Informing reproductive, maternal, neonatal, child, and adolescent health and nutrition priority-setting and financing in Guinea: Findings from a national investment case study.

Abstract

Guinea faces high maternal and child mortality, low coverage of essential reproductive, maternal, neonatal, child and adolescent health and nutrition (RMNCAH+N) services, and major financing constraints. This study developed a national investment case for 2026–2030 to estimate the costs, health gains, economic returns, and fiscal feasibility of scaling up priority interventions. The analysis integrated situational, budget, costing, cost–benefit, cost of inaction, and fiscal space assessments, and modelled four scenarios. Despite broad service availability, major gaps persist in quality, continuity, and effective coverage. Health expenditure reached USD 776 million in 2022 but remained heavily reliant on household spending. Scale-up would require an additional USD 200–447 million above the baseline, could avert about 334,000 disability-adjusted life years (DALYs) by 2030, and would generate benefit–cost ratios ranging from 6.7 by 2030 to more than 110 by 2050. By contrast, the cost of inaction would reach USD 1.6–2.8 billion by 2030. These findings indicate that scaling high-impact interventions is economically justified and fiscally feasible.