Some 225 million women in developing countries want to avoid pregnancy but do not have access to modern contraceptives, while tens of millions still do not receive basic pregnancy and delivery care, a report has found.

The report estimated that providing women in the developing world with essential sexual and reproductive health services costing $25 (£16; €20) a year per woman would reduce unintended pregnancies by 70% and unsafe abortion by 74%.1

The $25 is roughly double the current level of spending on sexual and reproductive health among this group. It would provide contraceptive services, pregnancy and newborn care, services for pregnant women living with HIV (including prevention of mother to child transmission of the virus), and treatment for four other sexually transmitted infections.

The report analysed data from a wide range of sources, including survey data from women in developing countries. It has been produced by the Guttmacher Institute, a non-profit organisation that works to advance sexual and reproductive health and rights, and the United Nations Population Fund.

It calculated that the average cost of providing a woman with essential healthcare varies across the world from $31 per woman in Latin America and the Caribbean to $14 in Asia and $76 in sub-Saharan Africa, where health systems are generally weakest.

If contraceptive needs were met and all pregnant women and their newborns received the basic standards of care recommended by the World Health Organization the number of women dying from pregnancy related causes would drop by two thirds, from 290 000 to 96 000. In addition, newborn deaths would drop by more than three quarters, from 2.9 million to 660 000, and transmission of HIV from mothers to newborns would be nearly eliminated. For every additional dollar invested in contraceptive services, $1.47 is saved in maternal and newborn health care, the report estimated.

Ann Starrs, president and chief executive officer of the institute, said, “Over the past two decades, we have achieved striking progress in making pregnancy and childbirth safer in developing countries. Despite those gains, these new findings make clear that universal access to sexual and reproductive health services must remain a global health priority requiring urgent attention. The report also makes clear that this is an affordable goal that will have a dramatic impact in improving the lives of millions of women and families.”

Babatunde Osotimehin, executive director of United Nations Population Fund, said, “This report is an urgent call to action for increased investments in sexual and reproductive health services, including family planning. These investments save lives, empower women and girls, strengthen health systems and have a profound and lasting impact on development. We must ensure the quality of services and availability of a full range of choices so women and men can get the health care they need.”

BMJ 2014;349:g7446

5th December 2014

$25 per woman per year would cut pregnancies and unsafe abortions by 70%

Some 225 million women in developing countries want to avoid pregnancy but do not have access to modern contraceptives, while tens of millions still do not […]