD