The focus of the course is maternal health (Millennium Development Goal 5). The World Bank has adopted a five-year Reproductive Health Action Plan, and other donors have pledged renewed support for reproductive health. This ends a decade of comparative neglect of reproductive health, and of slow progress toward the two main MDG 5 targets - reducing maternal mortality and universal access to reproductive health services. Progress has been particularly slow in the poorest countries, many of which face severe financial and organizational constraints, forcing difficult choices about how and where to allocate scarce human and financial resources.

Since world leaders committed themselves to improving reproductive health at the 1994 International Conference on Population and Development, aid modalities have changed in at least two major ways. The first is the shift away from disease-specific projects and funding to a broader approach of health system development and reforms. This has brought new organizational and financing arrangements for health care, changing public and private roles and responsibilities, and an emphasis on improving performance and accountability in health systems.

Second, many countries center their development agenda on poverty reduction, guided by Poverty Reduction Strategy Papers (PRSPs). Most funding for implementing the strategies flows through finance ministries as budget support, which finance ministries then allocate among sectors. Reproductive health competes for resources not just within health but with other sectors as well, including education and infrastructure, all of which are important for reducing poverty and speeding economic growth.

These changes create challenges for champions of reproductive health (RH). Even when there is donor commitment to RH, funding flows through the new aid modalities. The World Bank's Reproductive Health Action Plan, for example, pledges support to RH as part of broader health system strengthening. Health sector financing more often comes as sector-wide assistance rather than issue-specific project funding. There is a risk that reproductive health will not be on the table in broad development assistance forums.

Achieving MDG 5 in the context of health sector reforms and PRSP processes requires an understanding of how the new approaches work, and capacity to work with the tools used to set budget priorities and allocate resources among competing interests. Understandably, national managers and decision-makers, and others in the international development community have expressed an increased demand for learning that enhances the skills needed to finance, design, and implement reproductive health programs in this changing environment. To meet this demand, WBI developed this innovative, intensive learning program for its client countries and development partners.