Transcript ADDING IT UP The costs and benefits of investing in family planning and maternal and newborn health www.guttmacher.org.

ADDING IT UP
The costs and benefits of investing in
family planning and maternal and
newborn health
www.guttmacher.org
February 2003
December 2009
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Objectives of 2009 study
Estimate the costs and benefits of providing family planning
and maternal and newborn health care to women in
developing countries who are in need of these services.
Provide data to help decision makers focus resources on
health care interventions with the greatest returns for
individuals and societies.
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Key Findings
Simultaneously meeting the needs for family
planning services and maternal and newborn
health care in the developing world would
• cut maternal deaths by more than two-thirds;
• reduce newborn deaths by more than half; and
• generate a range of other benefits, such as reducing
poverty and helping countries achieve economic
development goals.
Investing in family planning would reduce
maternal and newborn health care costs.
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GLOBAL CONTEXT
Uneven Progress
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Unintended pregnancy rates have fallen in
all regions of the developing world
Number of unintended pregnancies per 1,000 women aged 15–44
100
80
23%
7%
92
20%
25%
96
86
60
72
64
40
71
57
49
20
0
Africa
1995
Asia
2008
Latin America
Developing
world
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Globally, unintended pregnancy rates
have decreased because
contraceptive use has increased
% of married women aged 15–49 practicing contraception
Africa
17
1990
28
57
Asia
71
66
68
71
72
Europe
North America
World
68
62
Latin America
2003
54
63
But 215 million women in the developing world have an
unmet need for modern contraception
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More progress is needed in
maternal and newborn care
Of the 123
million women giving birth each year…
60 million make too few or
no antenatal visits
55 million do not deliver in
a health facility
21 million have obstetric
complications that go
untreated
= 10 million
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Unsafe abortion and its consequences
are all too common
20 million women have
unsafe abortions each year
8.5 million experience
complications that require
medical treatment
3 million of these women
do not get the care they
need
= 10 million
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Disparities in maternal health care remain
very large in developing countries
% of women giving birth who receive care, 2008
Low-income
countries
Lower-middle–
income countries
76
54
38
At least four
antenatal visits
93
60
38
Upper-middle–
income countries
Delivery in a
health facility
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We considered three scenarios
Meeting 100% of the need for:
Scenario 1
Scenario 2
Scenario 3
Modern family
planning
services alone
Maternal and
newborn care
alone
Family planning and
maternal and newborn
care together
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SCENARIO 1
Meeting the need for modern
family planning services
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Providing contraceptives to all who need
them would cost an additional $3.6 billion
Costs in 2008 US$ (in billions)
8.0
7.0
6.7
6.0
5.0
3.6
4.2
4.0
3.0
2.0
1.0
2.7
1.6
3.1
0.0
Total
0.6
1.0
Contraceptive
commodities and
supplies
0.8
0.6
Health worker
salaries
1.5
Program and
systems costs
100% of unmet need met
Current levels of care
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Addressing all unmet need for modern
family planning would result in fewer:
Unintended
pregnancies
Abortions
Unplanned
births
53
25
22
million
million
million
$1.40
$1= saved
spent
Deaths
Children
among women who will lose
and newborns their mothers
680,000
390,000
$1 spent on contraception =
$1.40 saved in maternal and
newborn health care costs
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SCENARIO 2
Meeting the need for maternal
and newborn health services
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Providing basic maternal and newborn
heath care to all who need it would cost an
additional $14 billion…
Costs in 2008 US$ (in billions)
25.0
23.0
20.0
15.0
14.3
10.0
5.0
14.0
8.1
8.2
8.7
0.0
Total
5.8
0.8
Delivery,
newborn &
postpartum care
Postabortion
care
5.6
2.5
Antenatal care
100% of unmet need met
Current levels of care
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…but would dramatically reduce
maternal and newborn deaths
Number (in thousands), 2008
3,500
3,000
42%
3,170
Newborn
deaths
2,500
2,000
1,500
1,000
57%
Maternal
deaths
500
0
1,840
356
Current maternal and
newborn health care
100% coverage
153
Maternal deaths
Newborn deaths
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SCENARIO 3
Meeting the needs for family
planning and maternal &
newborn health care
simultaneously
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Expanding access to family planning would
reduce the cost of improved maternal and
newborn health care, saving $1.5 billion
Costs in 2008 US$ (in billions)
Expanded MNH
care only
3.1
Expanded FP
and MNH care
6.9
6.7
0
1.8
5
26.1
16.1
24.6
16.1
10
15
20
25
30
Contraceptive services
Maternal and newborn care for unintended pregnancies
Maternal and newborn care for intended pregnancies
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Simultaneously meeting family
planning and maternal and newborn
health care needs would prevent:
53 million
unintended
pregnancies
250,000
maternal
deaths
22 million unplanned births
25 million abortions
1.7 million
newborn
deaths
7 million miscarriages
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Maternal deaths would decline by 71%
if family planning and maternal health
care needs were met
Maternal deaths (in thousands), 2008
Current levels of care
232
Expanded FP use only
232
Expanded MNH care only
89
Expanded FP and MNH care
89
0
50
125
31 262
65
71%
153
Maternal
deaths
16 105
100
357
150
200
250
300
350
400
Deaths related to intended pregnancies
Deaths related to unintended pregnancies
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Africa would account for more than half of
the global reduction in maternal deaths
Latin
America 2%
57%
of all maternal
deaths averted
Asia 41%
Africa 57%
Maternal deaths prevented (250,000)
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Bottom line: Dual investment (MNH + FP)
is the most cost-effective strategy…
The total cost of providing both services
is $24.6 billion. This is $1.5 billion less than
providing maternal and newborn care
alone, savings that result from preventing
unintended births
…and saves more lives than either
intervention alone.
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Thank You
Adding It Up was a collaborative project of Guttmacher Institute
and the United Nations Population Fund. This presentation was
made possible in part by a grant from the World Bank.
For more information, visit www.guttmacher.org.
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