When I first entered this line of work, I often heard one thing: the maternal health market is way too small to be sustainable, much less lucrative. Naturally, one can only expect market failure for maternal health drugs and, by extension, a chronic situation of limited access to lifesaving medicines among those most in need.
However, I disagree.
The maternal health market is, of course, comparatively small when looking at the parallel markets for reproductive health, HIV, TB, malaria and even child health.
Take malaria for example. Prepared technical guidance provided by the President’s Malaria Initiative states that the unit cost for delivery of long-lasting insecticidal nets (LLINs) provided free of charge through antenatal clinics in four countries ranged from US $1.61 to $2.35 – which is roughly equivalent to the unit cost of US $1.50 for a delivery package of the three essential maternal health medicines: oxytocin, misoprostol and magnesium sulfate. However, in 2014 an estimated 214 million long-lasting insecticidal nets were delivered to malaria-endemic countries in Africa, while only 36 million women gave birth in the same region that same year. As any business school student can tell you, applying the formula of Price x Quantity = Revenue means that the maternal health market simply doesn’t compare in size.
This is the origin of the myth. For those of us committed to the goal of improved maternal health, we cannot confuse a small market with an unhealthy market – small can still mean healthy. Small can and should still mean a consistent and sustainable supply of high-quality and affordable maternal health drugs to all mothers in all settings.
There is a catch. The maternal health community cannot wait for market realities to drift toward our favor – we must actively and purposefully shape them. This begins with strong political will at both global and national levels. The creation of the UN Commission on Lifesaving Commodities for Women and Children is an excellent start, as is the inclusion of maternal health within the Reproductive Health Supplies Coalition (RHSC) agenda. These actions complement the ongoing efforts of other groups in this space, including the Maternal Health Task Force, itself.
The good news is that in the context of strong political will, there is plenty of research to shape evidence-based next steps. Together, we have built a clear understanding of market access barriers and we even know ways to incentivize around them. We also have market shaping strategies from other priority health areas, such as family planning, that serve as blueprints that we can adapt for our own purposes. As the maternal health community, it is up to us to use these tools to advocate for and help ourselves.
Finally, it’s good to revisit why this issue is critically important. Several studies and reports have demonstrated time and time again that healthy mothers strengthen families, societies and a nation’s economic development, which, in turn, strengthen a nation’s markets. Let’s say that again: Healthy mothers strengthen markets. It’s time markets returned the favor.
Resources used in the writing of this post:
- President’s Malaria Initiative Technical Guidance Document (2014)
- MHTF Blog post, Three Barriers to Delivering Maternal Health Supplies and the Solution (2015)
- World Malaria Report (2014)
- USAID-Accelovate Maternal Health Market Assessments (2014)
- MHTF Blog post, Changing Incentives: Creating a Market for High Quality Oxytocin (2015)
- RHSC and Dalberg Report, Market Shaping for Family Planning (2014)
- WHO Report: Maternal Health: Investing in the lifeline of Healthy Societies and Economies (2010)
This post is part of the blog series “Increasing access to maternal and reproductive health supplies: Leveraging lessons learned in preventing maternal mortality,” hosted by the Maternal Health Task Force, Reproductive Health Supplies Coalition/Maternal Health Supplies Caucus, Family Care International and the USAID-Accelovate program at Jhpiego which discusses the importance and methods of reaching women with lifesaving reproductive and maternal health supplies in the context of the proposed new global target of fewer than 70 maternal deaths per 100,000 births by 2030. To contribute a post, contact Katie Millar.