Childbirth doesn't have to be so deadly

Every two minutes, nine newborns and one mother die from complications related to pregnancy and childbirth. A total of 2.4 million newborn babies will die in the first month of life this year and 295,000 women will die of pregnancy-related complications.

These deaths represent 2.7 million immeasurable annual tragedies for families and communities. For societies, deaths also represent losses that undermine growth and prosperity. For low-income and lower-middle-income countries, these deaths represent a loss of almost half a trillion dollars each year, or 6% of their annual GDP.

In 2015, world leaders pledged to fix maternal and newborn health, as well as hunger, peace, education and virtually every other major issue by 2030 in what became the Sustainable Development Goals (SDGs). Unfortunately, we've fallen short on virtually all of the promises.

For mothers and newborns, progress is much slower than it should be. Given our current trends, by 2030, some 131,000 mothers and 900,000 infants will die each year, which would not have been the case if we had kept our promises.

It doesn't have to be that way. In a world without budgetary constraints, all governments would invest generously in all the SDGs. In the real world, governments can only moderately increase investment in certain policies. My think tank, Copenhagen Consensus, has undertaken extensive research with dozens of the world's top economists to discover where additional resources can do the most good. Maternal and newborn health is one such area.

In fact, new research published this week shows that targeted investment in maternal and newborn health can deliver amazing returns to society, saving lives and providing an incredible $87 in social benefits for every dollar spent.< /p>

Researchers focus on the 55 countries that experience nearly all of the world's maternal and newborn deaths. They are looking at a vast plethora of potential policies: doing more pregnancy checkups, prescribing more iron supplements, or paying for more health worker visits to counsel mothers after childbirth.

Research demonstrates that the best investment is to increase access to family planning and, most importantly, to increase access to a set of simple procedures known as obstetric and neonatal care. basic emergency. This package, known as BEmONC, means providing better care at low cost, often with nurses and midwives instead of more expensive doctors.

For example, BEmONC provides access to neonatal resuscitation. It only requires a hand pump or resuscitator, which costs around $65. If used 25 times per year, the cost per use is only $2.60. Adding the health worker's time, the total cost to save a child's life is in the order of $5 - a tiny sum spent on an incredible good. Neonatal resuscitation can prevent 30% of deaths associated with asphyxia, one of the leading causes of neonatal death.

Another example of an approach offered as part of the BEmONC package is the kangaroo mother, which promotes skin-to-skin contact between mother and baby, a simple act that could reduce mortality by half in premature infants.

Much of the cost of increased BEmONC comes from better access of pregnant women to maternity wards, which reduces the risk of death for both mother and child. Today, two-thirds of women in these 55 countries give birth in such facilities. In Nigeria, the WHO estimates this figure at just under 40%. The researchers' proposal is to stimulate investment to bring 90% of women to these facilities.

Family planning is an important part of the picture, as an estimated 217 million women who want to avoid pregnancy still do not have access to safe and effective family planning methods. If 90% of women in the 55 hardest-hit countries had access to these services, fewer women would become pregnant and 87,000 fewer mothers would die each year.

The annual financial cost is $2.1 billion, with women's overtime estimated at $1.6 billion. Yet this modest total cost of just $3.7 billion a year can avert 161,000 maternal deaths, more than 1.2 million newborn deaths, and almost as many stillbirths in the 55 countries each year.

In addition to saving millions of lives, a reduction in mortality and fertility can also lead to a significant increase in per capita income, as fewer but healthier children become more productive. This is called the “demographic dividend”. In total, it is estimated that reduced fertility yields a benefit equivalent to $28 billion per year.

When you add up all the returns to society, it turns out that the annual cost of $3.7 billion will provide overall benefits of fewer fatalities and more...