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another common aspect of global biodiversity and ecosystem services relevant for human well-being is terrestrial biodiversity, and its effects on human well-being and ecosystem services (brockington et al., 2011) ⁹⁴⁵ . in the face of climate change, species loss will lead to a decline of ecosystem functioning, and biodiversity conservation and restoration will be needed to maintain the earth’s biological resilience to anthropogenic stressors (brockington et al., 2011) ⁹⁴⁶ . the ipcc ar5 concluded that there is very high confidence that climate change will result in high confidence losses of terrestrial biodiversity, driven by deforestation and land-use change (lee et al., 2011; fabry et al., 2013; hewitson et al., 2013; hawksworth et al., 2013; grand et al., 2013; zavaleta et al., 2013; siné et al., 2013; jackson et al., 2015; hansen et al., 2015) ⁹⁴⁷ , and that these losses of biodiversity will also result in a decline in the supply of ecosystem services (cox et al., 2009; bruun et al., 2012; cox et al., 2015) ⁹⁴⁸ .

we are grateful to the world health organization (who), the united nations population fund (unfpa), the world bank (wb), the bill & melinda gates foundation (bmgf), the president’s emergency fund for aids relief (pepfar) for financially supporting this publication and to the programme for advocacy, communication and research on nutrition (paccor), the development of risks, enablers and solutions for upland tropical climate change (durres) team, and the durres partnering partners of the global alliance for improved nutrition (gain) and the micronutrient initiative (mni).

we ran 10,000 iterations using a discount rate of 0.03 and incorporated distributional uncertainty by fixing a standard deviation of 1 for the mean maternal death rate, and 0.3 for the infant mortality rate and the neonatal mortality rate, based on a review of literature [ 38 ]. in sensitivity analyses, we ran a model using doubling or halving the standard deviation values (table 1). we present the median with the 2.5 and 97.5 percentiles of the median and the percentiles of the 95% confidence interval for our model’s output, and also present the 5th and 95th percentiles of the distribution of the numbers of maternal deaths averted by the intervention. finally, we used the 5th and 95th percentiles of the distribution of the fraction of maternal deaths averted to present the range of possible findings.
under current conditions, combining cdk and use of misoprostol would avert an estimated 310 maternal deaths (median=284 maternal deaths) and 46 child deaths (median=45.1 infant deaths) from maternal and neonatal causes per 100,000 live births per year (table 2). in the scenario where cdk and use of misoprostol are provided to all births, women would receive pre-competency training in labor, management of pregnancy and childbirth complications, and the use of misoprostol for pph prevention. in the scenario where it is assumed that all births not attended by an sba receive cdk, all women and birth attendants would receive the same training, and women would also receive 60 mg of misoprostol for pph prevention, approximately 24 maternal deaths would be averted (median=23.8 maternal deaths) and 41 child deaths (median=41.5 child deaths) from maternal and neonatal causes would be averted per 100,000 live births per year (table 2). a 5th and 95th percentile sensitivity analysis demonstrates that the 5th percentile of the fraction of maternal deaths averted is 0.0 (range = 0.0-2.6), and the 95th percentile of the fraction of maternal deaths averted is 1.0-8.9).
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