[waveman2]

This seems like an obvious point, but when you are dealing with complex systems second-order effects often result in totally perverse outcomes. Often the result of pushing the system in one direction is an outcome in the opposite direction.

In this case, providing medical services results in more children living, which [often] means larger populations, which means more pressure on food and infrastructure, and more unemployment.

So providing medical care can make people worse off.

The book "An End to Alms" points to an interesting example of this phenomenon. Hygiene standards in England were far worse in earlier times than in China [read Samuel Pepys's diaries if you don't believe me]. As a result, more people died from infections in England at a given level of nutrition than in China. As a result, per person calorie intake in China fell until the lower food intake balanced out the higher standards of hygiene.

More in any book on Systems Theory, or "Poor Charlie's Almanack".