www.guttmacher.org 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.
Dec 15, 2015
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ADDING IT UPThe 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 studyEstimate 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
• 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.
Simultaneously meeting the needs for family planning services and maternal and newborn health care in the developing world would
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GLOBAL CONTEXTUneven 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
Africa
Asia
Latin
Am
erica
Dev
elop
ing
wor
ld0
40
80 9264
9671
86
4972
57
1995 2008
7% 23% 25% 20%
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% of married women aged 15–49 practicing contraception
Africa
Asia
Latin America
Europe
North America
World
17
57
62
66
71
54
28
68
71
68
72
63
2003 1990
Globally, unintended pregnancy rates have decreased because contraceptive use has increased
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
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
Of the 123 million women giving birth each year…
= 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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At least four antenatal visits
Delivery in a health facility
385476
6038
93
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
Upper-middle–income countries
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Modern family
planning services
alone
Maternal and newborn care
alone
Family planning and maternal and newborn care
together
Scenario 1 Scenario 2 Scenario 3
We considered three scenarios
Meeting 100% of the need for:
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SCENARIO 1Meeting the need for modern family planning services
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Total0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
3.1
3.6
Contraceptive commodities and supplies
Health worker salaries
Program and systems costs
1.0 0.600000000000001
1.5
0.600000000000001
2.7
Providing contraceptives to all who need them would cost an additional $3.6 billion
Costs in 2008 US$ (in billions)
6.7
1.6
0.8
4.2
Current levels of care
100% of unmet need met
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Addressing all unmet need for modern family planning would result in fewer:
Unintended pregnancie
s
53million
Abortions
25million
Deaths among women
and newborns
22million
Childrenwho will losetheir mothers
680,000 390,000
Unplanned
births
$1=spent
$1.40saved
$1 spent on contraception = $1.40 saved in maternal and newborn health care costs
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SCENARIO 2Meeting 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)
Delivery, newborn & postpartum
care
Postabortion care
Antenatal care
5.82.5
8.2
5.6
Total0.0
5.0
10.0
15.0
20.0
25.0
8.7
14.3
23.0
14.0
0.8
8.1
Current levels of care
100% of unmet need met
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Maternal deaths Newborn deaths0
500
1,000
1,500
2,000
2,500
3,000
3,500
356
3,170
153
1,84057%Maternal
deaths
42%Newborndeaths
…but would dramatically reduce maternal and newborn deaths
Number (in thousands), 2008
Current maternal and newborn health care100% coverage
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SCENARIO 3Meeting 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
Expanded FP and MNH care
0 5 10 15 20 25 30
3.1
6.7
6.9
1.8
16.1
16.1
Contraceptive services
Maternal and newborn care for unintended pregnancies
Maternal and newborn care for intended pregnancies
24.6
26.1
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22 million unplanned births
25 million abortions
250,000 maternal deaths
53 million
unintended pregnancie
s
1.7 million
newborn deaths
7 million miscarriages
Simultaneously meeting family planning and maternal and newborn health care needs would prevent:
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Current levels of care
Expanded FP use only
Expanded MNH care only
Expanded FP and MNH care
0 50 100 150 200 250 300 350 400
232
232
89
89
125
31
65
16
Deaths related to intended pregnancies
Deaths related to unintended pregnancies
71%Maternal
deaths
Maternal deaths would decline by 71% if family planning and maternal health care needs were met
Maternal deaths (in thousands), 2008
105
262
153
357
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57%
of all maternal deaths averted
Africa would account for more than half of the global reduction in maternal deaths
Latin America 2%
Africa 57%
Asia 41%
Maternal deaths prevented (250,000)
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…and saves more lives than either intervention alone.
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
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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.
Thank You
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