Financing for women and children takes center stage at UNGA 81
As countries confront rising debt burdens, shrinking fiscal space and weaker development assistance, leaders gathered on the margins of the 81st United Nations General Assembly to press a blunt message: health gains for women, children and adolescents will erode unless financing is protected now. The session, titled Financing for Women’s, Children’s and Adolescents’ Health in a Time of Austerity, brought together government representatives, multilateral institutions, development partners, philanthropy and civil society under the umbrella of the Global Leaders Network for Women’s, Children’s and Adolescents’ Health and the Partnership for Maternal, Newborn and Child Health.
The discussion centered on a practical question with immediate consequences at the bedside and in the community: how can countries sustain hard-won progress when public budgets are under pressure and external funding is less predictable? The answer, repeated across interventions, was not to rely on a single funding stream. Domestic resource mobilization, better alignment of external support and more diversified financing mechanisms emerged as the core pillars.
Rt Hon. Helen Clark, former Prime Minister of New Zealand and PMNCH Board Chair, framed the meeting around political accountability. “Leadership is not measured by declarations in New York. It’s measured by the choices made at home later,” she said.
Maternal survival remains vulnerable when budgets tighten
The stakes were described in direct terms by Spain’s State Secretary, H.E. Eva Granados, speaking on behalf of Prime Minister Pedro Sánchez. She reminded the audience that childbirth should be associated with hope, not fear, in a line that captured the public health urgency behind the financing debate. She also cited the scale of avoidable loss: one woman dies every two minutes in childbirth, and almost five million children do not reach their fifth birthday.
Spain linked health spending to broader national development and equality goals. “Progress in health is inseparable from progress in equality and development,” Granados said. In practice, that means maternal, newborn and adolescent health cannot be treated as expendable line items when budgets contract. They are core services, and when they are interrupted, mortality rises quickly.
A similar point came through from South Africa, which convened the meeting alongside Spain and Tanzania. Speaking on behalf of H.E. President Cyril Ramaphosa, Hon. Ronald Lamola said the Global Leaders Network exists to catalyze, convene and enable collective action, with protection of financing for women, children and adolescents at the center of its mission.
Tanzania and Sierra Leone show what sustained investment can change
Tanzania offered one of the clearest examples of what continued commitment can deliver. Speaking on behalf of H.E. President Samia Suluhu Hassan, Hon. Dr Florence George Samizi, Deputy Minister of Health, said the country reduced its maternal mortality ratio by 80% between 2015–16 and 2022, alongside a substantial decline in child mortality. The figures were presented as evidence that political commitment, domestic resource mobilization and national prioritization can move outcomes in the right direction when sustained over time.
Sierra Leone brought a more operational example to the discussion. The government’s 300 Days of Activism for Triple Zero, launched by President Julius Maada Bio in February, is aimed at three targets: zero preventable maternal deaths, zero preventable child deaths and zero zero-dose children. After 205 days, the country had recorded a 31% reduction in maternal mortality and an 11.7% reduction in infant mortality, while children previously identified as zero-dose had been fully vaccinated.
The campaign is designed to outlast the campaign. “The 300 days will end on December 25th. On December 26th, we want to change the culture. It’ll never be a campaign anymore. This will be our way of life to protect our women and children in Sierra Leone,” Dr. Austin Demby, the Minister of Health, said. The message was simple: short bursts of attention are not enough unless they alter how the health system is financed and run.
New financial tools enter the discussion
Several countries used the session to describe how they are trying to widen the financing base without abandoning domestic responsibility. Kenya said it has committed US$58 million through its Every Woman, Every Newborn, Everywhere Acceleration Plan to support free maternity services, essential commodities, family planning and recruitment of 5,000 nurses and midwives across all 47 counties. The country also pointed to debt-for-health mechanisms, concessional finance and blended finance as ways to complement domestic resources.
Nigeria described nearly US$3 billion in domestic health financing over five years, together with US$2 billion in U.S. support, directed toward primary health care, the health workforce and removal of financial barriers to emergency obstetric services. The scale matters because financing shortages do not stay abstract for long; they show up as fewer skilled staff, stockouts of essential supplies and delays in emergency care.
Mexico emphasized the earliest phase of life. Its national approach centers on the first 1,000 days and combines antenatal care, maternal nutrition, immunization, breastfeeding, screening and child development. H.E. Dr David Kershenobich, Secretary of Health, stressed that survival alone is not the endpoint. “Our responsibility does not end when a child survives,” he said, describing care that extends beyond survival to lifelong development.
Mexico also announced that it will host the Global Forum on Maternal and Child Survival in Mexico City from 2 to 4 March 2027, co-hosted with Spain, WHO, PAHO and other multilateral institutions. Around 300 participants are expected to attend, with the stated aim of building a new coalition and turning commitments into action toward 2030.
Donor alignment and country ownership remain the fault lines
Somalia’s intervention brought the financing debate back to fragility, climate shocks and conflict. The country is working to strengthen primary health care, integrate maternal, newborn and child health with nutrition and immunization, and improve the alignment of external resources. Yet the message from Hon. Dr Ali Haji Adam Abubakar was that domestic resources alone cannot cover the gap. “We must ensure that fiscal austerity does not translate into fewer midwives, fewer vaccines, interrupted nutrition services, or preventable deaths among mothers and children,” he said.
Somalia is calling for a health architecture that is country-led rather than donor-driven, with partners aligning behind one plan, one budget and one report. In a period of constrained aid, that request carries concrete operational weight. Fragmented funding does not merely waste administrative effort; it can also pull health systems away from national priorities and make service delivery less reliable.
France’s announcement that it is joining the Global Leaders Network added another layer to the session. Jean-Sébastien Conty, Deputy Director for Global Affairs at France’s Ministry for Europe and Foreign Affairs, said France intends to contribute to more sustainable action for the health of women, newborns and children. France placed sexual and reproductive health and rights at the center of its approach, calling them a cornerstone of its feminist foreign diplomacy, and invited participants to the Child Summit at the Paris Peace Forum in November.
Africa CDC Director-General H.E. Dr. Jean Kaseya placed the country examples in a continental frame, pointing to the Africa Health Security and Sovereignty agenda as evidence that the continent can take bold action on maternal and child health financing. The session ended with broad agreement on the same point: unless governments protect health budgets, align external support and use new financing tools carefully, the cost will be paid in avoidable deaths, interrupted services and lost developmental gains.