MCC recognizes that a healthy population–including reduced illness and increased life expectancy–is critical for achieving sustained economic growth and poverty reduction. Where national growth is potentially stymied by poor health, MCC investments can help governments ensure that critical, cost-effective health services are available where they have the most potential to make a difference in enhancing the quality of life, leading to greater productivity and economic growth. In other areas, such as road infrastructure, MCC works to ensure that health and safety considerations are identified early in the project cycle and integrated into the project design and implementation process.
‘Invest in health, build a safer future’
The MCC selection indicators for Total Public Expenditure on Health, Immunization Rate, and Natural Resources Management specifically focus on a country’s efforts to provide adequate health care and healthy living conditions to its citizens. The MCC program targets different areas of health interventions. Examples include:
HIV/AIDS Prevention and Treatment
Forty percent of the Lesotho compact is aimed at strengthening the delivery of essential health services, including HIV/AIDS prevention and treatment. The $122 million health component targets improved health sector response to HIV/AIDS, tuberculosis and maternal and child health through health systems strengthening - human resources, health information and management system investments - and public and private health infrastructure rehabilitation. The activity places special emphasis on systems and infrastructure needed to roll out intensive HIV counseling, testing and anti-retroviral treatment. The program partners with efforts of PEPFAR and other USG Agencies, including USAID and the Centers for Disease Control and Prevention (CDCP), and with other donors.
The MCC Environmental Guidelines establish a process for the review of environmental and social impacts (including health impacts), to ensure that Compact-funded projects are environmentally sound, are designed to operate in compliance with applicable regulatory requirements, and are not likely to cause a significant environmental, health or safety hazard. As such, all projects are reviewed to ensure identification and mitigation of potential health and safety impacts. For example, MCC-funded infrastructure projects typically require HIV/AIDS awareness campaigns and other mitigation measures be integrated into the construction and other project activities.
Maternal and Child Health (MCH)
In Indonesia the $20 million MCC-funded threshold program is supporting the government in reaching immunization targets of at least 80 percent of children under the age of one for diphtheria, tetanus, and pertussis and 90 percent of children for measles in 90 percent of Indonesia’s districts.
The threshold program with Kenya includes $4 million in activities to strengthen transparency and accountability in the health sector to reduce corruption in the provision of essential services – largely targeted at MCH activities. MCC funding will strengthen procurement capacity and accountability, improve supply chain management of public health resources, and establish capacity within the Ministry of Health to monitor procurements and assess compliance.
MCC threshold funds are being used to increase immunization coverage of rural children for measles, diphtheria, pertussis and tetanus in eight targeted regions in Peru. The MCC program provides $11.5 million to assist the country in reaching its childhood immunization targets for all population subgroups and assists the Ministry of Health in strengthening information and vaccination management systems.
Non-communicable Disease and Injury
In Mongolia a $17 million Compact investment is strengthening the national program for prevention, early diagnosis and management of non-communicable diseases and injuries (NCDI). Like many countries of the former Soviet Union, Mongolia has seen death rates from premature heart disease, stroke, diabetes and pedestrian traffic accidents rise precipitously over the past decade. Increased smoking, alcohol use, obesity and sedentary lifestyles as well as economic stress have contributed to this epidemic. The MCC funded public health intervention expands and better targets prevention and early diagnosis efforts of the national NCDI program.
Road traffic related deaths are the fifth leading cause of death worldwide. MCC utilizes a multidisciplinary approach to identify roads safety concerns early in the project development cycle and to integrate appropriate mitigation measures into road design and construction. For example, at the feasibility stage, MCC focuses on the identification and analysis of road geometric deficiencies, high-accident locations; sensitive land uses such as schools, markets adjacent to proposed roads with potentially high pedestrian traffic.During design, MCC seeks to incorporate internationally accepted design standards and provide safety provisions for pedestrians and non-motorized transportation aimed at minimizing vehicular-pedestrian conflicts. In addition, during procurement, MCC considers contractor environmental health and safety qualifications, and provides contractor safety training and onsite safety supervision during construction.
Water and Sanitation
Diarrhea remains the second cause of death, after respiratory illnesses, for children in developing countries. Poor access to safe drinking water and sanitation is the main cause of many of these deaths. MCC Compacts include a total of $530 Million in water and sanitation activities in countries such as Burkina Faso, Mozambique, El Salvador, and Georgia. Many of the economic benefits from these activities will accrue from reduced illness and improved health, particularly for the poor.
For example, in El Salvador the MCA compact is investing nearly $24 million to provide access to potable water systems and sanitation services to benefit 90,000 people in the poorest region of the country.
Irrigation development and other water infrastructure activities include review and mitigation of health impacts, including malaria and other water-related diseases.
Roads and other infrastructure activities often result in improved access for poor people to health services and hospitals.