Report calls for increased investment in the health of mothers and children in Asia and the Pacific

Global financial and economic crisis must not be allowed to derail investment in the world’s poorest region

Investing in maternal, newborn and child health cover

3 MAY 2009 | DENPASAR/GENEVA - Financial and fiscal measures to stimulate the ailing global economy should include significant and sustained funding to improve the health of mothers, babies and children in the world’s poorest region. If this doesn’t happen, the impact of the global financial and economic crisis could place people in poor countries at even greater risk. This is a key message of the new Investment Case launched today by the Maternal, Newborn and Child Health Network for Asia and the Pacific.

Investing in Maternal, Newborn and Child Health – the Case for Asia and the Pacific has been developed by experts from ten major international development organizations and foundations: Asian Development Bank; Australian Agency for International Development; Bill and Melinda Gates Foundation; Japan International Cooperation Agency; Partnership for Maternal, Newborn and Child Health (PMNCH); UNFPA; UNICEF; US Agency for International Development; World Bank; and the World Health Organization.

The new Investment Case:

  • Highlights the urgent need to accelerate progress in the world’s poorest region towards Millennium Development Goals (MDGs) 4 and 5 (which aim to reduce child and maternal mortality and achieve universal access to reproductive health)
  • Describes the acute problems facing countries in Asia and the Pacific in the area of maternal, newborn and child health, and recommends practical steps for tackling them, based on the best-available evidence
  • Provides detailed cost estimates, which show that at least US$15 billion in additional resources is needed by 2015 to achieve MDGs 4 and 5
  • Demonstrates how governments and their development partners have an opportunity to protect the poor, strengthen fragile health systems, and invest in long-term social and economic growth and social and political stability.

The Investment Case for MNCH in Asia and the Pacific is launched against the backdrop of Annual General Meeting of the Asian Development Bank in Indonesia on May 3-5. This is fitting, as many of the issues affecting poor and inequitable health outcomes are related to economics, financing and public expenditure, and because dozens of Ministers of Finance and their senior officials will attend the meeting. The decisions they make about the level – and quality – of public expenditure are central to achieving MDGs, and protecting the poor from further hardship.

Background information
  • Despite strong economic growth in Asia in recent years, many countries in Asia and the Pacific still have poor basic health outcomes, particularly for women and children.
  • 35% of maternal deaths occur in South Asia alone, and 44% of maternal deaths in Asia and the Pacific.
  • Of all the people in the world who require family planning services, but do not have access to them, 55% live in Asia.
  • More than half of the world's newborn deaths occur in the region. And an alarming 15% of all the world’s newborn deaths occur in just three states of India: Bihar, Madhya Pradesh and Uttar Pradesh.
  • There are three times more underweight children in South Asia than in all of Sub-Saharan Africa and Latin America combined.

These and many similar indicators demonstrate the urgent need for greatly increased investment in maternal, newborn and child health in Asia and the Pacific. As highlighted in the Investment Case, many of the interventions needed are simple and extremely cost-effective, such as basic family planning, antenatal care, skilled birth attendance, and essential supplements for babies and children.

However, there is genuine concern that the current global financial and economic crisis could derail some investment plans and make the situation even more acute. Experience of previous financial and economic crises in the region suggests that the current crisis is likely to hamper economic growth, reduce household incomes and increase rates of poverty and infant mortality (from 1980 to 2004, more than one million excess infant deaths occurred in the developing world in countries experiencing economic contractions of 10 per cent or greater). Furthermore, government expenditure measured in real per capita terms tends to decline during a recession, and there is a significant risk that international development assistance will be cut.

"We are facing a severe economic downturn. Now more than ever, it is critical to invest in maternal, newborn and child health, because of the long-term socio-economic benefits that such an investment accrues. Increased and more predictable international development assistance will contribute to improved health for women and children." Flavia Bustreo, Acting Director, PMNCH

Many factors contribute to poor health outcomes in Asia and the Pacific, including class, caste, custom, poverty and illiteracy. But expenditure on essential health care is an important part of the explanation. It is often inadequate, inefficient, inequitable, fragmented, unpredictable and poorly aligned with incentives. Total health expenditure in South Asia was just $26 per person per year in 2006, lower than even Sub-Saharan Africa. Government expenditure is often even lower. An estimated 78 million people fell below the US$1 a day poverty line in Asia and the Pacific because of the need to pay out-of-pocket expenditure on essential health care. This is often a result of poorly functioning social protection measures.

Investing in Maternal, Newborn and Child Health – the Case for Asia and the Pacific makes a strong case for investment, combining the best available science and economics with evidence about what works in practice. It presents the investment options clearly, suggesting Core, Expanded and Comprehensive intervention packages, and giving additional costs per capita for each. It also identifies ‘best buys’ that take account of local problems, priorities and costs.

By bringing together analysis by experts from major development agencies supporting international health, the Investment Case demonstrates that we have the technical means at our disposal to make great headway on MDGs 4 and 5. However, we need to see leadership and increased spending on maternal, newborn and child health to protect mothers and their children.

For further information, please contact:

Henrik Axelson, Health Economist, Partnership for Maternal, Newborn and Child Health (PMNCH) at axelsonh@who.int (available at the Annual General Meeting of the Asian Development Bank in Bali on May 3-5, 2009), at axelsonh@who.int.

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