BACKGROUND: Achievement of high coverage of effective interventions and Millennium Development Goals (MDGs) 4 and 5A requires adequate financing. Many of the 68 priority countries in the Countdown to 2015 Initiative are dependent on official development assistance (ODA). We analysed aid flows for maternal, newborn, and child health for 2007 and 2008 and updated previous estimates for 2003-06. METHODS: We manually coded and analysed the complete aid activities database of the Organisation for Economic Co-operation and Development for 2007 and 2008 with methods that we previously developed to track ODA. By use of newly available data for donor disbursement and population estimates, we revised data for 2003-06. We analysed the degree to which donors target their ODA to recipients with the greatest maternal and child health needs and examined trends over the 6 years. FINDINGS: In 2007 and 2008, US$4·7 billion and $5·4 billion (constant 2008 US$), respectively, were disbursed in support of maternal, newborn, and child health activities in all developing countries. These amounts reflect a 105% increase between 2003 and 2008, but no change relative to overall ODA for health, which also increased by 105%. Countdown priority countries received $3·4 billion in 2007 and $4·1 billion in 2008, representing 71·6% and 75·6% of all maternal, newborn, and child health disbursements, respectively. Targeting of ODA to countries with high rates of maternal and child mortality improved over the 6-year period, although some of these countries persistently received far less ODA per head than did countries with much lower mortality rates and higher income levels. Funding from the GAVI Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria exceeded core funding from multilateral institutions, and bilateral funding also increased substantially between 2003 and 2008, especially from the USA and the UK. INTERPRETATION: The increases in ODA to maternal, newborn, and child health during 2003-08 are to be welcomed, as is the somewhat improved targeting of ODA to countries with greater needs. Nonetheless, these increases do not reflect increased prioritisation relative to other health areas. FUNDING: Partnership for Maternal, Newborn, and Child Health on behalf of the Countdown to 2015 Initiative.