maternal and child health programs in countries 
such as Nepal, Ethiopia, and Senegal have dem-
onstrated that community-based approaches, linked 
to primary and referral care when possible, can de-
liver high-impact interventions to prevent or treat 
many of the life-threatening conditions affecting 
mothers, newborns, and children under the age of 5. 
(20) More than half of all children and preg-
nant women in developing countries suffer from ane-
mia, which is exacerbated by malaria, neglected 
tropical diseases, and nutritional deficits, causing 
adverse pregnancy outcomes and even death. 
(21) According to WHO, women that have un-
dergone female genital mutilation are significantly 
more likely than those who have not undergone fe-
male genital mutilation to experience serious 
postpartum health problems, and children born to 
mothers who have undergone female genital mutila-
tion face higher death rates immediately after birth. 
(22) According to the Director of National 
Intelligence’s 2009 Annual Threat Assessment, wide-
spread poor maternal and child health and malnutri-
tion has the potential to weaken central governments 
and empower non-state actors, including terrorist 
and paramilitary groups. 
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(23) The United States Agency for Inter-
national Development has estimated the economic 
impact of maternal and newborn mortality to be a 
global loss of over $15,000,000,000 due to dimin-
ished productivity. 
(b) PURPOSES.—The purposes of this Act are— 
(1) to authorize assistance to improve maternal 
and newborn health in developing countries; and 
(2) to develop a strategy to reduce mortality 
and improve maternal and newborn health in devel-
oping countries. 
SEC. 3. ASSISTANCE TO IMPROVE MATERNAL AND NEW-
BORN HEALTH IN DEVELOPING COUNTRIES. 
(a) IN GENERAL.—Chapter 1 of part I of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend-
ed— 
(1) in section 102(b)(4)(B), by striking ‘‘reduc-
tion of infant mortality’’ and inserting ‘‘reduction of 
maternal and newborn mortality’’; and 
(2) by inserting after section 104C the fol-
lowing new section: 
‘‘SEC. 104D. ASSISTANCE TO REDUCE MORTALITY AND IM-
PROVE MATERNAL AND NEWBORN HEALTH. 
‘‘(a) 
AUTHORIZATION.—Consistent 
with 
section 
104(c), the President is authorized to furnish assistance, 
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on such terms and conditions as the President may deter-
mine, to reduce mortality and improve maternal health 
and the health of newborns in developing countries. 
‘‘(b) ACTIVITIES SUPPORTED.—Assistance provided 
under subsection (a) shall, to the maximum extent prac-
ticable, include— 
‘‘(1) activities to expand access and improve 
quality of maternal health services, including— 
‘‘(A) comprehensive voluntary family plan-
ning services, integrated into antenatal and 
postnatal care and in child health services, to 
support women and men in making informed 
decisions and having timely, intended, well- 
spaced pregnancies and to help women with 
preexisting conditions avoid high-risk, unin-
tended pregnancies; 
‘‘(B) birth preparedness through the provi-
sion of quality antenatal care, including— 
‘‘(i) educating women and families 
about danger signs to look for, potential 
complications during pregnancy and child-
birth, and where to access care; 
‘‘(ii) providing counseling about hy-
giene, nutrition, and the care and feeding 
of babies; 
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‘‘(iii) helping women and families de-
velop a birth plan that includes skilled de-
livery care and a transport plan in case of 
emergencies; 
‘‘(iv) screening for complications in-
cluding blood pressure screenings; 
‘‘(v) diagnosis and treatment of exist-
ing conditions, such as HIV/AIDS, syphi-
lis, malaria, and tuberculosis, and ensuring 
that women are provided with, or referred 
to, appropriate care and treatment for 
those conditions; 
‘‘(vi) ensuring that women infected 
with HIV are provided mother-to-child 
transmission prevention services, including 
access to voluntary family planning, medi-
cations to prevent such transmission, and 
counseling on infant feeding; and 
‘‘(vii) making vaccines, micronutri-
ents, and treatment for infections and 
parasites available and accessible; 
‘‘(C) skilled delivery care, including— 
‘‘(i) the presence of an accredited 
health professional, such as midwife, doc-
tor, or nurse, who has been educated and 
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trained to proficiency in the skills needed 
to manage normal or uncomplicated preg-
nancies, childbirth, and the immediate 
postnatal period, and in the identification, 
management, or referral of complications 
in women and newborns, including active 
management of the third stage of labor; 
and 
‘‘(ii) an enabling environment that in-
cludes access to a referral system, commu-
nication and transport, drugs and supplies, 
and equipment appropriate for a normal 
delivery; 
‘‘(D) quality emergency obstetric care, in-
cluding— 
‘‘(i) increasing the technical com-
petence of health care providers; 
‘‘(ii) increasing the essential supplies 
and equipment including fluids, blood 
products, and drugs to treat complications 
such as infection, bleeding, and hyper-
tension; 
‘‘(iii) providing the information and 
counseling for the client, including quality 
of client-provider interaction; 
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‘‘(iv) ensuring continuity of com-
prehensive, acceptable care, referrals and 
followup; and 
‘‘(v) access to cesarean section when 
necessary; 
‘‘(E) postpartum care and support, includ-
ing— 
‘‘(i) activities to promote immediate 
exclusive breastfeeding; 
‘‘(ii) activities to promote essential 
care of newborns; 
‘‘(iii) activities to treat, repair, and 
provide followup services for injuries re-
sulting from pregnancy and childbirth, in-
cluding fistula; and 
‘‘(iv) family planning counseling and 
service provision; and 
‘‘(F) postabortion care, including— 
‘‘(i) emergency treatment of complica-
tions of unsafe abortion; 
‘‘(ii) family planning counseling and 
services; and 
‘‘(iii) linkages to other reproductive 
health services; 
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‘‘(2) working with communities and health care 
providers to identify and remove barriers to mater-
nal health care services, including barriers such as 
financial, sociocultural, transportation, gender dis-
crimination, and stigma based on preexisting health 
concerns, and ensure that those services are based in 
individual human rights, as recognized by inter-
national agreements and instruments; 
‘‘(3) comprehensive sexuality education pro-
grams and services for youth that provide adoles-
cents with information, skills, and materials nec-
essary to postpone childbearing; 
‘‘(4) promotion of activities that focus on em-
powering women and girls and engaging men and 
boys at the individual, household, and community 
levels to improve the health outcomes of women, 
newborns, and children including education and 
awareness programs about gender-based violence, 
the health risks of female genital mutilation, and 
shared responsibility for and benefits of family plan-
ning; 
‘‘(5) activities to improve essential newborn 
care and treatment, including educating families and 
communities about proper antenatal and skilled de-
livery care, tetanus toxoid immunization during 
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pregnancy, immediate and exclusive breastfeeding, 
keeping the newborn warm, such as by providing 
skin-to-skin care, keeping the cord clean, resuscita-
tion of newborns who are not breathing properly, 
and treatment of infections; 
‘‘(6) activities to prevent and treat childhood ill-
ness, including early infant diagnosis of HIV infec-
tion and increasing access to appropriate prevention 
and treatment for diarrhea, pneumonia, malaria, 
HIV/AIDS, and other life-threatening childhood ill-
nesses; 
‘‘(7) activities to improve child and maternal 
nutrition, including the delivery of iron, zinc, vita-
min A, iodine, and other key micronutrients, the 
promotion of breastfeeding and appropriate com-
plementary feeding, and the utilization of Ready to 
Use Therapeutic Foods (RUTF) that, to the extent 
practicable, are developed, purchased, or produced in 
the country or region that they are utilized; 
‘‘(8) activities to strengthen the delivery of im-
munization services, including efforts to strengthen 
routine immunization, introduce new vaccines for 
diseases such as rotavirus and pneuomcoccal disease, 
and eliminate polio; 
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‘‘(9) activities to improve household-level behav-
ior related to safe water, hygiene, safe and hygienic 
food preparation and storage, exposure to indoor 
smoke, and environmental toxins such as lead; 
‘‘(10) activities to improve capacity for health 
governance, health finance, and the health work-
force, including in the private sector, and support 
for training clinicians, nurses, technicians, sanitation 
and public health workers, community-based health 
workers, midwives, birth attendants, peer educators, 
volunteers, and private sector enterprises to provide 
integrated health services and referrals that meet 
the needs of patients across a continuum of care; 
‘‘(11) activities to address antimicrobial resist-
ance in treating maternal health infections; 
‘‘(12) activities to establish and support man-
agement of host country institutions’ information 
systems and the development and use of tools and 
models to collect, analyze, and disseminate informa-
tion related to maternal and newborn health; 
‘‘(13) activities to develop and conduct needs 
assessments, baseline studies, targeted evaluations, 
or other information-gathering efforts for the design, 
monitoring, and evaluation of maternal and newborn 
health efforts, including— 
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‘‘(A) studying the availability and effects 
of critical medicines, particularly those of im-
portance in the developing world, on pregnant 
women and newborns; 
‘‘(B) collection, evaluation, and use of data 
on the medical and socioeconomic factors that 
led to a maternal or newborn death or ‘near 
miss’ at the community and health facility lev-
els; and 
‘‘(C) sociocultural barriers, influencers, 
and enhancers of health and nutrition behav-
iors; 
‘‘(14) activities to integrate and coordinate as-
sistance provided under this section with existing 
health programs for— 
‘‘(A) the prevention of the transmission of 
HIV from mother to child and other HIV/AIDS 
prevention, care, treatment, and counseling ac-
tivities; 
‘‘(B) malaria; 
‘‘(C) tuberculosis; 
‘‘(D) family planning and reproductive 
health; 
‘‘(E) counseling for survivors of sexual- 
and gender-based violence; 
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‘‘(F) neglected tropical diseases; and 
‘‘(G) nutrition; 
‘‘(15) activities to improve orphan care services 
and to support innovative orphan and vulnerable 
children programs; 
‘‘(16) activities to end harmful traditional prac-
tices including female genital mutilation and child 
marriage; 
‘‘(17) activities to train health care providers to 
prevent, identify, and manage cases of gender-based 
violence as part of family planning and maternal and 
newborn health services; 
‘‘(18) activities to support mental health care 
and provide psychosocial support; 
‘‘(19) activities to improve access to clean water 
and improved sanitation through community-based 
hygiene education programs, access to household- 
and community-level water purification tools and de-
vices, and latrine construction; and 
‘‘(20) activities to prevent, control, and in some 
cases eliminate neglected tropical diseases for both 
newborns and mothers. 
‘‘(c) GUIDELINES.—To the maximum extent prac-
ticable, programs, projects, and activities carried out using 
assistance provided under this section shall be— 
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‘‘(1) carried out through private and voluntary 
organizations, including community and faith-based 
organizations, and relevant international and multi-
lateral organizations, including the United Nations 
Population Fund, the United Nations Children’s 
Fund, and the Global Alliance for Vaccines and Im-
munizations, that demonstrate effectiveness and 
commitment to improving the health and rights of 
mothers, newborns, and children; 
‘‘(2) carried out in the context of country-driv-
en plans in whose development the United States 
Government participates along with other donors 
and multilateral organizations, nongovernmental or-
ganizations, and civil society; 
‘‘(3) carried out with input by beneficiaries and 
other directly affected populations, especially women 
and marginalized communities; and 
‘‘(4) designed to build the capacity of host 
country governments and civil society organizations. 
‘‘(d) ANNUAL REPORT.—Not later than January 31, 
2011, and annually thereafter for 4 years, the President 
shall transmit to Congress a report on the implementation 
of this section for the prior fiscal year. 
‘‘(e) DEFINITIONS.—In this section: 
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‘‘(1) AIDS.—The term ‘AIDS’ has the meaning 
given the term in section 104A(g)(1) of this Act. 
‘‘(2) HIV.—The term ‘HIV’ has the meaning 
given the term in section 104A(g)(2) of this Act. 
‘‘(3) HIV/AIDS.—The term ‘HIV/AIDS’ has 
the meaning given the term in section 104A(g)(3) of 
this Act.’’. 
SEC. 4. DEVELOPMENT OF STRATEGY TO REDUCE MOR-
TALITY AND IMPROVE MATERNAL AND NEW-
BORN HEALTH IN DEVELOPING COUNTRIES. 
(a) DEVELOPMENT OF STRATEGY.—The President 
shall develop and implement a comprehensive strategy as 
part of the Global Health Initiative to reduce mortality 
and improve the health of mothers and newborns in devel-
oping countries. 
(b) 
COMPONENTS.—The 
comprehensive 
United 
States Government strategy developed pursuant to sub-
section (a) shall include the following: 
(1) An identification of not less than 30 coun-
tries, including fragile states and countries affected 
by conflict, with priority needs for the 5-year period 
beginning on the date of the enactment of this Act 
based on— 
(A) the number and rate of neonatal 
deaths; 
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(B) the number and rate of maternal 
deaths; 
(C) the number and rate of malnourished 
women of reproductive age; and 
(D) the number of individuals with an 
unmet need for family planning. 
(2) For each country identified in paragraph 
(1)— 
(A) an assessment of the most common 
causes of maternal and newborn mortality and 
morbidity; 
(B) a description of the programmatic 
areas and interventions providing maximum 
health benefits to populations at risk and max-
imum reduction in mortality and morbidity; 
(C) an assessment of the investments need-
ed in identified programs and interventions to 
achieve the greatest results; 
(D) a description of how United States as-
sistance complements and leverages efforts by 
other donors and builds capacity and self-suffi-
ciency among recipient countries; and 
(E) a description of goals and objectives 
for improving maternal and newborn health, in-
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cluding, to the extent feasible, objective and 
quantifiable indicators. 
(3) Enhanced coordination among relevant de-
partments and agencies of the United States Gov-
ernment engaged in activities to improve the health 
and well-being of mothers and newborns in devel-
oping countries. 
(4) A description of the measured or estimated 
impact on maternal and newborn morbidity and 
mortality of each project or program. 
(c) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the President shall transmit 
to Congress a report that contains the strategy described 
in this section. 
SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—There are authorized to be appro-
priated to carry out this Act, and the amendments made 
by this Act, such sums as may be necessary for each of 
fiscal years 2011 through 2015. 
(b) AVAILABILITY
OF
FUNDS.—Amounts appro-
priated pursuant to the authorization of appropriations 
under subsection (a) are authorized to remain available 
until expended. 
Æ 
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