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Adding It Up:The Costs and Benefits of Investing in Sexual and Reproductive Health 2014
Authors: S Singh, JE Darroch and L Ashford
Presenter: Ann Starrs, President, Guttmacher InstituteBerlin, Germany April 16, 2015
Key Findings on Women’s Need for Sexual and Reproductive Health Services,
2014
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Modern contraceptive use grew by a large margin over the last decade...
2003 2008 2014
510596 652
Unmet need
No. of women wanting to avoid pregnancy (millions)
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… but unmet need did not decline
2003 2008 2014
510596 652
210220
225
Unmet need
Using modern contraception
720817
877
No. of women wanting to avoid pregnancy (millions)
(71%) (73%) (74%)
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Prevalence of key reasons for nonuse of contraception, by region
LAC Asia Africa0
10
20
30
40
50
Unaware of methodsLack of accessPP amenorrhea/ breast-feedingInfrequent or no sex OppositionSide effects/ health risks
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Pregnancy-related care increased between 2008–2014, but millions of women
still lack essential services
2008 2014 2008 2014
6371 68
82
60 54 5543
Unmet need
Received care
No. of women giving birth (millions)
125123125123
Facility delivery4+ antenatal care visits
(51%) (57%) (55%) (66%)
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More than one-third of pregnant women living with HIV receive no antiretroviral medication
38%
36%
26% None
Antiretroviral care to prevent transmission only (Option B)
Ongoing an-tiretroviral care (Option B+)
1.5 million pregnant women living with HIV
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In developing regions, an estimated eight in 10 women with a curable STI received no
medical care
Did not receive care83%
Received care17%
Had symptoms
Did not have symptoms Had symptoms
204 million women with a curable STI, 2014
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Across developing regions, unmet need for delivery in a health facility is highest
among the poorest women
Africa Asia* Latin America and the Caribbean
0
20
40
60
80
100
71 68
29
6154
12
5042
5
3727
3
188
1
Poorest Poorest Middle Rich RichestWealth quintile:
% of women giving birth who do not delivery in a facility, 2014
*Excludes Eastern Asia and Oceania.
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Sub-Saharan Africa Asia* Latin America & Caribbean -
20
40
60
80
100
73
40 31
65
35 25
60
32 23
53
30
19
46
29 19
Poorest Poor Middle Rich Richest
% of women wanting to avoid pregnancy who have an unmet need, 2014
Levels of unmet need for modern contraception are highest among the
poorest women
Wealth quintile:
*Excludes Eastern Asia and Oceania
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Millions of women and newborns don’t receive essential pregnancy and delivery care
Investing in Sexual and Reproductive Health Care
is Cost-Effective
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Providing women the modern contraceptive services they need yields cost savings
Current care Expanded MNH care only Expanded contraceptive and MNH care
0
10
20
30
40
$4.1 $4.1$9.4
$4.3$10.5 $2.7
$9.9
$25.3$25.3
Cost of care for intended preg-nancies
Cost of care for unintended pregnancies
Cost of modern contracetive care
2014 U.S. dollars (in billions)
$40.0$37.5
$18.4
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Providing sexual and reproductive services for all women: a smart investment
Providing women the care they need would cost just
$25 per woman per year
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21 million fewer
unplanned births
If all 225 million women with unmet need used modern methods, each year there would be:
52 million fewer
unintended pregnancies
24 million fewer
abortions (15 million of which would be unsafe)
6 million fewer
miscarriages
600,000fewer
stillbirths
Conclusions
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Investing in sexual and reproductive health care saves lives and is cost-effective
• Substantial progress has been made in the past decade
• However, large gaps still remain
• Enormous benefits would result from investing in sexual and reproductive services
• Investing in SRH services is a “best buy”
We gratefully acknowledge the financial support of UK aid, the Bill &
Melinda Gates Foundation and UNFPA
Findings and conclusions are those of the authors and do not necessarily reflect positions or policies of these donors.
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