Every two minutes, nine newborn babies and one mother die from complications related to pregnancy and childbirth. This year, 2.4 million newborns will die within their first month, and 295 000 women will succumb to pregnancy‑related complications. These 2.7 million annual tragedies are immeasurable for families and communities, and they also undermine societal growth and prosperity. In low‑income and lower‑middle‑income countries, the deaths amount to a loss of almost half a trillion dollars each year—about 6 % of their annual GDP.
In 2015, world leaders pledged to address maternal and newborn health, along with hunger, peace, education, and other major challenges, by 2030 under the Sustainable Development Goals (SDGs). Unfortunately, progress is far off‑track, especially for mothers and newborns. At the current rate, by 2030 an additional 131 000 mothers and 900 000 infants will die each year—deaths that could have been avoided if the promises were met. It does not have to be this way.
In a world without fiscal constraints, governments would invest lavishly across all SDGs. In reality, they can only modestly increase investments in certain policies. My think tank, Copenhagen Consensus, has conducted extensive research with dozens of the world’s leading economists to identify where extra resources can do the most good. Maternal and newborn health is one of those areas. New research published this week shows that focused investment in this sector can deliver astonishing returns: for every dollar spent, society gains $87 in social benefits.
The researchers examined the 55 countries that account for almost all global maternal and newborn deaths. They evaluated a wide range of potential policies—more pregnancy check‑ups, increased iron supplementation, and paid health‑worker visits to counsel mothers after birth. The study found that the most effective investment is to expand access to family planning and, most importantly, to provide a package of simple procedures known as Basic Emergency Obstetric and Newborn Care (BEmONC). BEmONC delivers better care at low cost, often using nurses and midwives instead of more expensive doctors.
For example, BEmONC includes neonatal resuscitation, which requires only a hand‑pump resuscitator costing about $65. Used 25 times a year, the cost per use is $2.60; adding the health worker’s time brings the total cost of saving a child’s life to roughly $5. This modest expense can prevent 30 % of deaths from asphyxia, a leading cause of newborn mortality. Another BEmONC component, kangaroo mother care—skin‑to‑skin contact between mother and baby—can halve mortality among premature infants.
A large portion of BEmONC costs involves improving access to birth facilities, which reduces death risks for both mother and child. Currently, two‑thirds of women in the 55 target countries give birth in such facilities; in Nigeria, the figure is just under 40 % according to WHO. The researchers propose investing to raise facility births to 90 % of women.
Family planning is a crucial element of the package. An estimated 217 million women who wish to avoid pregnancy lack access to safe, effective methods. If 90 % of women in the hardest‑hit countries had access, 87 000 fewer mothers would die each year. The annual financial cost would be $2.1 billion, with women’s additional time valued at $1.6 billion—a total of $3.7 billion per year. This investment could avert 161 000 maternal deaths, more than 1.2 million newborn deaths, and a comparable number of stillbirths across the 55 countries.
Beyond saving lives, reducing mortality and fertility can generate a significant increase in income per capita, as fewer but healthier children become more productive—a phenomenon known as the “demographic dividend.” The fertility reduction alone is estimated to yield $28 billion in annual benefits. Summing all returns, the $3.7 billion yearly cost would produce overall benefits worth $322 billion each year.
The death toll of mothers and young infants in the world’s poorest countries is an unacceptable and largely avoidable tragedy. Investing just $3.7 billion annually in BEmONC and family planning is not only low‑cost but also one of the most effective ways to fulfill our global promises.
Dr. Bjorn Lomborg is President of the Copenhagen Consensus and a Visiting Fellow at Stanford University’s Hoover Institution.
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