Analysis reveals triple return on investment to save three million mothers’ and babies’ lives annually
The first comprehensive analysis in nearly a decade of the evidence for interventions to prevent newborn deaths suggests that nearly three million mothers’ and babies’ lives could be saved annually, if available methods to improve newborn health care were scaled up to at least 90% coverage in all countries. Two million lives could be saved simply by ensuring that for all births occurring in health care facilities, women and babies receive effective, high-quality care, underlining the urgency and potentially high impact of improving quality of care at birth.
The analysis, led by Professor Zulfiqar Bhutta atthe Hospital for Sick Children, Canada, and the Aga Khan University, Pakistan, and published in The Lancet as part of its Every Newborn Series, examines the latest evidence for health interventions to prevent newborn and maternal deaths, estimates their potential for saving lives, and evaluates how much investment will be needed to scale up the most effective interventions to nearly universal coverage.
The interventions examined involve the provision of integrated care for mothers before birth, and quality care for both mother and baby at the time of birth, including access to basic and emergency obstetric care. Essential aspects of newborn care include ensuring that both mother and baby have access to adequate nutrition, and infection control, and small and ill newborn babies also need to have access to timely specialist care.
The authors estimate that if the full package of interventions they recommend were to be made available to at least 90% of mothers and their babies by 2025, the annual cost would be no more than US$5·65 billion – around $1·15 per person globally, or slightly less than $2000 for each mother or child’s life saved. The majority of these costs relate to human resources, and commodities, including drugs.
While in future decades, increasing numbers of women are expected to give birth in hospitals, the study also shows that commitment to implementing the most effective community and primary care-based interventions will also have a substantial effect on reducing mortality rates. Even when most women are able to give birth at a health facility, community interventions will still contribute to reducing around a fifth of newborn deaths.
According to Professor Bhutta, “Although the costs of radically scaling up healthcare for mothers and their babies may be substantial, the impact of this investment is enormous. Integration and further scale up of these interventions in health systems will bring benefit for women, babies, development outcomes and economic capital – a triple or even quadruple return on investment. No country can afford to ignore this investment case to change survival and health for every newborn and future generations.”
Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Zulfiqar A Bhutta, Jai K Das, Rajiv Bahl, Joy E Lawn, Rehana A Salam, Vinod K Paul, Jeeva M Sankar, Hannah Blencowe, Arjumand Rizvi, Victoria B Chou, Neff Walker, for The Lancet Newborn Interventions Review Group and The Lancet Every Newborn Study Group, The Lancet, DOI: 10.1016/S0140-6736(14)60792-3, published online 20 May 2014.