,i #aae? ,,congress #a/ ,session ,h4 ,r4 #djbb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,octob] #aa1 #bjag,mr4 ,rei*]t 7= himself1 ,ms4 ,mc,collum1 ,ms4 ,lee1 & ,mr4 ,donovan7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,=eign ,affairs ,a ,,bill ,to implem5t a /rategic approa* = provid+ =eign assi/ance 9 ord] to end prev5table *ild & mat]nal dea?s globally )9 a g5]ation1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,rea* ,e ,"m & ,*ild ,act ( #bjag4 #b4 ,assi/ance to end prev5table *ild & mat]nal dea?s ,! ,=eign ,assi/ance ,act ( #aifa 7#bb ,u4,s4,c4 #baea et seq47 is am5d$ by add+ at ! end ( *apt] #a ( "p ,i ! foll[+3 #acg4 ,assi/ance to end prev5table *ild & mat]nal dea?s 7a7 ,s5se ( ,congress ,x is ! s5se ( ,congress t ,unit$ ,/ates =eign assi/ance ef=ts %\ld focus on c\ntries1 regions1 & communities ) ! greate/ ne$ & ! highe/ burd5 ( prev5table *ild & mat]nal dea?s4 7b7 ,/atem5t ( policy ,x %all be ! policy ( ! ,unit$ ,/ates1 9 coord9ation ) recipi5t c\ntries & relevant p>tn] entities1 to e/abli% & implem5t a coord9at$1 integrat$1 & compreh5sive /rategy to combat ! lead+ causes ( mat]nal1 newborn1 & *ild mortality globally & ensure heal?y & productive lives = wom5 & *ildr51 by-- 7#a7 scal+ up ! highe/-impact1 evid5ce-bas$ int]v5tions1 includ+ = ! mo/ vuln]able populations1 ) a focus on c\ntry own]%ip2 7#b7 design+1 implem5t+1 monitor+1 & evaluat+ programs 9 a way t enhances transp>5cy & acc\ntability1 increases su/a9ability1 & improves outcomes 9 t>get c\ntries2 & 7#c7 support+ ! developm5t & scale-up ( innovative tools & approa*es to accel]ate progress t[>d end+ prev5table *ild & mat]nal dea?s & rea* ! goal ( sav+ ! lives ( #ae1jjj1jjj *ildr5 & #fjj1jjj wom54 7c7 ,/rategy 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is section1 ! ,presid5t %all e/abli% & implem5t a compreh5sive five-ye>1 :ole-(-gov]nm5t /rategy to accel]ate progress t[>d end+ prev5table *ild & mat]nal dea?s )9 a g5]ation & ensure heal?y & productive lives = wom5 & *ildr54 7#b7 ,elem5ts ,! /rategy e/abli%$ "u p>agraph 7#a7 %all-- 7,a7 set specific1 outcome-bas$1 & measurable t>gets to a*ieve ! goals ( ! /rategy & id5tify basel9e data = ea* t>get c\ntry & = all areas ( focus & programm+1 z ( ! date ( ! publication ( su* /rategy2 7,b7 incorporate exi/+ ,f$]al /rategies & frameworks relevant to end+ prev5table *ild & mat]nal dea?s1 includ+ specific objectives1 programs1 & approa*es to implem5t highe/-impact1 evid5ce-bas$ int]v5tions1 to address ! lead+ causes ( dea? 9 t>get c\ntries1 p>ticul>ly among ! mo/ vuln]able populations1 =-- 7i7 wom51 relat$ to pregnancy1 *ildbir?1 or ! po/-deliv]y p]iod2 7ii7 newborn *ildr5 dur+ _! fir/ #bh days2 & 7iii7 infants & *ildr5 "u ! age ( five2 7,c7 include developm5t & scale up ( new te*nologies & approa*es1 includ+ ^? support$ by public-private p>tn]%ips = rese>* & innovation2 7,d7 promote coord9ation & effici5cy )9 & among/ ! relevant ,f$]al dep>tm5ts & ag5cies2 7,e7 project ! g5]al levels ( res\rces ne$$ to a*ieve ! /rategy's /at$ objectives2 7,f7 id5tify /rategies = lev]ag+ res\rces ) new & innovative f9ancial tools2 7,g7 align ) ! mat]nal1 newborn1 & *ild heal? & survival plans ( t>get c\ntries & improve coord9ation ) =eign gov]nm5ts & int]national organizations2 7,h7 outl9e consultations ) t>get c\ntries & relevant p>tn] entities2 7,i7 implem5t results-bas$ contract+1 su* z pay-=-outcome arrangem5ts1 & r$uce f9ancial & op]ational risks2 7,j7 promote a %ift t[>d inclusive & su/a9able inve/m5ts2 7,k7 support ! transition to su/a9ably f9anc$1 dome/ic heal? sy/ems 9 t>get c\ntries2 & 7,l7 promote p>tn]%ips ) organizations t h a long-t]m pres5ce 9 t>get c\ntries & h %[n evid5ce ( su/a9able community impact1 includ+ ?r\gh ! capacity build+ ( local & community-bas$ organizations4 7#c7 ,id5tification ( t>get c\ntries ,= purposes ( ! /rategy "u p>agraph 7#a71 ! ,adm9i/rator %all-- 7,a7 id5tify ea* c\ntry t has ! greate/ ne$ & faces ! highe/ burd5 ( prev5table *ild & mat]nal dea?s1 tak+ into consid]ation c\ntries t-- 7i7 h high-ne$1 und]s]v$1 m>g9aliz$1 vuln]able1 or impov]i%$ communities2 7ii7 are fragile or conflict-affect$ c\ntries2 7iii7 are l[- or middle-income c\ntries2 or 7iv7 are locat$ 9 regions ) weak heal? sy/ems2 & 7,b7 e/abli% transp>5t selection crit]ia = su* t>get c\ntries4 7d7 ,improv+ coord9ation & ov]sight 7#a7 ,e/abli%m5t ( s5ior coord9ator = *ild & mat]nal survival ,! ,adm9i/rator %all designate a curr5t employee s]v+ 9 a c>e] or non-c>e] position 9 ! ,s5ior ,executive ,s]vice or at ! level ( a ,deputy ,assi/ant ,adm9i/rator or high] at ! ,unit$ ,/ates ,ag5cy = ,int]national ,developm5t 7,,usaid7 to s]ve concurr5tly z ! ,s5ior ,coord9ator = ,*ild & ,mat]nal ,survival4 7#b7 ,duties ,! ,s5ior ,coord9ator %all-- 7,a7 h ! prim>y responsibility = ! ov]sight & coord9ation ( int]national mat]nal & *ild heal? & nutrition fund+ manag$ by ! ,,usaid ,bureau ( ,global ,heal?2 7,b7 lead ! developm5t ( ! /rategy e/abli%$ "u subsection 7c7 & its implem5tation by ,,usaid1 includ+ by direct+ ! budget1 plann+1 & /aff+ ) respect to su* implem5tation2 7,c7 facilitate program & policy coord9ation ( int]national mat]nal & *ild heal? & nutrition programs betwe5 ! ,,usaid1 o!r relevant ,f$]al dep>tm5ts & ag5cies1 & relevant p>tn] entities2 7,d7 monitor1 evaluate1 & report on any activities und]tak5 by ,,usaid pursuant to ! /rategy requir$ "u subsection 7c72 & 7,e7 provide direction to ! design & ov]sight ( grants1 contracts1 & coop]ative agreem5ts ) any recipi5t ( funds "u ! responsibility ( ! ,s5ior ,coord9ator pursuant to subp>agraph 7,a74 7#c7 ,re/riction on additional or supplem5tal comp5sation ,! ,s5ior ,coord9ator %all n receive any additional or supplem5tal comp5sation z a result ( c>ry+ out responsibilities & duties "u ?is section4 7e7 ,prioritization ( greate/ ne$ & maximum impact 7#a7 ,t>gets = increas$ implem5tation requir$ ,9 accordance ) ! guidel9es e/abli%$ "u section #c ( ! ,=eign ,aid ,transp>5cy & ,acc\ntability ,act1 any grant made available by ! ,adm9i/rator & any contract or coop]ative agreem5t ent]$ into by ! ,adm9i/rator 9 ord] to implem5t ! /rategy e/abli%$ "u subsection 7c7 ( ?is section %all-- 7,a7 include t>gets = increas$ implem5tation ( high-impact1 evid5ce-bas$ int]v5tions & /r5g!n+ heal? sy/ems1 z appropriate2 & 7,b7 e/abli% basel9e measurem5ts f :i* to quantify progress t[>d su* t>gets & t[>ds ! goal ( prev5t+ life-?reat5+ morbidity & mortality = at lea/ #ae1jjj1jjj *ildr5 & at lea/ #fjj1jjj wom51 z describ$ 9 subsection 7b77#c74 7#b7 ,exception ,9 exceptional circum/ances :5 ! ,adm9i/rator det]m9es t ! inclusion ( cov]age t>gets or basel9e measures is n reasonable or practicable = a grant1 contract1 or coop]ative agreem5t1 ! fund+ me*anism = su* grant1 contract1 or agreem5t %all include an explanation ( ! omission & explicitly /ate h[ measurable impact w be t>get$ & track$4 7f7 ,use ( innovative public-,private f9anc+ tools 7#a7 ,9 g5]al ,9 addition to exi/+ bilat]al & multilat]al assi/ance = *ild & mat]nal survival1 ! ,adm9i/rator %all implem5t ! /rategy e/abli%$ "u subsection 7c7 ?r\gh ! use ( innovative f9anc+ tools1 :]e appropriate1 to exp& deliv]y ( highe/-impact1 evid5ce-bas$ int]v5tions to address ! lead+ causes ( prev5table *ild & mat]nal dea?s1 p>ticul>ly among vuln]able populations4 ,! ,adm9i/rator %all also explore models1 :e!r exi/+ or innovative1 to improve ! effici5cy & effectiv5ess ( inve/m5ts ?r\gh results-bas$ contract+ 7su* z pay-=-outcome arrangem5ts7 & r$uce f9ancial & op]ational risks ) respect to su* implem5tation4 7#b7 ,au?orization to fund programs on pay-=-outcome basis 7,a7 ,9 g5]al ,! ,adm9i/rator %all h ! au?ority to provide assi/ance = *ild & mat]nal survival on a pay-=-outcome basis1 z describ$ 9 subp>agraph 7,b71 to any initiative t meets ! requirem5ts describ$ 9 subp>agraph 7,c74 7,b7 ,pay-=-outcome basis describ$ ,! pay-=-outcome basis describ$ 9 ?is p>agraph is a p]=mance-bas$ grant1 contract1 or coop]ative agreem5t aw>d$ 9 ! =m ( a commitm5t to provide paym5ts t is cont+5t on improv$ outcomes result+ 9 a social b5efit to ! public & 9 direct co/ sav+s or co/ avoidance to ! ,unit$ ,/ates ,gov]nm5t4 7,c7 ,requirem5ts = pay-=-outcome fund+ ,! ,adm9i/rator may only provide assi/ance "u subp>agraph 7,a7 to an initiative t includes ! foll[+3 7i7 ,a detail$ implem5tation plan describ+ h[ ! propos$ pay-=-outcome initiative is bas$ on evid5ce support+ an expectation ( improv$ effectiv5ess4 7ii7 ,a rigor\s1 indep5d5t1 ?ird-p>ty evaluation1 us+ exp]im5tal or quasi-exp]im5tal design or o!r quantitative rese>* me?odologies1 t all[s = ! /ronge/ possible causal inf]5ces1 :5 r&om assignm5t is n feasible1 to det]m9e :e!r ! initiative has a*iev$ ! propos$ improvem5t 9 outcomes4 7,d7 ,limitation on availability ( fund+ ,any paym5ts provid$ to an initiative pursuant to ! au?orization "u subp>agraph 7,a7 may only be made available = exp5diture = n m ?an #e ye>s aft] ! date on :i* su* paym5ts are fir/ made available4 7g7 ,reports 7#a7 ,report requir$ ,n lat] ?an #b ye>s aft] ! date ( ! publication ( ! /rategy requir$ "u subsection 7c71 & annually !reaft]1 ! ,presid5t %all submit to ! appropriate congressional committees1 & make publicly available1 a report describ+ ! implem5tation ( ! /rategy4 7#b7 ,in=mation includ$ 9 report ,! report requir$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a summ>y & evaluation ( progress made to a*ieve ! objectives describ$ 9 subsection 7b71 includ+ ! goal to end prev5table *ild & mat]nal dea?s1 & ! progress made t[>d a*iev+ ! goal ( r$uc+ life ?reat5+ morbidity & mortality = at lea/ #ae1jjj1jjj *ildr5 & at lea/ #fjj1jjj wom54 7,b7 ,a description ( ! nature & ext5t ( coord9ation among relevant ,f$]al dep>tm5ts & ag5cies on ! implem5tation ( ! /rategy4 7,c7 ,a description ( h[ ea* aspect ( ! /rategy is be+ implem5t$1 includ+-- 7i7 ! mann] 9 :i* multi-sectoral approa*es & concrete1 high-impact1 evid5ce-bas$ int]v5tions are be+ us$ to address ! lead+ causes ( prev5table *ild & mat]nal dea?s2 7ii7 ! degree to :i* ! /rategy increases assi/ance to & activities by ! ,unit$ ,/ates 9 t>get c\ntries2 7iii7 ! use ( programs1 projects1 or activities to develop & scale-up new te*nologies & approa*es1 includ+ ^? id5tifi$ by public-private p>tn]%ips = rese>* & innovation1 & ! degree to :i* su* programs1 projects1 or activities are pos$ to g to scale2 & 7iv7 ! me?ods us$ to lev]age innovative f9anc+ & o!r public & private res\rces & ! progress made by su* me?ods4 7,d7 ,a description ( h[ ea* program1 project1 or activity implem5t+ ! /rategy is design$ to-- 7i7 rea* und]s]v$1 m>g9aliz$1 vuln]able1 or impov]i%$ populations2 7ii7 address ! causes ( newborn1 infant1 *ild1 & mat]nal morbidity & mortality1 includ+ pre-t]m bir?s1 ) innovative ef=ts & int]v5tions2 7iii7 inve/ 9 programs1 projects1 or activities t emp[] wom51 support volunt>ism1 & provide quality1 respectful1 evid5ce-bas$ mat]nity c>e2 7iv7 improve transp>5cy & acc\ntability at all levels & include common metrics = track+ progress 9 a*iev+ ! objectives ( ! /rategy2 7v7 ensure t high-impact1 evid5ce-bas$ int]v5tions are prioritiz$1 includ+ int]v5tions promot+ heal?y pregnancies2 & 7vi7 exp& access to quality s]vices = heal?c>e work]s & = communities 9 t>get c\ntries & include measures ( acc\ntability to su* communities4 7,e7 ,a compreh5sive li/ ( grants1 contracts1 & coop]ative agreem5ts aw>d$ to implem5t ! /rategy1 t includes-- 7i7 a description ( ! t>gets = cov]age ( int]v5tions or s]vices support$ by su* grants1 contracts1 or coop]ative agreem5ts1 ! basel9e aga9/ :i* !y are measur$1 & ! /atus ( _! progress 9 meet+ ! t>gets2 or 7ii7 9 ! case ( exceptional circum/ances :]e ! inclusion ( t>gets or basel9e measurem5ts is n reasonable or practicable1 an explanation ( h[ ! impact ( ! grant1 contract1 agreem5t1 or result+ program is be+ measur$4 7,f7 ,a description ( h[ ! ,adm9i/rator has p>tn]$ ) relevant p>tn] entities at ! national & local levels1 includ+ z subgrantees4 7,g7 ,a det]m9ation1 aft] apply+ rigor\s monitor+ & evaluation me?odologies1 :e!r ! programs1 projects1 or activities implem5t+ ! /rategy h a*iev$ measurable improvem5ts 9 *ild & mat]nal heal? or survival1 p>ticul>ly among ! mo/ vuln]able populations1 9 ea* t>get c\ntry & ov]all1 & ! specific improvem5ts a*iev$ ) respect to-- 7i7 ! mat]nal mortality ratio p] #ajj1jjj live bir?s & ! "u-#e mortality ratio p] #a1jjj live bir?s2 7ii7 ! numb] ( newborn1 infant1 *ild1 & mat]nal dea?s av]t$2 & 7iii7 ! p]c5tage ( bir?s att5d$ by skill$ heal? p]sonnel4 7,h7 ,an analysis ( ! gaps 9 ! heal? work=ce t mu/ be fill$ 9 ord] to end prev5table newborn1 infant1 *ild & mat]nal dea?s1 includ+ an analysis ( heal? work=ce d5sity relat+ to c]tifi$ heal? work]s & community-bas$ heal? work]s4 7,i7 ,a description ( ! measur$ or e/imat$ impact on newborn1 infant1 *ild1 & mat]nal survival ( ea* ongo+ program1 project1 or activity implem5t+ ! /rategy4 7,j7 ,an assessm5t ( progress made t[>d a*iev+ ! t>gets e/abli%$ pursuant to subsection 7c77#b77;,a74 7,k7 ,a description ( any innovative public-private f9anc+ tools1 includ+ an analysis ( ! feasibility & pot5tial effectiv5ess1 t c\ld be us$ to fund ef=ts to end prev5table *ild & mat]nal dea?s4 7h7 ,def9itions ,9 ?is section3 7#a7 ,adm9i/rator ,! t]m ,adm9i/rator means ! ,adm9i/rator ( ! ,unit$ ,/ates ,ag5cy = ,int]national ,developm5t4 7#b7 ,appropriate congressional committees ,! t]m appropriate congressional committees means-- 7,a7 ! ,committee on ,=eign ,relations & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,=eign ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#c7 ,relevant ,f$]al dep>tm5ts & ag5cies ,! t]m relevant ,f$]al dep>tm5ts & ag5cies includes ea* ( ! foll[+3 7,a7 ,! ,dep>tm5t ( ,/ate4 7,b7 ,! ,unit$ ,/ates ,ag5cy = ,int]national ,developm5t1 includ+ ! ,presid5t's ,mal>ia ,initiative4 7,c7 ,! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7,d7 ,! ,dep>tm5t ( ! ,treasury4 7,e7 ,! ,dep>tm5t ( ,def5se4 7,f7 ,! ,c5t]s = ,disease ,control & ,prev5tion4 7,g7 ,! ,national ,in/itutes ( ,heal?4 7,h7 ,! ,mill5nium ,*all5ge ,corporation4 7,i7 ,! ,peace ,corps4 7,j7 ,! ,(fice ( ! ,global ,,aids ,coord9ator4 7,k7 ,any o!r ,f$]al dep>tm5t or ag5cy det]m9$ by ! ,presid5t to be relevant to c>ry out ! purposes ( ?is section4 7#d7 ,relevant p>tn] entities ,! t]m relevant p>tn] entities means ea* ( ! foll[+3 7,a7 ,multilat]al & int]national organizations4 7,b7 ,int]national f9ancial in/itutions4 7,c7 ,! national & local gov]nm5ts ( recipi5t c\ntries4 7,d7 ,community nongov]nm5tal organizations1 includ+ fai?-bas$1 pr(essional1 & civil society organizations4 7,e7 ,entities 9 ! private sector4 7,f7 ,entities 9 ! heal?c>e sector ( recipi5t c\ntries4 7#e7 ,s5ior ,coord9ator ,! t]m ,s5ior ,coord9ator means ! ,s5ior ,coord9ator = ,*ild & ,mat]nal ,survival e/abli%$ "u subsection 7d74 7#f7 ,t>get c\ntry ,! t]m t>get c\ntry means a c\ntry id5tifi$ by ! ,adm9i/rator pursuant to subsection 7c77#c74 4