An integrated investment approach for women’s and children’s health

Advancing social and economic development by investing in women's and children's health: a new Global Investment Framework.

Stenberg K, Axelson H, Sheehan P, Anderson I, Gülmezoglu AM, Temmerman M, Mason E, Friedman HS, Bhutta ZA, Lawn JE, Sweeny K, Tulloch J, Hansen P, Chopra M, Gupta A, Vogel JP, Ostergren M, Rasmussen B, Levin C, Boyle C, Kuruvilla S, Koblinsky M, Walker N, de Francisco A, Novcic N, Presern C, Jamison D, Bustreo F; on behalf of the Study Group for the Global Investment Framework for Women's Children's Health. Lancet. 2013 Nov 18. doi: S0140-6736(13)62231-X. pii: 10.1016/S0140-6736(13)62231-X. [Epub ahead of print]

A new Global Investment Framework for Women's and Children's Health demonstrates how investment in women's and children's health will secure high health, social, and economic returns. We costed health systems strengthening and six investment packages for: maternal and newborn health, child health, immunisation, family planning, HIV/AIDS, and malaria. Nutrition is a cross-cutting theme. We then used simulation modelling to estimate the health and socioeconomic returns of these investments. Increasing health expenditure by just $5 per person per year up to 2035 in 74 high-burden countries could yield up to nine times that value in economic and social benefits. These returns include greater gross domestic product (GDP) growth through improved productivity, and prevention of the needless deaths of 147 million children, 32 million stillbirths, and 5 million women by 2035. These gains could be achieved by an additional investment of $30 billion per year, equivalent to a 2% increase above current spending.

Abstract access  [1]

Editor’s notes: Over the past 20 years there have been substantial gains in maternal and child health (MCH). However, much still needs to be done – assuming a continuation of current rates of progress, there would nevertheless be shortfalls in the achievement of MDG 4 and 5 targets. Especially in sub-Saharan Africa, HIV is an important underlying cause of maternal and child ill health. This paper models the costs and benefits of an accelerated action on MCH, including for HIV, the prevention of mother to child HIV transmission; first line treatment for pregnant women; cotrimoxazole for children, and the provision of paediatric antiretroviral therapy (ART). These HIV services are complemented by health systems strengthening; increased family planning provision; and packages for malaria, immunisation, and child health. The paper is interesting for many reasons, including both the breadth of its intervention focus, and the detailed modelling of the likely health, social and economic benefits of such investments.

Although the direct HIV related benefits are not described in detail in the main paper, it is likely that these result both from increased contraceptive use (prong 2 for preventing vertical HIV transmission), as well as ART and cotrimoxazole provision. It also illustrates the potential value of developing a cross-disease investment approach, as a means to ensure that services effectively respond to the breadth of women’s and children’s health needs. This more ‘joined up’, integrated perspective on strategies for health investment can support core investments in health systems strengthening. It can also potentially achieve important cross-disease synergies, e.g., ensuring that a child who has not acquired HIV at birth does not then die from malaria. 

Africa [12], Asia [13], Latin America [14], Oceania [15]
Afghanistan [16], Angola [17], Azerbaijan [18], Bangladesh [19], Benin [20], Bolivia [21], Botswana [22], Brazil [23], Burkina Faso [24], Burundi [25], Cambodia [26], Cameroon [27], Central African Republic [28], Chad [29], China [30], Comoros [31], Congo [32], Côte d'Ivoire [33], Democratic People's Republic of Korea [34], Democratic Republic of the Congo [35], Djibouti [36], Egypt [37], Equatorial Guinea [38], Eritrea [39], Ethiopia [40], Gabon [41], Gambia [42], Ghana [43], Guatemala [44], Guinea [45], Guinea-Bissau [46], Haiti [47], India [48], Indonesia [49], Iraq [50], Kenya [51], Kyrgyzstan [52], Lao People's Democratic Republic [53], Lesotho [54], Liberia [55], Madagascar [56], Malawi [57], Mali [58], Mauritania [59], Mexico [60], Morocco [61], Mozambique [62], Myanmar [63], Nepal [64], Niger [65], Nigeria [66], Pakistan [67], Papua New Guinea [68], Peru [69], Philippines [70], Rwanda [71], Sao Tome and Principe [72], Senegal [73], Sierra Leone [74], Solomon Islands [75], Somalia [76], South Africa [77], Sudan [78], Swaziland [79], Tajikistan [80], Togo [81], Turkmenistan [82], Uganda [83], United Republic of Tanzania [84], Uzbekistan [85], Viet Nam [86], Yemen [87], Zambia [88], Zimbabwe [89]
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