Radical reductions in maternal and newborn deaths are within reach

How much would it cost to ensure that women have healthy, planned pregnancies, to prevent needless deaths among women and their newborns, and to increase their chances of leading healthier, more productive lives? And how would the benefits compare with those of other investments? Around the world, governments face these questions as they strive to strengthen the capacity of health systems to provide essential services. A new report, Adding It Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health, recently released by the Guttmacher Institute and the United Nations Population Fund, UNFPA, provides some answers. It documents the enormous-and synergistic-benefits that would come from increasing the global investment in both family planning services and pregnancy-related and newborn care. Improved maternal and newborn health is not a challenge in search of technically complicated solutions. A handful of basic, standard health care services could save the lives of hundreds of thousands of women and babies every year. Currently, some 550,000 pregnancy-related deaths and 3.5 million newborn deaths occur annually, most of which could be prevented by helping women time and space their pregnancies and providing WHO-recommended standards of basic maternal and newborn care. Roughly 215 million women who want to avoid pregnancy are not using an effective method of contraception, and only about half of the 123 million women who give birth each year receive the antenatal, delivery and newborn care they need. Another 20 million women have unsafe abortions each year-70,000 die, and 8.5 million experience serious complications requiring treatment that three million of them never receive. The world currently spends approximately US$12 billion a year on these efforts, with developing countries providing the bulk of the total. Doubling that modest investment would yield staggering results: a 70% reduction in maternal deaths and a 44% reduction in the deaths of newborns. A host of other additional health, societal and economic benefits would follow. Adding It Up documents the interrelationship between family planning and better maternal and newborn health. It demonstrates that providing women family planning information and services frees up scarce resources that could be used to provide universal access to maternal and newborn care. The combined investment in family planning and maternal and newborn services leads to dramatic improvements in care, lives saved and illness prevented, for US$1.5 billion less than investing in maternal and newborn health services alone. In other words, investments in family planning boost the overall effectiveness of every dollar spent providing pregnancy-related and newborn health care. Policymakers urgently need to recognize these synergies. The immediate benefits of meeting the need for both family planning and maternal and newborn health services are dramatic: Unintended pregnancies would drop by more than two-thirds annually, the deaths of 400,000 mothers and 1.6 million newborns would be prevented, and unsafe abortions and resulting complications would both drop steeply, by about 75%. These investments would have profound additional benefits. The decreased need to deal with pregnancy-related and newborn health complications would improve health care systems’ capacity to address other needs. Increases in condom use for pregnancy prevention would simultaneously curb transmission of HIV and other STIs; women’s educational and employment opportunities would increase, enhancing their social and economic status; and family savings and investment would rise, spurring economic growth and reducing poverty. These advances would make social and economic development goals easier to achieve. The case for helping the world’s women to become pregnant only when they want to be and for providing them the pregnancy-related and newborn care they need is clear. Investing in women’s reproductive health and autonomy always yields dividends-dividends that accrue at the individual, family and societal levels. While an additional US$13 billion investment may seem steep, it is modest in relation to the dramatic returns it guarantees. The global community has the means to provide the funding. Given the enormous benefits, one has to wonder: What is taking us so long? Sharon L. Camp is president and CEO of the Guttmacher Institute. Thoraya A. Obaid is executive director of UNFPA, the United Nations Population Fund.