Executive Director’s blog

November

The Global Investment Framework for Women’s and Children’s Health

Next week marks the launch of a special Lancet issue from the Commission on Investing in Health. This marks the 20th anniversary of the 1993 World Development Report on Investing in Health. That report was a sea change in how the world looked at spending on health – as a key input to economic growth and human development, not as a drain on public finances.

To collaborate with the Lancet Commission, PMNCH , WHO and the University of Washington have led a major process with partners over the past year to develop the Global Investment Framework for Woman’s and Children’s Health.

This Framework presents a compelling case for increasing investments in women and children’s health. It shows how, with an increase of US$5 per capita per year to 2035, in 74 high burden countries, we can achieve nine-fold social and economic returns in addition to millions of lives saved. The investment framework looks at the evidence we have on the interventions that work across the reproductive, maternal, newborn and child health continuum – and the impact they would have in the countries most affected by maternal and child mortality. By investing in these interventions, in an accelerated scenario, the analysis shows that it would be possible to avoid the deaths of 147 million children, 32 million stillbirths, and 5 million women by 2035.

Here are some of the key messages from the Investment Framework:

  • Additional investments of US$ 5 per person per year in 74 countries, with 95% of the global maternal and child mortality burden, would yield high rates of return, producing up to nine times the economic and social benefit by 2035. •
  • Continuing historical trends of coverage increases is not sufficient. Accelerated investments are needed to bring health benefits to the majority of women and children.
  • Compared with current trends, our accelerated investment scenario estimates that a total of 5 million maternal deaths, 147 million child deaths, and 32 million stillbirths can be prevented in 2013–35 in 74 high-burden countries.
  • Expanding access to contraception will be a particularly cost-effective investment potentially accounting for half of all the deaths prevented in the accelerated investment scenario.
  • More than a third of the additional costs required are health systems investments that are also required for services beyond those for reproductive, maternal, newborn, and child health. An ambitious scale-up would require an additional 675 000 nurses, doctors, and midwives in 2035, along with 544 000 community health workers.
  • The new global investment framework could serve as a guide to countries to optimise investments in women’s and children’s health within national health and development plans over the next two decades.

The analysis presented in the Investment Framework is the first substantial update on RMNCH financing recommendations since the launch of the Global Strategy for Women’s and Children’s Health in 2010. The Global Strategy drew on the work of the High-Level Task Force on Innovative Financing (2009), relating to 49 countries. However, the GIF goes wider. It bases its work on 74 Countdown countries, using the most up to date coverage estimates we have (2012). Importantly, the Framework takes the estimates of the Global Strategy well beyond the 2015 timeframe to 2035, with an eye on the post-2015 agenda. The Framework reinforces and complements other initiatives and will assist countries either in confirming that they are doing the right things, at the right scale or in identifying investments that will impact national health and development plan.

This is a notable piece of work, the product of a major inter-agency and multisectoral effort Involving more than two dozen partners. It reflects the commitment of the RMNCH community to improving the wellbeing of women and children and will further strengthen our communities resolve in addressing maternal and child health. This will be a valuable tool in our ongoing advocacy to ensure that women and children are positioned at the very heart of the post-2015 development framework.

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