Health and Economic Benefits of Achieving Contraceptive and Maternal Health Targets in Small Island Developing States in the Pacific and Caribbean

Background: Reducing unmet need for modern contraception and expanding access to quality maternal health (MH) services are priorities for improving women’s health and economic empowerment including in Small Island Developing States in the Pacific and Caribbean. We estimated health benefits and return-on-investment for contraceptive and MH interventions to help ensure appropriate prioritization. Methods: Contraceptive and MH interventions were scaled linearly from 2022 (following COVID-19 disruptions) to reach zero unmet need for modern contraception and 95% MH intervention coverage by 2030. Five Pacific (Kiribati, Samoa, Solomon Islands, Tonga, and Vanuatu) and four Caribbean (Barbados, Guyana, Jamaica, and Saint Lucia) countries were considered based on population survey availability. Health outcomes were estimated and converted to economic benefits, and compared for business-as-usual (BAU) (coverage maintained) and coverage-targets-achieved scenarios. Findings: An additional US$13.4M (US$10.9M-US$16.0M) is needed over 2020-2030 for the five Pacific countries to reach coverage targets (19% more than US$70.5M to maintain BAU). This could avert 126,000 (40%) unintended pregnancies, 2,200 (28%) stillbirths, and 121 (29%) maternal deaths and bring an elevenfold economic benefit of US$149.7M (US$54.5M-US$214.7M) by 2040. For the four Caribbean countries, an additional US$18.8M (US$15.3M-US$22.4M) is needed to reach targets (5% more than US$342.3M to maintain BAU). This could avert 127,000 (23%) unintended pregnancies, 3,600 (23%) stillbirths, and 221 (25%) maternal deaths and bring a twentyfold economic benefit of US$375.4M (US$137.9M-US$540.6M) by 2040. Interpretation: Achieving full coverage of contraceptive and maternal health services in the Pacific and Caribbean is likely to be affordable and have high return-on-investment. Funding Information: Funding for this study was provided by UNFPA. Declaration of Interests: None declared.