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In 2010, the G8 placed renewed focus on maternal health via the Muskoka Initiative by committing to spend an additional $5 billion on maternal, newborn, and child health before 2015. Following the end of the Millennium Development Goals and the advent of the Sustainable Development Goals, maternal health issues have continued to feature prominently on the global health agenda. Despite these substantial investments of foreign aid over the past decade, there is limited evidence on the effectiveness of foreign aid in reducing maternal mortality in low- and middle-income countries (LMICs). Using data from the Organisation for Economic Cooperation and Development, the World Development Indicators and the Institute of Health Metrics and Evaluation, this study analyzes the effects of aid on maternal health in a sample of 130 LMICs from 1996 through 2015. Our results show that the effects of total foreign aid on maternal mortality are limited, but that aid allocated to the reproductive health sector and directly at maternal health is associated with significant reductions in maternal mortality. Given these targeted effects, it is important to channel more donor assistance to the promotion of reproductive health and contraceptive use among women as it serves as a tool towards the reduction of maternal mortality.

In this dissertation, I examine how Canada’s Muskoka Initiative discursively constructs and addresses maternal, newborn and child health (MNCH) as a global development problem. I evaluate how the Muskoka Initiative aligns with, and departs from feminist articulations of sexual and reproductive health, rights and justice. I do this by analyzing how the Muskoka Initiative drew on and reinforced dominant norms of motherhood, and aligned with neoliberal development frameworks. I also examine how the reproductive bodies and lives of women in the Global South were configured as sites of both development intervention and biopolitical governance. My findings are based on a critical discourse analysis of texts from the Government of Canada’s MNCH website, and of project descriptions of programs funded through the Muskoka Initiative. I also conducted semi-structured interviews with key informants within the Canadian development sector. My analysis is informed by feminist and postcolonial development theory, and by theories of biopolitics, governmentality, healthism, risk and reproductive justice. My findings demonstrate that maternal health was constructed as a problem of unmanaged risk that could be solved by increasing access to medical services. Canadian interventions sought to increase access to medical services by providing capital and technology; building the capacity of developing countries to deliver services; and promoting particular reproductive health and childcare behaviours among developing world women. Through these interventions, Canada situated itself as a global leader in MNCH. I argue that the Muskoka Initiative adopts a depoliticized, technocratic approach to MNCH that aligns with neoliberal development frameworks while leaving existing structural power relations unexamined. I also argue that MNCH interventions operate as a site of biopolitics, wherein women’s reproduction is governed through discourses of medical risk. Women are instrumentalized, and made responsible for the health of themselves, their children, and the population. I conclude that although the Muskoka Initiative contributed to reproductive justice by improving access to medical care and contraception, its contributions were constrained by its adoption of a technocratic, depoliticized approach to health and development; its exclusion of abortion and non-reproductive sex; and its promotion of particular reproductive choices, including the limiting of developing world women’s fertility.