Forbes | December 5, 2014
By Bill Frist, MD and Jenny Eaton Dyer, PhD
As governments, organizations, and private individuals commit large contributions to fight Ebola in western Africa, we are reminded of the need to invest in building health care systems in developing nations that are designed to handle public health crises, and provide basic primary health services for the people they serve. The World Bank estimates that the world will spend $32.6 billion by the end of 2015 to combat the spread of Ebola.
The human and economic return on that investment is yet to be determined. But for many global health issues, we know every dollar we invest today will allow us to reap a strong return on investment. For instance, every dollar invested in clean water initiatives now will return at least $4 in economic productivity and decreased health care costs.
Similarly, global investments that provide women and girls with the information and tools they need to time and space their pregnancies are driving progress across the health and development spectrums. This November, a report by the global initiative FP2020 showcased the impressive progress in 2013 to expand access to contraceptives across 69 of the world’s poorest countries:
- More than 8.4 million additional women and girls, compared to the prior year, gained access to contraceptives
- More than 77 million unintended pregnancies were averted
- More than 125,000 women and girls’ lives were saved from complications due to unintended pregnancies
- More than 24 million abortions were averted
Let’s understand the realities behind these numbers. First and foremost, healthy timing and spacing of pregnancies saves lives. We know that if young women in developing countries delay their first pregnancy until they are 20-24 years old, they are 10-14 times more likely to survive than those who have babies when they are younger.
And if women in these countries are able to space their children every three years, their newborns are twice as likely to survive their first year. Access to family planning reduces maternal and infant mortality worldwide. This is why our organization, Hope Through Healing Hands, is leading an awareness and advocacy initiative to promote education and action for maternal and child health, with a special emphasis on healthy timing and spacing of pregnancies.
Ethiopian First Lady Mrs. Roman Tesfaye recently told the Center for Strategic and International Studies, “To be engaged in the economic sphere, to create income, to contribute to family health and well-being and to the country’s development, we must have family planning services.”
Ethiopia has become a standard-bearer for increases in healthy timing and spacing of pregnancies. Between 2005 and 2011, the country increased women’s access to education and contraceptives for family planning, leading its contraceptive prevalence rate to increase by 51%, from 14.7% to 28.6%.
At the same time, the country’s GDP per capita also increased from $236 in 2007 to $453 in 2012, a 47% increase per capita. While there are clearly many factors in such a change at the national level, access to family planning is one of them. Access can allow mothers to work for income, providing stronger financial support for their families. This is a critical component of lifting families, communities, and nations out of poverty. For every dollar invested to support women in healthy timing and spacing of pregnancies, countries save at least $6 in health, education, water, housing, and other public services.
There is another dimension to the economic impact of healthy timing and spacing of pregnancies. When infant and child mortality rates decline, population growth rates decline as well. This makes sense—when women are educated, have the information and tools they need to plan their families, and are confident their children will survive childhood, many naturally choose to have smaller families.
The aggregate effect of these individual decisions is that there are relatively fewer dependents that rely on government services, and the working-age—and therefore economically productive—population goes up in relative terms, setting the stage for rapid economic growth. Examples of the effects of this shift, known as the ‘demographic dividend,’ can be seen in the economies of Thailand, Bangladesh, South Korea, and Brazil.
Investing in global health issues, like healthy timing and spacing of pregnancies, yields impressive returns in terms of saving lives and promoting economic growth in developing nations. Yet family planning often goes overlooked on the crowded landscape of urgent global health issues. Let’s reconsider its role, and how the U.S. budget might better invest in programs that save the lives of women and children while also helping to break the cycle of poverty and create sustainable futures for some of the world’s most vulnerable populations.