Adding It Up: The Need for and Cost of Maternal and Newborn Care—Estimates for 2012

• In 2012, there were an estimated 122 million births in the developing world. All of these women and newborns needed antenatal, delivery and postnatal care.

• Only 55% of developing-country women who gave birth in 2012 made four or more antenatal visits. Many who received antenatal care did not receive screenings and other necessary services they needed to ensure a healthy pregnancy.

• Sixty-four percent of women who gave birth delivered in a health facility. This proportion varied from 51% in the poorest countries to 94% in higher-income developing countries. n Between 2008 and 2012, the proportion of women receiving adequate antenatal care increased by a modest one percentage point per year. The proportion delivering in health facilities increased faster, by 2.3 percentage points per year, markedly reducing the numbers of women and newborns with unmet need for facility-based delivery care.

•  An estimated 55 million women giving birth in 2012 had an unmet need for adequate antenatal care (four or more visits), and 44 million women had an unmet need for delivery care in a health facility. Two regions, Sub-Saharan Africa and South Asia, accounted for about 80% of the total unmet need for each of these types of care.

• Although only a minority of women and newborns experienced medical complications at the time of delivery in 2012, most of them did not receive the recommended care.

• Unmet need for maternal and neonatal care reflects a number of barriers that need to be overcome, such as weak health infrastructure, lack of trained professionals, distance to care, and issues related to knowledge and attitudes about the need for care.

• The total cost of providing the recommended levels of maternal and neonatal care to all women giving birth and their newborns is an estimated $24.1 billion annually, of which $8.5 billion is for direct costs and $15.6 billion is for program and systems costs. This is more than double the cost of current care in 2012, estimated at $11 billion. n These additional investments would provide immediate returns in terms of saving lives and reducing disabilities among women and newborns, and would bring long-term benefits as human and physical capacity in the health sector is improved.