,,ii #aafth ,,congress #ast ,session ,s4 #agff ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #aj1 #bjai,ms4 ,collins 7for herself1 ,mr4 ,coons1 ,mr4 ,roberts1 ,ms4 ,duckworth1 ,mr4 ,sullivan1 ,mr4 ,van ,hollen1 ,mrs4 ,capito1 ,mr4 ,markey1 ,mr4 ,isakson1 ,mr4 ,merkley1 ,mr4 ,moran1 ,mr4 ,cardin1 ,mr4 ,cornyn1 ,ms4 ,rosen1 ,mr4 ,young1 ,ms4 ,stabenow1 ,mr4 ,enzi1 ,mr4 ,wyden1 ,mr4 ,cramer1 ,mr4 ,murphy1 ,mr4 ,rubio1 and ,mr4 ,reed7 introduced the following bill2 which was read twice and referred to the ,committee on ,foreign ,relations ,a ,,bill ,to implement policies to end preventable maternal1 newborn1 and child deaths globally4 #a4 ,short title ,this ,act may be cited as the ,reach ,every ,mother and ,child ,act of #bjai4 #b4 ,assistance to end preventable maternal1 newborn1 and child deaths globally ,the ,foreign ,assistance ,act of #aifa 7#bb ,u4,s4,c4 #baea et seq47 is amended by adding at the end of chapter ,i of part ,i the following new section3 #acg4 ,assistance to end preventable maternal1 newborn1 and child deaths globally 7a7 ,purpose ,the purpose of this section is to implement a strategic approach for providing foreign assistance in order to end preventable child and maternal deaths globally by #bjcj4 7b7 ,definitions ,in this section3 7#a7 ,administrator ,the term ,administrator means the ,administrator of the ,united ,states ,agency for ,international ,development4 7#b7 ,appropriate congressional committees ,the term appropriate congressional committees means-- 7,a7 the ,committee on ,foreign ,relations and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,foreign ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7#c7 ,coordinator ,the term ,coordinator means the ,child and ,maternal ,survival ,coordinator established under subsection 7e74 7#d7 ,international maternal and child health and nutrition programs ,the term international maternal and child health and nutrition programs means all programs carried out using funds appropriated or otherwise made available for international maternal and child health and nutrition that are managed by the ,united ,states ,agency for ,international ,development ,bureau of ,global ,health4 7#e7 ,relevant partner entities ,the term relevant partner entities means each of the following3 7,a7 ,the governments of other donor countries4 7,b7 ,international financial institutions4 7,c7 ,nongovernmental organizations4 7,d7 ,faith-based organizations4 7,e7 ,professional organizations4 7,f7 ,the private sector4 7,g7 ,multilateral organizations4 7,h7 ,local and international civil society groups4 7,i7 ,local health workers4 7,j7 ,international organizations4 7#f7 ,target countries ,the term target countries means specific countries that have the greatest need and highest burden of child and maternal deaths1 taking into consideration countries that-- 7,a7 have high-need communities in fragile states or conflict-affected states2 7,b7 are low- or middle-income countries2 or 7,c7 are located in regions with weak health systems4 7c7 ,statement of policy ,it is the policy of the ,united ,states1 in partnership with target countries and relevant partner entities1 to establish and implement a coordinated1 integrated1 and comprehensive strategy to combat the leading causes of maternal1 newborn1 and child mortality globally and ensure healthy and productive lives by-- 7#a7 focusing on bringing to scale1 specific to each country's needs1 the highest impact1 evidence-based interventions1 including for the most vulnerable populations1 with a focus on country and community ownership2 7#b7 designing1 implementing1 monitoring1 and evaluating programs in a way that enhances transparency and accountability1 increases sustainability1 and improves outcomes in target countries2 and 7#c7 supporting the research1 development1 and introduction of innovative tools and approaches to accelerate progress toward ending preventable child and maternal deaths4 7d7 ,strategy 7#a7 ,in general ,not later than one year after the date of the enactment of the ,reach ,every ,mother and ,child ,act of #bjai1 the ,president shall establish and implement a comprehensive five-year1 whole-of-government strategy1 together with target countries and donors1 to contribute toward the global goal of ending preventable child and maternal deaths by #bjcj as a foundation for ensuring healthy and productive lives4 7#b7 ,elements ,the strategy established under paragraph 7#a7 shall-- 7,a7 set outcome-based targets to achieve the goals of the strategy and ascertain baseline data relevant for each target country and for all areas of focus and programming as of the date of the release of the strategy2 7,b7 utilize ,united ,states ,government strategies and frameworks relevant to ending preventable child and maternal deaths1 including specific objectives1 programs1 and approaches to achieve the highest-impact1 evidence-based interventions to address the leading causes of death1 particularly among the most vulnerable populations1 of-- 7i7 women related to pregnancy1 childbirth1 and post-delivery2 7ii7 newborns in their first #bh days2 and 7iii7 infants and children under the age of five years old2 7,c7 include development and scale up of new technologies and approaches1 including those supported by public-private partnerships1 for research and innovation2 7,d7 promote coordination and efficiency within and amongst the relevant executive branch agencies and initiatives1 including the ,united ,states ,agency for ,international ,development1 the ,department of ,state1 the ,department of ,health and ,human ,services1 the ,centers for ,disease ,control and ,prevention1 the ,national ,institutes of ,health1 the ,millennium ,challenge ,corporation1 the ,peace ,corps1 the ,department of the ,treasury1 the ,office of the ,global ,,aids ,coordinator1 and the ,president's ,malaria ,initiative2 7,e7 project general levels of resources needed to achieve the strategy's stated objectives2 7,f7 identify strategies for leveraging resources in new and innovative ways2 7,g7 align with country- and community-driven maternal1 newborn1 and child health and survival plans and improve coordination with foreign governments and international organizations2 7,h7 outline consultations with relevant partner entities as appropriate2 7,i7 implement results-based contracting 7such as pay-for-success7 and financial and operational risk reduction2 7,j7 promote a shift towards investments that support inclusive and sustainable business models2 and 7,k7 support the transition to domestic sustainably financed health systems4 7#c7 ,initial strategy ,for the purposes of this section1 a strategy meeting the criteria described in paragraph 7#b7 that is in effect as of the date of enactment of this section may be deemed to fulfill the establishment requirement in paragraph 7#a74 7e7 ,establishment of child and maternal survival coordinator 7#a7 ,in general ,the ,president shall designate a current ,,usaid employee serving in a career or non-career position in the ,senior ,executive ,service or at the level of a ,deputy ,assistant ,administrator or higher to serve concurrently as the ,child and ,maternal ,survival ,coordinator4 ,the ,coordinator shall be responsible for-- 7,a7 overseeing the strategy established under subsection 7d72 and 7,b7 international maternal and child health and nutrition programs4 7#b7 ,duties ,the ,coordinator shall-- 7,a7 have the primary responsibility for the oversight and coordination of all resources and international activities1 as determined appropriate by the ,administrator of the ,united ,states ,agency for ,international ,development1 of the ,united ,states ,government appropriated or used for international maternal and child health and nutrition programs2 7,b7 direct the budget1 planning1 and staffing to implement international maternal and child health and nutrition programs for the purpose of ending preventable child and maternal deaths2 7,c7 lead implementation and revision1 not less frequently than once every #e years1 of the strategy established under subsection 7d77#a72 7,d7 coordinate with relevant executive branch agencies1 target countries1 and relevant partner entities as appropriate1 to carry out the strategy established under section #e7;a7 and to align current and future investments with high-impact1 evidence-based interventions to save lives2 7,e7 provide guidance on the design and oversight of grants1 contracts1 and cooperative agreements with nongovernmental organizations 7including community1 faith-based1 and civil society organizations7 and private sector entities for the purpose of carrying out the strategy established under subsection 7d77#a72 and 7,f7 report directly to the ,administrator regarding implementation of the strategy established under subsection 7d77#a74 7#c7 ,restriction on additional or supplemental compensation ,the ,coordinator shall receive no additional or supplemental compensation as a result of carrying out responsibilities and duties under this section4 7f7 ,authority ,to assist in implementation of the strategy 7#a7 ,in general ,the ,president shall provide assistance to implement the strategy established under subsection 7d77#a74 7#b7 ,focus on impact 7,a7 ,targets for increased implementation required ,consistent with the requirements for foreign assistance programs included in the ,foreign ,aid ,transparency and ,accountability ,act of #bjaf 7,public ,law #aad-aai71 ,,usaid grants1 contracts1 and cooperative agreements for the purposes of the strategy established under subsection 7d77#a7 shall be required to include targets for increased implementation of high-impact1 evidence-based interventions and strengthening health systems1 as appropriate1 including the establishment of baseline measurements from which to quantify progress4 7,b7 ,exception ,in exceptional circumstances where ,,usaid determines that inclusion of coverage targets or baseline measures are not reasonable or practicable for the grant1 contract1 or cooperative agreement1 the funding mechanism shall include an explanation of the omission and explicitly state how measurable impact will be targeted and tracked4 7g7 ,reports 7#a7 ,report required ,not later than one year after the date of the enactment of this section1 and annually thereafter for #e additional years1 the ,president shall submit to the appropriate congressional committees a report on progress made to achieve the strategy established under subsection 7d77#a7 as well as progress toward the goal to end preventable child and maternal deaths globally4 ,the report shall be made publicly available4 7#b7 ,information included in report ,the report required under paragraph 7#a7 shall include the following elements3 7,a7 ,indicators of progress made by ,united ,states ,government programs carried out under international maternal and child health and nutrition programs for the purposes of improving maternal1 newborn1 and child health and survival1 particularly among the most vulnerable populations1 in each target country and overall1 including-- 7i7 maternal mortality ratio per #ajj1jjj live births and under-#e mortality ratio per #a1jjj live births2 7ii7 number of maternal1 newborn1 and child deaths averted2 7iii7 percentage of births attended by skilled health personnel2 7iv7 an analysis of gaps in the health workforce required to end preventable child and maternal deaths1 including an analysis of health workforce density 7number of certified health workers1 including community-based health workers1 per population72 7v7 a description of the measured or estimated impact on maternal1 newborn1 and child survival of each ongoing program or project2 7vi7 progress towards achieving the goal to save #ae1jjj1jjj children's lives and #fjj1jjj women's lives1 and any subsequent goals established under the strategy required under subsection 7d72 and 7vii7 any other targets identified by the ,coordinator as essential to meeting the goals of the strategy for ending preventable child and maternal deaths4 7,b7 ,assessments of progress made toward achieving the targets set forth under subparagraph 7,a74 7,c7 ,a description of how the interventions or programs are designed to-- 7i7 increase activities in target countries2 7ii7 reach underserved1 marginalized1 vulnerable1 under nourished or malnourished1 and impoverished populations2 7iii7 address causes of maternal1 newborn1 and child mortality with innovative efforts and interventions posed to go to scale2 7iv7 invest in activities that empower women1 support voluntarism1 and provide respectful maternity care2 7v7 improve transparency and accountability at all levels and include common metrics for tracking progress2 7vi7 ensure that high-impact1 evidence-based interventions are prioritized2 and 7vii7 expand access to quality services through community-based approaches and include community accountability measures4 7,d7 ,reporting on each aspect of the strategy established under subsection 7d77#a71 including-- 7i7 multi-sectoral approaches1 specific strategies1 and programming utilizing high-impact1 evidence-based interventions to address the leading causes of preventable child and maternal deaths2 7ii7 activities to develop and scale up new technologies and approaches1 including those identified by public-private partnerships1 for research and innovation2 7iii7 coordination with ,united ,states agencies1 foreign governments1 nongovernmental organizations1 and international organizations2 7iv7 methods used to leverage new financial and other public and private resources in innovative ways2 and 7v7 best practices identified by the executive branch4 7,e7 ,reporting on grants1 contracts1 and cooperative agreements awarded1 including-- 7i7 a comprehensive list of ,,usaid grants1 contracts1 and cooperative agreements awarded in implementation of the strategy established under subsection 7d77#a72 and 7ii7 a description of-- 7,i7 the targets for coverage of interventions or services and the baseline against which they are measured and the status of progress in meeting the targets2 or 7,,ii7 in the case of exceptional circumstances where ,,usaid determines that inclusion of targets or baseline measurements is not reasonable or practicable1 an explanation of how the impact of the grant1 contract1 agreement1 or resulting program is being measured4 7,f7 ,reporting on the innovative public-private financing tools1 including an analysis of the feasibility and potential effectiveness of new financing tools that could be used to fund efforts to end preventable child and maternal deaths globally4 7h7 ,authorization of appropriations 7#a7 ,authorization ,for each of fiscal years #bjbj and #bjba1 there is authorized to be appropriated to the ,secretary of ,state and the ,administrator of the ,united ,states ,agency for ,international ,development to carry out this section-- 7,a7 #ede1jjj1jjj for bilateral maternal and child health2 7,b7 #bij1jjj1jjj for ,gavi1 the ,vaccine ,alliance2 and 7,c7 #ade1jjj1jjj for nutrition4 7#b7 ,application ,funds appropriated or otherwise made available to carry out activities under this section shall be subject to all applicable restrictions under ,federal law4 7#c7 ,expiration of funds ,amounts appropriated or otherwise made available to carry out activities under this section shall remain available for obligation for a period of #e years4 4