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What does it take to meet the need for sexual and and reproductive health services? Guttmacher did the math.

18/8/2020

 
PicturePhoto by Joshua Hanson
Guttmacher’s recently published 2019 “Adding it Up” report captures the shortages in sexual and reproductive health services in low and middle income countries (LMIC). The research institute calculated what it would take to bridge the gap.

Major shortcomings
218 million women of reproductive age (15-49) in LMIC countries have a an unmet need for modern contraception—that is, they want to avoid a pregnancy but are not using a modern method. About half (49%) of all pregnancies in LMICs—111 million annually—are unintended.
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Millions of women do not receive adequate pregnancy-related and newborn health care: 50 million make fewer than four antenatal care visits and 31 million do not deliver in a health facility. This puts women and newborns needlessly at risk.

Major change
If all women in LMICs wanting to avoid a pregnancy were to use modern contraceptives and all pregnant women and their newborns were to receive care at the standards recommended by the World Health Organization, the impacts would be dramatic:
  • Unintended pregnancies would drop by 68%
  • Unsafe abortions would drop by 72%
  • Maternal deaths would drop by 62%
Providing the recommended maternal and newborn care would also vastly improve newborn health. Newborn deaths would drop by 69%, and new HIV infections among babies six weeks and younger would drop by 88%.

In addition, if all women infected with chlamydia or gonorrhea were given effective and timely treatment, cases of pelvic inflammatory disease and infertility caused by these sexually stransmitted infections would be eliminated.

What would it take to get there?
A package of care that would meet all women’s needs for modern contraception, pregnancy-related and newborn care, and treatment for the major curable STIs would cost approximately €9 per capita (i.e., per total population in LMICs) per year, Guttmacher calculated. This represents an increase over current costs of about €4 per capita per year.

Spending an average extra €4 per would improve the quality of services women currently receive and enable all women to receive the care they need.

The costs may very from country to country though. The low-income countries in Sub-Saharan Africa require the largest boost in resources — an increase from the current €3 to 13 (per capita annually). These countries’ unmet needs for services are the highest and the health systems supporting these services require the most expansion and improvement.

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