Millions of maternal and child lives could be saved every year for less than $5 a person

April 10, 2016, Johns Hopkins University Bloomberg School of Public Health
A small child in Mumbai, with a shaved head, eating bread with her hand. Credit: Wen-Yan King/Wikipedia

By spending less than $5 per person on essential health care services such as contraception, medication for serious illnesses and nutritional supplements, millions of maternal and child lives could be saved every year, according to a new analysis led by the Johns Hopkins Bloomberg School of Public Health.

The findings, published April 9 in The Lancet, suggest it is possible to save many lives by broadly expanding basic services in the 74 low- and middle-income countries where more than 95 percent of the world's maternal and occur annually.

In 2015, nearly six million children under the age of five died as did more than 300,000 women from pregnancy-related causes across the globe. These numbers fall short of the Millennium Development Goals for reducing maternal and child mortality by 2015 that world leaders committed to back in September of 2000. The goals called for a two-thirds reduction in from 1990 levels and a three-quarters reduction in from 1990 levels.

"Many of these deaths could be prevented if high-impact and affordable solutions reached the populations that needed them most," says study leader Robert Black, PhD, a professor in the Department of International Health at the Bloomberg School. "Our analysis shows that expanding access to care to keep more mothers and children alive and healthy is feasible and a highly cost-effective investment."

Black will present the research April 9 at the Consortium of Universities for Global Health conference in San Francisco.

For the study, the researchers analyzed three essential packages of care presented in the Reproductive, Maternal, Newborn, Child Health volume of Disease Control Priorities, 3rd edition, published by the World Bank Group. The three packages (maternal and newborn , child health and reproductive health) together comprise 66 proven health interventions that focus on a range of health problems.

The researchers found that four million lives could be saved every year by reaching 90 percent of the target populations with services included in the maternal and and packages. Interventions ranged from improving pregnancy and delivery care, to treating life-threatening infectious diseases like pneumonia, diarrhea, and malaria, and better childhood nutrition.

These services, they found, could prevent 1.5 million newborn deaths, 1.5 million child deaths, and 149,000 maternal deaths—equivalent to half of all maternal, newborn and child deaths annually. They could also prevent 849,000 stillbirths, or more than a third of all annual stillbirths.

The authors looked separately at the reproductive health package. By meeting unmet demand for family planning, more than 1.5 million lives could be saved every year by preventing just under 28 million pregnancies. Increased access to contraception would reduce by 67,000, by 440,000, deaths by 473,000 and stillbirths by 564,000, they found.

Health services from all three packages with the largest impact included management of acute malnutrition; pre-term birth care; provision of contraception; management of labor and delivery; and treatment of serious infections including pneumonia, diarrhea, malaria and neonatal sepsis.

Researchers also estimated the cost of expanding coverage for all three packages to reach 90 percent of the target populations. Estimates produced for this analysis show that all three packages could be immediately scaled up to nearly all people in need with an investment of $6.2 billion in low-income countries, $12.4 billion in lower middle-income countries, and $8 billion in upper middle-income countries. This is equivalent to an average investment per person in 2015 of just $6.70, $4.70, and $3.90, respectively—or $4.70 overall.

"For less than $5 per person, essential health services could reach the people who are most in need of them," Black says. "Community health workers or primary health centers can deliver the majority of these services, which reduces the cost of expanding coverage.

"The benefits of scaling up these interventions extend well beyond health. For example, improving care at the time of birth gives a quadruple return on investment by saving mothers' and children's lives and preventing stillbirths and disability, while investing in nutrition can help children reach their potential in cognitive development."

Explore further: Stillbirth should be given greater priority on the global health agenda, argue experts

More information: "Reproductive, maternal, newborn, and child health: key messages from Disease Control Priorities, 3rd Edition" The Lancet, 2016. … (16)00738-8/abstract

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3.4 / 5 (5) Apr 10, 2016
If the left (and is a part of it) wanted to save lives, they would not be demanding abortion.
1 / 5 (3) Apr 10, 2016
But abortion is necessary to counter the effects of our tropical repro rate and the religionist cultures which are Designed to maximize it for the purpose of outgrowing and overrunning each other.

Over ONE BILLION ABORTIONS since roe v Wade means that it has nothing to do with women's right to choose other than to choose not to stand in bread lines or send their children off to die on some battlefield.

Or to die themselves bearing one child too many.

Those cultures once served a vital Purpose of spreading Stability and enabling Progress. But they are now obsolete and must be destroyed if we are to end hunger and poverty and suffering and war in any meaningful way.

-The most important site on the internet-
1 / 5 (2) Apr 10, 2016
$5 per year? That is not clear. What about the cost to administer such care?

In the US, we could actuall SAVE money and lives at the same time. By getting rid of abortions (saving money) we could literally have millions more healthy babies.

- BartV
Did you happen to notice what Otto said: "Those cultures once served a vital Purpose of spreading Stability and enabling Progress. But they are now obsolete and must be destroyed..."

Perhaps it would have been better if Otto had been aborted/destroyed also...don'tcha think so?

not rated yet Apr 11, 2016
Whether the causes be environmental, socioeconomic etc, does our species really need to subvert natural selection to such an extent? Do we really have a shortage within our species?
5 / 5 (1) Apr 12, 2016
Against abortion? Then you should be in favor of contraception,sex ed, and education for girls.
1 / 5 (1) Apr 12, 2016
Contraception is good to prevent unwanted pregnancies. Sex education doesn't always work once the "juices" start flowing, so to speak. Education for girls? What about for boys too? What about for parents taking the responsibility to educate their sons and daughters, not just to avoid pregnancies, but also STDs, guilt, mental and physical abuse, anguish, fear, and keeping off the public dole?

Abortion in the last trimester is murder, no matter which way you look at it.
1 / 5 (1) Apr 12, 2016
Whether the causes be environmental, socioeconomic etc, does our species really need to subvert natural selection to such an extent? Do we really have a shortage within our species?

- V E
A shortage of "common sense" is more like it.

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