Giving What We Can no longer conducts our own research into charities and cause areas. Instead, we're relying on the work of organisations including J-PAL, GiveWell, and the Open Philanthropy Project, which are in a better position to provide more comprehensive research coverage.
These research reports represent our thinking as of late 2016, and much of the information will be relevant for making decisions about how to donate as effectively as possible. However we are not updating them and the information may therefore be out of date.
Maternal mortality refers to the death of women directly due to pregnancy or childbirth. The overwhelming majority of such deaths occur in developing countries and are mostly preventable with today’s technology. However, interventions in this area are often complex, as they require increased access to doctors, medical equipment, facilities and drugs, both during pregnancy and birth.
Globally, around 800 women die from preventable causes related to pregnancy and childbirth each day, and 99% of these deaths occur in the developing world. However, extensive efforts can reap results - between 1990 and 2010, maternal mortality dropped by 50% worldwide.
A 2005 BMJ report states that interventions in both community and hospital care are highly cost effective - with the most effective interventions, such as community management of neonatal pneumonia, being in the 1–20 $/DALY range 2. However, current levels of access to such care are lower than required to meet the millennium development targets.
Beyond the obvious benefit of DALYs saved for mothers, the other benefits of interventions in this area include the fact that reducing pregnancy-related deaths ensures that more children grow up with their mother’s care. This improves their health (girls, in particular, are more likely to survive if their mother is alive), and their education (children are less likely to be forced to stay and look after the home, or go out and work). These factors indirectly improve the cost-effectiveness of maternal mortality interventions.
Furthermore, interventions that reduce maternal deaths also reduce disabilities. This is not necessarily accounted for in the statistics or quantifiable in terms of DALYs (e.g. the DCP analysis does not include this). Finally, some of the worst consequences of maternal mortality may be social rather than physical: for example, women suffering from obstetric fistula (caused by obstructed labour) are frequently ostracised by their communities.
The cost-effectiveness of interventions aiming to prevent maternal deaths is reduced by the large and unpredictable number of potential complications, by the manpower needed to monitor pregnant women to diagnose problems earlier, and by the high levels of training and equipment needed to deal with severe complications. Many of the most effective interventions require significantly improved access to clinical health facilities and systems before they can be deployed; as such they are more complicated and vulnerable to failure compared with other health interventions such as bed nets or deworming. Nonetheless, maternal care interventions appear reasonably cost-effective and have numerous positive side-effects.
We will be investigating charities that reduce maternal mortality using demonstrated cost-effective methods, and we will compare their effectiveness with that of our currently recommended health interventions.
Last updated: in or before 2012