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CNN  — 

The US government’s global work on sexual and reproductive health and rights declined during the first year of the Trump administration, according to a newly released study.

The SRHR Index was compiled by the Center for Health and Gender Equity, a women’s rights organization, in partnership with the George Washington University Global Women’s Institute. The index assigned rankings to the White House, the State Department, the Department of Health and Human Services, the US Agency for International Development, the Department of Defense and Congress. It assigned ratings for 2016 and 2017 based on their budgets and policies on three main issues relating to global health assistance for sexual and reproductive health and rights: family planning, maternal and child health, and HIV and AIDS.

“In order to capture the breadth of SRHR, we developed cross-cutting issues. So each internal policy and budget from those actors … we grade each internal policy to see: Is this evidence based? Is it based in rights? Is it gender transformative? And is it situated within internationally recognized human rights norms?” Bergen Cooper, the Center for Health and Gender Equity’s director of policy research, explained to CNN.

The index found that overall global health assistance on sexual and reproductive health and rights declined from 2016 to 2017 from a B to a C. All of the actors, with the exception of USAID, had a dip in grades. The most stark decline, according to the index, was from the White House, which went from an A- to a C-. The index attributes this drop to changes in maternal and child health and family planning. The White House did, however, receive a consistently high score (A-) for HIV/AIDS policy and budget priorities both years.

“The changes that the White House enacted in 2017 were harmful to both policy lines and budget lines,” Cooper said. She said the White House’s decision to withhold funding to the United Nations Population Fund and its reinstatement of the “Mexico City policy” factored into their scoring. In January 2017, President Donald Trump signed an executive action reinstating that policy, also known as the “Global Gag Rule,” which prevents international nongovernmental organizations that perform or promote abortions from receiving US government funding.

The Department of Health and Human Services received a D+ in 2016 and 2017 because of what the index described as “low transparency in policy and funding data.”

“We recognize that a lack of available or insufficient data is not necessarily a reflection of malfeasance or a lack of political will on the part of the government,” Cooper said.

USAID was the only agency with an increased score from 2016 to 2017, going from a B+ to an A-.

“USAID received a 91.5 (A-) because it released a positive new ‘Acting on the Call’ policy document regarding maternal and child health, and also is spending money in a way that is highly responsive to global need,” the index said.

Cooper told CNN that the center hopes the index will be “a road map for this government and future governments on how to successfully implement sexual and reproductive health and rights through our global health assistance programs.”