Adding It Up: The Costs and Benefits of Investing in Sexual and Reproductive Health 2014
The report, released by the Guttmacher Institute and UNFPA, the United Nations Population Fund, analyzed data from a wide range of sources, including survey data from women in developing countries, to document the number of women who lack services, what it would cost to meet their needs, and the benefits of meeting these needs.
“Over the past two decades, we have achieved striking progress in making pregnancy and childbirth safer in developing countries. Despite those gains, these new findings make clear that universal access to sexual and reproductive health services must remain a global health priority requiring urgent attention,” said Ann Starrs, President and CEO of the Guttmacher Institute. “The report also makes clear that this is an affordable goal that will have a dramatic impact in improving the lives of millions of women and families.”
The study calculates that it would cost on average $25 per woman aged 15–49, roughly double the current level of spending, to provide a package of essential sexual and reproductive health services to all women in developing regions each year. This package includes: contraceptive services, pregnancy and newborn care, services for pregnant women living with HIV, including prevention of mother-to-child transmission of the virus, and treatment for four other sexually transmitted infections.
“This report is an urgent call to action for increased investments in sexual and reproductive health services, including family planning. These investments save lives, empower women and girls, strengthen health systems and have a profound and lasting impact on development,” said Dr. Babatunde Osotimehin, Executive Director of UNFPA. “We must ensure the quality of services and availability of a full range of choices so women and men can get the health care they need.”
Providing this basic package of services to all women who need them in developing countries would have a dramatic impact. If all women wanting to avoid pregnancy used a modern contraceptive method, the number of unintended pregnancies would drop by 70% and unsafe abortions by 74%. If contraceptive needs were met and, in addition, all pregnant women and their newborns received the basic standards of care recommended by the World Health Organization:
- The number of women dying from pregnancy-related causes would drop by two-thirds, from 290,000 to 96,000;
- Newborn deaths would drop by more than three-fourths, from 2.9 million to 660,000;
- Transmission of HIV from mothers to newborns would be nearly eliminated.
The report—which presents findings from Africa, Asia, and Latin America and the Caribbean—found that the situation varies widely by region. According to the analysis, in Latin America and the Caribbean, the average annual cost of providing a woman with the needed health care would be $31, compared with $14 per woman in Asia. However, costs would be significantly higher—$76 per woman—in Sub-Saharan Africa, the subregion with the greatest need for services and where health systems are generally weakest.
Currently, of the 125 million women in developing countries who give birth every year:
- 54 million do not receive adequate antenatal care;
- 43 million do not deliver in a health facility;
- 21 million women and 33 million newborns do not receive care for medical complications;
- 550,000 pregnant women living with HIV do not receive treatment to prevent mother-to-child transmission of HIV.
Differences within regions are also considerable. In East Africa, 42% of women deliver in a health facility, compared with 62% in Middle Africa and 87% in Southern Africa. In Asia, just 32% of the poorest women deliver in facilities, compared with 92% of the wealthiest women.
Providing all women with the health care they need would also be cost-effective. With far fewer unintended pregnancies, the cost of providing maternal and newborn care to all who need it becomes more affordable: For every additional dollar invested in contraceptive services, $1.47 is saved in maternal and newborn health care.
“If we continue to underinvest in sexual and reproductive health, we will be missing out on a tremendous opportunity to save lives, improve the health and well-being of families, and ultimately build stronger nations,” said Ms. Starrs.