The first World Development Report in 1993 was devoted to the importance of investing in health. Cost containment was strongly advocated in the report and cost-effectiveness was recommended as a tool for prioritizing health interventions. During the era of Millennium Development Goals (2000- 2015), Bangladesh demonstrated remarkable success in health indicators in relation to the goals on maternal and child mortality, among others. The current report thus intends to analyze the return on investment for reducing maternal and neonatal mortality as well as child immunization, based on evidence from Bangladesh and other relevant low- and middle-income countries. The future priority of the Bangladesh government in maternal and child health is to improve coverage of effective newborn health interventions, increase skilled birth attendance and facility deliveries. Furthermore, the future priorities for healthcare in general address “increased access to quality health services by strengthening the health workforce and provision of health services”; and “support the equitable delivery of health interventions and services, particularly for underserved populations and marginalized groups”. In addition, widespread application of large-scale community-based approaches, especially investment in community health workers using a doorstep delivery approach, has been recommended by a Lancet series on Bangladesh. Challenges and priorities in health sector by the Government of Bangladesh and evidence from research initiatives mainly in Bangladesh and in some other low- and middle-income countries were used as the basis for analyzing the returns on investment in maternal and neonatal health and child immunization. Our analysis assumes a service target scenario that 80% of the currently unattended births (1.5 million) would be covered by facility delivery with presence of skilled birth attendants and 20% (374.2 thousand) would be attended by trained birth attendants at the community level. Forty percent of neonates (748.5 thousand) would also get homecare by trained attendants at the community level. Children in urban slums and rural hard-to-reach areas were identified as under-served population of EPI in Bangladesh. Our estimation took an approach to expand the coverage of children in urban slums and rural hard-to-reach areas. An estimated 665 thousands under-five children live in urban slums, of which 57% or 372.4 thousands are currently unvaccinated. Of the estimated 1.2 million under-five children in the rural hard-to-reach areas, 49.3% or 592.5 thousands were unvaccinated. We posit that the coverage in urban slums would be expanded to the national full immunization coverage level at 84.7% and in rural hard-to-reach areas to 83.5% as found in a research initiative. The costs of the interventions were calculated by using cost data extracted from previous studies carried out in Bangladesh. Since the health system of Bangladesh is considered to be well structured for providing health maternal and neonatal services to populations in rural, suburb and urban areas through Family Health and Welfare Centres, Upazila (sub-district) Health Complexes, district hospitals as well as regional and tertiary level hospitals, additional costs for infrastructure development was not considered in the analysis. Direct medical costs (medicine, diagnostic tests, surgical procedure) and out-of-pocket spending of the patients (mainly for medicine, travels, food) and if applicable training costs (like, for health workers) were considered in the costs of intervention. For estimating the economic benefits of interventions Disability-Adjusted Life Years (DALYs) averted were calculated by multiplying the number of deaths with the difference in years between life expectancy of target population and average age of death. It needs to emphasis here that DALYs includes years of life lost (YLL) due to premature death and years lost due to disability (YLD). In this current analysis, we included only YLL because of lack of data on disability in connection with morbidity in all except homecare for neonates. Finally, for estimating the economic benefits of averting the DALYs due to reduction in deaths, we adopted the method of estimating statistical years of life, i.e. multiplying the total DALYs averted with GDP per capita (1,235 USD) of Bangladesh. The estimates showed that providing facility-based delivery with skilled birth attendance (SBA) to pregnant women would cost $115 million USD in total and $77.0 USD per woman served. Such intervention was estimated to save 3,260 maternal and 37,727 neonatal mortality cases which would avert 2.56 million DALYs, resulting in $1.33 billion USD in total economic benefits. One USD investment on this intervention would get a return on investment of 11.5 USD. Child deliveries to 374.2 thousand pregnant women with trained birth attendance (TBA) would cost $7 million USD, which would avert 344 maternal and 5,988 neonatal deaths and consequently 455,635 DALYs. The estimated total benefits would be $227.4 million USD. A return of $32.5 USD was estimated from each USD invested in this intervention. Homecare package for 748,492 neonates would cost 8.1 million USD in total, with a unit cost of $10.9 USD per neonate served. A total of 8,907 deaths and 636,169 DALYs would be averted, which would result in total benefits of $326.9 million USD. One USD investment in homecare would save $40.2 USD. Child immunization in rural slums would cost 18.0 USD for full immunization of each child, which would cost $2.67 million USD for immunizing 148,367 children through the intervention under study. A total 1,710 death cases and 117,985 DALYs could be averted by the intervention, which would result in total estimated economic benefits of $61.2 million USD. Our estimatesshow that each USD invested in the intervention would give a return of $23.0 USD. In the rural hard-to-reach areas, the intervention under study cost $24.5 USD for vaccinating one child and the total costs for vaccinating additional 263,782 children would cost $6.46 million USD. An estimated 2,430 deaths would be prevented, which would avert 167,639 DALYs. The total estimated benefits would be $87.0 million USD. Each USD investment thus resulted in a return of $13.5 USD. The economic estimatesshow incentives for investing in the health interventions with higher expected return than required investment. Bangladesh has long-time experience in health service deliveries through public, NGO, private organizations and public-private partnership (PPP). However, how these interventions should be organized for reaching the target populations is out of scope of this report. The level of intervention costs through public and NGO providers are generally comparable. To keep the costs of service deliveries low, even for for-profit/private providers, market competition should be created while making any public-private partnership. In sum, investments in reducing maternal and neonatal deaths and child immunization were estimated to have large returns. Inclusion of disability due to morbidity would be useful for getting a more complete picture. Data from several countries have been employed, though efforts were made to utilize Bangladesh specific data. Usage of more Bangladesh specific data could make the estimation more robust. However, despite certain limitations, evidence-based findings of this report should be useful in the health sector of Bangladesh, especially on best ways to allocate limited resources.