Technically feasible and cost-effective interventions exist to reduce maternal, newborn, and child mortality. This potential has not been fully realised due to the failure of health systems to improve the delivery and uptake of these priority interventions, particularly amongst the most vulnerable women and children. Underfunded investments in maternal, newborn, and child health (MNCH) are part of the impediment, but unspent funds in a diversity of resource-constrained settings reflect a common problem of low absorptive capacity and the challenges of implementation at the local level.