The countries where EQUAL works – DRC, South Sudan, Somalia, and Nigeria – have among the highest burdens of maternal and newborn death worldwide. Where government policies addressing maternal and newborn health do exist, implementation is often weak due to a range of factors including a lack of political will, inadequate funding, health worker capacities, governance and other dynamics related to power, gender, and social norms. There is increasing recognition of the importance of understanding the political economy to improve the effectiveness of health sector policy making and programmatic practice.  A careful examination of the political and economic factors driving MNH policymaking in each country will shed light on drivers of policy development, implementation and funding while an examination at the global level will highlight decision making structures, agenda setting forums and political dynamics related to the prioritization of MNH in humanitarian settings.