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BMZ (Germany’s Federal Ministry for Economic Cooperation and Development or Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung) is consulting on how to implement a material reduction in its Official Development Assistance (ODA) budget. In this paper, we review where remaining funds would have the greatest impact, and propose a series of reforms accordingly. We recommend:

Focussed thematic allocation: Germany’s development projects have been substantially diluted over the last decade. We find that BMZ projects have progressively targeted a broader range of Sustainable Development Goals (SDGs). The number of projects that target more than four goals, for example has risen almost nine-fold from 72 to over 600 in the last ten years. Evidence suggests that less complex measures would have been more efficient and effective.We suggest focussing on 4–5 SDGs that align with the Government’s priorities and BMZ’s expertise render overall ODA allocation more effective.

Strategic country allocations: BMZ currently funds projects in a 110 of the 141 ODA-eligible countries in total. It seems clear this will need to be reduced. Providing development finance makes the biggest difference to those in greatest need, so we undertake an analysis to ascertain the level of ODA that each of these recipients receives from other countries, expressed in terms of ODA per person in extreme poverty. We identify 31 BMZ partner countries that are under-prioritised—of which 13 are significantly under-prioritised. In contrast, we find 48 countries that are over-prioritised by other providers. We urge BMZ to fully protect budgets in the 31 under-prioritised countries, and concentrate reductions in the 48 over-prioritised. This enhances the impact of BMZ funding overall and enables German funding to represent a larger and more influential share of recipients’ economies.

Sharpening instruments: Over the last five years, funding for the “Multilateral and European development cooperation” federal budget instrument has been cut by 34 percent, while there has been 20 percent cuts in bilateral efforts. Germany is below average in the share of its international finance that is allocated multilaterally. We argue this split should be reversed. First, multilateral organisations are assessed as highly effective by independent assessments, and surveys of the German public also suggest they garner a high level of trust. But there is an additional compelling geopolitical case for allocating funding multilaterally. Following the abrupt withdrawal of the United States from a number of organisations, the international system is more vulnerable than ever. It is difficult envisage a future where Germany is secure and prosperous if the multilateral system fails to endure. We urge the German government to shield its multilateral contributions in from these cuts, refocus earmarked multilateral spend towards core funding, and increase its core multilateral share to at least 40 percent in the next two years. Regarding the remaining bilateral share, we propose that Germany reconsider its current approach to the volume and tendering of technical assistance.

BMZ (Germany’s Federal Ministry for Economic Cooperation and Development or Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung) is consulting on how to implement a material reduction in its Official Development Assistance (ODA) budget. In this paper, we review where remaining funds would have the greatest impact, and propose a series of reforms accordingly. We recommend:

Focussed thematic allocation: Germany’s development projects have been substantially diluted over the last decade. We find that BMZ projects have progressively targeted a broader range of Sustainable Development Goals (SDGs). The number of projects that target more than four goals, for example has risen almost nine-fold from 72 to over 600 in the last ten years. Evidence suggests that less complex measures would have been more efficient and effective.We suggest focussing on 4–5 SDGs that align with the Government’s priorities and BMZ’s expertise render overall ODA allocation more effective.

Strategic country allocations: BMZ currently funds projects in a 110 of the 141 ODA-eligible countries in total. It seems clear this will need to be reduced. Providing development finance makes the biggest difference to those in greatest need, so we undertake an analysis to ascertain the level of ODA that each of these recipients receives from other countries, expressed in terms of ODA per person in extreme poverty. We identify 31 BMZ partner countries that are under-prioritised—of which 13 are significantly under-prioritised. In contrast, we find 48 countries that are over-prioritised by other providers. We urge BMZ to fully protect budgets in the 31 under-prioritised countries, and concentrate reductions in the 48 over-prioritised. This enhances the impact of BMZ funding overall and enables German funding to represent a larger and more influential share of recipients’ economies.

Sharpening instruments: Over the last five years, funding for the “Multilateral and European development cooperation” federal budget instrument has been cut by 34 percent, while there has been 20 percent cuts in bilateral efforts. Germany is below average in the share of its international finance that is allocated multilaterally. We argue this split should be reversed. First, multilateral organisations are assessed as highly effective by independent assessments, and surveys of the German public also suggest they garner a high level of trust. But there is an additional compelling geopolitical case for allocating funding multilaterally. Following the abrupt withdrawal of the United States from a number of organisations, the international system is more vulnerable than ever. It is difficult envisage a future where Germany is secure and prosperous if the multilateral system fails to endure. We urge the German government to shield its multilateral contributions in from these cuts, refocus earmarked multilateral spend towards core funding, and increase its core multilateral share to at least 40 percent in the next two years. Regarding the remaining bilateral share, we propose that Germany reconsider its current approach to the volume and tendering of technical assistance.

BMZ (Germany’s Federal Ministry for Economic Cooperation and Development or Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung) is consulting on how to implement a material reduction in its Official Development Assistance (ODA) budget. In this paper, we review where remaining funds would have the greatest impact, and propose a series of reforms accordingly. We recommend:

Focussed thematic allocation: Germany’s development projects have been substantially diluted over the last decade. We find that BMZ projects have progressively targeted a broader range of Sustainable Development Goals (SDGs). The number of projects that target more than four goals, for example has risen almost nine-fold from 72 to over 600 in the last ten years. Evidence suggests that less complex measures would have been more efficient and effective.We suggest focussing on 4–5 SDGs that align with the Government’s priorities and BMZ’s expertise render overall ODA allocation more effective.

Strategic country allocations: BMZ currently funds projects in a 110 of the 141 ODA-eligible countries in total. It seems clear this will need to be reduced. Providing development finance makes the biggest difference to those in greatest need, so we undertake an analysis to ascertain the level of ODA that each of these recipients receives from other countries, expressed in terms of ODA per person in extreme poverty. We identify 31 BMZ partner countries that are under-prioritised—of which 13 are significantly under-prioritised. In contrast, we find 48 countries that are over-prioritised by other providers. We urge BMZ to fully protect budgets in the 31 under-prioritised countries, and concentrate reductions in the 48 over-prioritised. This enhances the impact of BMZ funding overall and enables German funding to represent a larger and more influential share of recipients’ economies.

Sharpening instruments: Over the last five years, funding for the “Multilateral and European development cooperation” federal budget instrument has been cut by 34 percent, while there has been 20 percent cuts in bilateral efforts. Germany is below average in the share of its international finance that is allocated multilaterally. We argue this split should be reversed. First, multilateral organisations are assessed as highly effective by independent assessments, and surveys of the German public also suggest they garner a high level of trust. But there is an additional compelling geopolitical case for allocating funding multilaterally. Following the abrupt withdrawal of the United States from a number of organisations, the international system is more vulnerable than ever. It is difficult envisage a future where Germany is secure and prosperous if the multilateral system fails to endure. We urge the German government to shield its multilateral contributions in from these cuts, refocus earmarked multilateral spend towards core funding, and increase its core multilateral share to at least 40 percent in the next two years. Regarding the remaining bilateral share, we propose that Germany reconsider its current approach to the volume and tendering of technical assistance.

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Health workers attend to pregnant and breastfeeding mothers at an outreach visit supported by UNFPA in Loima sub-county. Credit: UNFPA/Luis Tato

By James Nyikal, Margaret Lubaale and Anne-Beatrice Kihara
NAIROBI, Kenya, Dec 12 2025 (IPS)

For women in labour across Kenya, reaching a health facility, finding skilled health workers, and affording care can be a matter of life and death. These challenges are not rare, but daily realities for many families.

Every year on 12 December, the world observes Universal Health Coverage Day, a chance to renew the promise of health for all. But for this promise to be meaningful, it must reach every woman and child, everywhere in Kenya.

Slow Progress in Maternal, Newborn, and Child Health

While Kenya has made gradual gains in maternal, newborn and child health with improved vaccination and increased antenatal care, progress in maternal survival has been painfully slow.

Between 2014 and 2019, the maternal mortality rate dropped by less than two percent, even as investment increased. United Nations data shows that Kenya’s maternal mortality ratio remains one of the highest in East Africa, exceeding those of Ethiopia, Uganda, and Tanzania.

Newborn and child deaths have also declined slightly and are severely constrained by inequities. For example, children born to mothers with only primary education face far higher mortality than those whose mothers have secondary education and beyond.

Persistent inequalities continue to deny children a healthy start in life.

The Urgency of the Maternal, Newborn and Child Health Bill

Kenya’s MNCH services have suffered from fragmented policies, inconsistent county financing, and short-term funding. Devolution has blurred responsibilities between national and county governments, leading to gaps in planning, poor reporting, and weak accountability.

The Maternal, Newborn and Child Health (MNCH) Bill, 2023, proposed by Sen. Beatrice Akinyi Ogolla, presents a vital opportunity to change this trajectory.

The MNCH Bill seeks to establish a clear legal framework guaranteeing the right to maternal, newborn, and child health services. It obliges both national and county governments to respect, protect, and fulfil these rights through enforceable mechanisms.

At its core, the Bill affirms that every woman and child in Kenya, regardless of location or economic status, deserves timely, affordable, respectful, and high-quality care.

It embeds service delivery in the principles of universal access, equity, dignity, availability of essential services, and continuous quality improvement.

How the MNCH Bill Delivers on the Promise of UHC.

1. Guarantees the right to the highest attainable health for all mothers and children.
2. Ensures access to the full continuum of care, including before pregnancy and through childhood
3. Protects marginalised and hard-to-reach communities, such as people living with disabilities or those unable to pay for health services
4. Guarantees respectful, dignified and non-discriminatory care, irrespective of identity, such as age, marital status or social background
5. Strengthens health financing at the county level through mandated country budget allocation for MNCH
6. Improves service availability through infrastructure and supplies such as ambulances, essential medicine and skilled health workers.
7. Institutionalizes accountability and reporting, with both the Cabinet Secretary and County Executives mandated to submit annual reports to Parliament and County Assemblies on services, financing, and gaps
8. Strengthens monitoring, data, and quality assurance through mandated continuous monitoring, maternal and child death surveillance, with enforcement of quality standards.

The MNCH Bill is more than a piece of legislation; it is a lifeline and a turning point for millions of Kenyan families.

By making essential services enforceable rights, strengthening accountability, and securing sustainable domestic financing, the Bill lays the foundation for people-centred Universal Health Coverage.

Political Will and National Commitment

Political leadership is aligning behind reforms for women and children. President Ruto’s involvement with the Global Leaders Network for Women’s, Children’s and Adolescents’ Health and his directive for real-time reporting of maternal and child deaths signal a strong executive commitment.

Cabinet Secretary Hon. Aden Duale’s focus on realizing the Social Health Authority and robust county leadership further demonstrates that Kenya is mobilizing on all fronts.

With government officials, communities, civil society, and health workers rallying together, Kenya stands ready to turn these commitments into action.

Call to Action

As the MNCH Bill reaches its final committee stages, now is a critical moment for public involvement. Citizens are encouraged to contact their Members of Parliament to express support for the Bill.

Advocates, experts, donors, and community members must unite and implement strategies to accelerate the reduction of maternal, newborn, and child mortality.

The passage of the MNCH Bill will show that “health for all” is no longer just a slogan, but a binding national pledge.

Hon. Dr James Nyikal is the Chairperson of National Assembly Health Committee; Dr. Margaret Lubaale is the Executive Director of Health NGO Network (HENNET); and Prof Anne-Beatrice Kihara is the immediate former President of International Federation of Gynaecology and Obstetrics.

IPS UN Bureau

 

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