EA - Introducing MSI Reproductive Choices by Meghan Blake

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Introducing MSI Reproductive Choices, published by Meghan Blake on May 21, 2024 on The Effective Altruism Forum.
In 1976, our founder Tim Black established MSI Reproductive Choices[1] to bring contraception and abortion care to women in underserved communities that no one else would go to. As a doctor, he witnessed firsthand the hardship caused by the lack of reproductive choice and accordingly, he established quality care, cost-effectiveness, data, and sustainability as foundational principles of the organization. Nearly 50 years later, this legacy remains at the core of MSI Reproductive Choices today.
Since our founding, MSI has served more than 200 million clients, of which more than 100 million were served in the last nine years. Since 2000, our global services have averted an estimated 316,000 maternal deaths and 158.6 million unintended pregnancies.
We deliver impact with exceptional cost-effectiveness. On a global scale via our Outreach and Public Sector Strengthening programs, which reach underserved "last mile" communities, our average cost per disability-adjusted life year (DALY) is $4.70[2], and our average cost per maternal death averted is $3,353. In Nigeria, our most cost-effective program, these figures drop to just $1.63 per DALY and $685 per maternal death averted in our programming with the most underserved communities.[3]
The Challenge
Health Benefits: Family planning saves lives and is a development intervention that brings transformational benefits to women, their families, and communities. While progress has been made, it hasn't been fast enough; 257 million people still lack access to contraception, resulting in 111 million unintended pregnancies annually. Additionally, 280,000 women - primarily in sub-Saharan Africa - lose their lives due to pregnancy-related complications each year, amounting to 767 deaths per day.
Maternal mortality is nearly 50 times higher for women in sub-Saharan Africa compared to high-income countries, and their babies are 10 times more likely to die in their first month of life.
The global disparity between the rate of maternal deaths is evident in low-income countries. In 2020, the Maternal Mortality Ratio (MMR) reached 430 per 100,000 live births in low-income countries, a significant contrast to just 12 per 100,000 live births in high-income nations. In some countries, like Nigeria, the maternal mortality rate exceeds 1,000 per 100,000 live births.
Demand for family planning and sexual and reproductive healthcare services will continue to grow, and by 2030, an additional 180 million women will need access to these services. The urgency of this need is emphasized by the adolescent girls in low- and middle-income countries who wish to avoid pregnancy, yet a significant 43% of them face an unmet need for contraception. Pregnancy-related deaths are the leading cause of death for adolescent girls globally.
The World Health Organization has stressed that to avoid maternal deaths, it is vital to prevent unintended pregnancies. They stated: "all women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care."
If all women in low- and middle-income countries who wish to avoid pregnancy had access to family planning, the rate of unintended pregnancies would drop by 68%.
Number of Maternal Deaths by Region, 2000 - 2017
Education and Economic Opportunities: The effects of inadequate access to family planning are profoundly felt in Sub-Saharan Africa, where every year, MSI analysis has estimated that up to 4 million teenage girls drop out of school due to teenage pregnancy. This education gap is exacerbated by disparities in contraceptive access: women in the wealthiest quintile have more than double the proportion of met contraceptive demand compa...