About the numbers: MMR and Aid Dollars

It certainly has been an interesting week  already for those of us who enjoy reading about numbers, with two major studies released in the Lancet.

First, the groundbreaking article with new maternal mortality ratio (MMR) numbers. The development community, and the global health community in particular, has used the dependable standby of “500,000” as the number of women who die each year from pregnancy-related causes. Researchers used an immense number of data points and sources to come up with a new figure that, pleasantly, paints a much more optimistic picture:

“The research team also generated the maternal mortality ratio (MMR) for each country. MMR is the number of women dying for every 100,000 live births. They found that globally, MMR declined from 422 in 1980 to 320 in 1990. It fell to 251 in 2008, and is, say the authors, on track for further decreases.

Dr Murray says the findings are contrary to previous research, which showed very little change in the maternal mortality ratio (MMR). This new research from IHME shows that maternal deaths have been declining at an annual rate of about 1.4% between 1990 and 2008.

The researchers found that progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. Nearly one out of every five maternal deaths – a total of 61,400 in 2008 – can be linked to HIV, and many of the countries with large populations affected by HIV have had the most difficulty reducing their maternal mortality ratio.”

You can read the commentary of the Lancet editor for some added perspective on the implications of these findings.

The second article that has generated some buzz is about the how fungible health aid dollars are. With the Global Health Initiative (GHI) championing more results-based funding flows, aiming to ensure that aid dollars are used more effectively and encourage local governments to eventually take over projects, this article looks at the relationship between aid funding flows and local government spending on health projects.

“At the country level, while shares of government expenditures to health increased in many regions, they decreased in many sub-Saharan African countries. The statistical analysis showed that DAH to government had a negative and significant effect on domestic government spending on health such that for every US$1 of DAH to government, government health expenditures from domestic resources were reduced by $0·43 (p=0) to $1·14 (p=0). However, DAH to the non-governmental sector had a positive and significant effect on domestic government health spending.”

Does this mean that Dambisa Moyo was correct, and aid dollars being shipped to country governments are crippling Africa? Perhaps that would be the simple conclusion to jump to, but as we all know, questions about aid are never simple. You can read an analysis of the findings, highlighting some important things to keep in mind, here. Bloggers with far more expertise and experience than I have already posted their thoughts on the findings; I’d recommend reading Alanna Shaikh’s UN Dispatch post and Laura Freschi’s Aid Watch post. All have an interesting perspectives and are worth a read.

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