Achieving the millennium development goals for health - Cost effectiveness analysis of strategies for. maternal and neonatal health in developing countries

Adam, T., Lim, S. S., Mehta, S., Bhutta, Z. A., Fogstad, H., Mathai, M., Zupan, J. and Darmstadt, G. L. (2005) Achieving the millennium development goals for health - Cost effectiveness analysis of strategies for. maternal and neonatal health in developing countries. British Medical Journal, 331 7525: 1107-1110. doi:10.1136/bmj.331.7525.1107


Author Adam, T.
Lim, S. S.
Mehta, S.
Bhutta, Z. A.
Fogstad, H.
Mathai, M.
Zupan, J.
Darmstadt, G. L.
Title Achieving the millennium development goals for health - Cost effectiveness analysis of strategies for. maternal and neonatal health in developing countries
Journal name British Medical Journal
ISSN 0959-8146
Publication date 2005
Sub-type Article (original research)
DOI 10.1136/bmj.331.7525.1107
Volume 331
Issue 7525
Start page 1107
End page 1110
Total pages 6
Place of publication London
Publisher B M J Publishing Group
Language eng
Subject 11 Medical and Health Sciences
Abstract Objective To determine the costs and benefits of interventions for maternal and newborn health to assess the appropriateness of current strategies and guide future plans to attain the millennium development goals. Design Cost effectiveness analysis. Setting Two regions classified by the World Health Organization according to their epidemiological grouping: Afr-E, those countries in sub-Saharan Africa with very high adult and high child mortality, and Sear-D, comprising countries in South East Asia with high adult and high child mortality. Data sources Effectiveness data from several sources, including trials, observational studies, and expert opinion. For resource inputs, quantifies came from WHO guidelines, literature, and expert opinion, and prices from the WHO choosing interventions that are cost effective database. Main outcome measures Cost per disability adjusted life year (DALY) averted in year 2000 international dollars. Results The most cost effective mix of interventions was similar in Afr-E and Sear-D. These were the community based newborn care package, followed by antenatal care (tetanus toxoid, screening for pre-eclampsia, screening and treatment of asymptomatic bacteriuria and syphilis); skilled attendance at birth, offering first level maternal and neonatal care around childbirth; and emergency obstetric and neonatal care around and after birth. Screening and treatment of maternal syphilis, community based management of neonatal pneumonia, and steroids given during the antenatal period were relatively less cost effective in Sear-D. Scaling up all of the included interventions to 95% coverage would halve neonatal and maternal deaths. Conclusion Preventive interventions at the community level for newborn babies and at the primary care level for mothers and newborn babies are extremely cost effective, but the millennium development goals for maternal and child health will not be achieved without universal access to clinical services as well.
Keyword Medicine, General & Internal
Effective Interventions
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Population Health Publications
 
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