Reproductive, Maternal, Newborn, and Child Health

There have been large reductions in the annual number of maternal and child deaths in the past 25 years, yet for many countries the rate of reduction has been too slow to achieve Millennium Development Goals 4 and 5 by 2015.

Progress could be accelerated by scaling up integrated packages of essential RMNCH interventions across the continuum of care. These interventions are highly cost-effective and result in benefits 8·7 times greater than the costs.

The continuum of care approach recognizes the links from mother to child and the need for health services across the stages of life.  Interventions have been grouped into three packages: reproductive health, maternal and newborn health and child health, to examine their potential impact on deaths and costs. 

Scaling up all interventions in the packages of Maternal and Newborn Health, plus folic acid before pregnancy, and of Child Health from 2015 rates to 90% coverage would avert 149,000 maternal deaths, 849,000 stillbirths, 1 498 000 neonatal deaths, and 1,515,000 child deaths.

Individual interventions that have the highest effect on deaths are provision of contraception; management of labour and delivery; care of preterm births; treatment of severe infectious diseases including pneumonia, diarrhoea, malaria, and neonatal sepsis; and management of severe acute malnutrition.

The three packages of RMNCH interventions have an annual incremental cost of US$6·2 billion in low-income countries, $12·4 billion in lower-middle-income countries, and $8·0 billion in upper-middle-income countries.