Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
2010
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care.
The most effective single intervention identified was increasing family planning, which could prevent more than 150,000 maternal deaths over five years and save more than $1 billion. However, to achieve a substantial reduction in maternal mortality (beyond 23%-35%), strategies must also include reliable access to intrapartum and emergency obstetric care (EmOC). An integrated and stepwise approach that combines improved family planning and safe abortion with better antenatal/postpartum care, and improved EmOC had ratios below $500 per year of life saved (YLS), well below India's per capita gross domestic product (GDP), a common benchmark for cost-effectiveness.
Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
Source:
Goldie SJ, Sweet S, Carvalho N, Natchu UCM, Hu D. Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis. PLoS Medicine 2010; 7 (4): e1000264. https://doi.org/10.1371/journal.pmed.1000264