UNITED NATIONS - Bangladesh, Ethiopia, Nepal and some of the world's other poorest countries helped lead the way over the past year as UN member states began meeting their unprecedented pledge of more than $40 billion for maternal and child health, a new study of the spending says.

The spending report was released on Tuesday at a high-level event chaired by UN Secretary-General Ban Ki-moon, who has made raising money for the health of mothers and their children a pet project.

"By and large, the commitments made have been met," said Dr Julio Frenk, chairman of the fundraising effort and dean of the Harvard School of Public Health.

Frenk, chairman of the World Health Organization's Partnership for Maternal, Newborn and Child Health and a former health secretary of Mexico, said he was especially pleased to see that some of the poorer nations are taking on more financial responsibility for their development needs.

Those countries are "moving away from the paternalistic to a framework for shared accountability," said Frenk.

"The leadership shown by the lowest-income countries in their commitments to improve women's and children's health has been outstanding."

Frenk said that close to $45 billion has been committed to the UN initiative known as Every Mother Every Child, passing the initial pledges of $40 billion made a year ago. That includes about $11 billion from the world's poorer countries, and $13.7 billion from high-income governments including the United States, Britain, Canada and Norway.

"I am delighted by the progress since last year," said pediatrician Dr Flavia Bustreo, WHO assistant director-general for family, women's and children's health. She added that commitments have included not only money, but changes in policy and delivery of services.

Bustreo said more still needs to done to treat severe infections in newborns and increase postnatal visits by mothers and babies. Up to 1 million more "front-line" health workers, especially midwives, are needed to care for mothers and their babies around the world, she added.

The report shows that Bangladesh and many of the other poorer countries that made pledges last year set aside more funds for better healthcare of mothers and small children within their borders as they take more responsibility for their own development.