Feature & Comment
Why it makes sense to invest in women and children’s health
Spending on the health of women and young people should be considered ‘investments’, because it accrues long-term rights and dividends, to the economy and to society, writes Mr. Chandra Kishore Mishra and Ms. Amina J. Mohammed.
We often think of money spent on hospitals or schools as ‘costs’: the government raises money via taxes, and spends it on things such as new hospitals or hiring teachers. Money is raised, and money is spent; end of story.
But rather than ‘costs’, it would be more appropriate to consider such spending as ‘investments’, because it accrues long-term rights and dividends, to the economy and to society. According to recent research, some of the best returns accrue from investments in the health and well-being of women, children and young people.
Take the example of child birth. According to a study published in the Lancet, money spent on providing good antenatal healthcare accrues a triple return on investment to the economy and society at large. Meanwhile, investments aimed at improving nutrition have, on average, a benefit-cost ratio of 16:1.
This makes intuitive, as well as statistical, sense: when preventable complications arise during labor, the woman and child may be left permanently sick or disabled, imposing huge long-term costs on them and their families, and on the government also, which may need to provide expensive, long-term health care. Likewise, investing so that children receive the calories they need to fully develop ensures they will be more productive and healthier over the entire course of their lives, preventing avoidable deaths and costs to society and government.
Studies show that eliminating under-nutrition in Asia would improve early development and education, and increase the GDP of Asian countries, on average, by a staggering 11%. Meanwhile, promoting breast-feeding in the first two years of a child’s life could avert almost 12% of deaths in children under five, prevent under-nutrition and ensure a good start for every child.
Asian nations are uniquely placed to take advantage of these returns on investments. Last month, health officials from across the region, and the world, attended the Call To Action Summit in New Delhi, which aimed to take stock of progress, share best practices, and forge alliances for ending preventable child and maternal deaths.
Many Asian countries, including India, have also enthusiastically supported, and led at country, level UN Secretary-General Ban Ki-moon’s Every Woman Every Child initiative to tackle the health problems faced by women, children and adolescents. This is a prominent agenda for the region and the world, and especially for the future generations who will inherit this planet.
We know that, despite our efforts, progress has been uneven. At the beginning of the year, we hosted a consultation in India to help inform the updated Global Strategy for Women’s, Children’s and Adolescents’ Health that the UN Secretary-General will launch later this month. We learned that we must build stronger and broader partnerships; we must invest wisely in infrastructure, training, innovation; we must respect and expand country ownership.
Direct investments in the health sector are only half the story: investments to ensure girls complete secondary school yield an average return around 10% in low- and middle-income countries. These returns include the health and social benefits of informed pregnancies and reduced fertility rates – because girls who finish secondary school tend to marry, and have children, later than girls who leave school early.
Interventions to prevent forced, child and early marriage — something Governments must do from a legal and moral standpoint — also bring tremendous benefits, not only to the children in question but also wider society. Girls that are married too soon, for example, tend to have lower levels of education and reduced economic earning potential. High rates of child marriages are also linked to lower use of family planning, which hinders child spacing and results in more unintended pregnancies.
Investments in the environment also generate big returns. According to recent studies, every dollar invested in improving water, sanitation and hygiene, accrues US$4 to society at large. Meanwhile, tackling indoor air pollution improves health-related productivity, on average, from 17-62% in towns and cities and 6-15% in rural areas.
Most Asian nations have much to be proud of when it comes to tackling poverty and improving the health of its citizens. In India, for example, over the past 25 years, maternal mortality rates have fallen by two-thirds, while child mortality rates have halved. More girls and women than ever before can access family planning and reproductive health services.
This is good news, but a push for better and more encompassing data is at the heart of our concerns. We are raising the ambition of what we must measure, which means not just looking back at what happened but examining trends as they emerge. And, as we follow this vision, we must also go beyond just studying hard figures to holistically consider people’s well-being, listen to their views, understand their priorities. Data must be aligned for data collection and decision-making to deliver maximum impact from the resources available. We must also ensure adequate investments to enhance both traditional and non-traditional data. This will provide the necessary disaggregated baselines needed to leave no one behind.
The realisation of the Sustainable Development Goals will require considerable resources, with serious implications on our existing business models. We must rethink how the international community delivers value in this new development era. We have to build institutions and develop partnerships that allow for different stakeholders to come together — and work together — to ensure that essential interventions get delivered to those who need them most, no matter who they are or where they live.
We believe that if we can change the way we think about spending money on women, children and adolescents health, we can make even faster progress in the future. Ensuring the well-being of women and children shouldn’t be viewed as a cost: for the future of our nations, it’s the best investment we can make.
Mr. Chandra Kishore Mishra is the Additional Secretary in the Ministry of Health & Family Welfare, India, and co-chair of The Partnership for Maternal, Newborn and Child Health.
Ms. Amina J. Mohammed is the United Nations Secretary-General Ban Ki-moon’s Special Adviser on Post-2015 Development Planning.
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