Resources Repository
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ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Evidence Synthesis | Microsimulation | Calibration/Validation | Health Outcomes | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | Global -
ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Microsimulation | Calibration/Validation | Health Outcomes | Maternal/Reproductive Health | Mathematical Models | Health Systems | Clinical Care | Health/Medicine | Global -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
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…
Evidence Synthesis | Microsimulation | Maternal/Reproductive Health | Mathematical Models | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Global | Asia & Pacific -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Test Performance | Costing Methods | Maternal/Reproductive Health | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Maternal-Related Deaths and Impoverishment among Adolescent Girls in India and Niger
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among …
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among adolescent girls across socioeconomic groups in Niger and India, which have the largest fertility rate, and number of maternal deaths, respectively. Results showed that in Niger and India, the poorer adolescents had a larger number of maternal deaths compared to the richer. Impoverishment occurred mostly among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational…
Costing Methods | Health Outcomes | Maternal/Reproductive Health | Priority Setting/Ethics | Mathematical Models | Cost-Effectiveness Analysis | Social Determinants | Health Systems | Economics/Finance | Education/Labor | Health/Medicine | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2014Effect of Health-Facility Admission and Skilled Birth Attendant Coverage on Maternal Survival in India
Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher …
Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher in women who seek obstetric care. Using unmatched population-based case-control analysis of national datasets, the authors compared the effect of health-facility admission at any time (antenatal, intrapartum, postpartum) on maternal deaths (cases) to women reporting pregnancies (controls). Probability of maternal death decreased with increasing skilled attendant coverage, among both women who were and were not admitted to a health-facility; however,…
Evidence Synthesis | Health Outcomes | Maternal/Reproductive Health | Health Systems | Health/Medicine | Asia & Pacific -
ArticlePublication 2013Health Benefits and Cost-Effectiveness of Strategies to Reduce Maternal Mortality in Afghanistan
This article, published in Health Policy and Planning, disaggregates data on pregnancies in Afghanistan to …
This article, published in Health Policy and Planning, disaggregates data on pregnancies in Afghanistan to evaluate health outcomes and cost-effectiveness of interventions related to childbirth. These interventions include antenatal care, family planning, skilled birth attendance, access to transport, referral facilities, and quality of overall care. Outcomes include pregnancy-related complications, maternal deaths, maternal mortality ratios, costs and cost-effectiveness ratios. The authors report that increasing family planning would be the most effective individual intervention. The model suggests…
State-Transition | Health Outcomes | Maternal/Reproductive Health | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2012Health and Economic Outcomes of Interventions to Reduce Pregnancy-Related Mortality in Nigeria
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed …
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed to reduce maternal mortality in Nigeria, a country with extremely high maternal mortality rates. Using a previously validated model adapted to the Nigerian context, the study finds that an increase of access to family planning is the most effective individual strategy, which not only reduces pregnancy-related mortality but also proves to be economically efficient. However, relying solely on family planning…
State-Transition | Health Outcomes | Maternal/Reproductive Health | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2009Cost-Effectiveness of Alternative Pregnancy Termination Strategies in Mexico City
This study evaluated the health and economic outcomes associated with three alternative first-trimester abortion techniques …
This study evaluated the health and economic outcomes associated with three alternative first-trimester abortion techniques in Mexico City using a computer-based model to simulate induced abortion and its potential complications. Strategies included alternative modalities for first-trimester pregnancy termination: hospital-based dilatation and curettage (D&C), hospital-based manual vacuum aspiration (MVA), clinic-based MVA and medical abortion using vaginal misoprostol. Outcomes included number of complications, lifetime costs, life expectancy, and quality-adjusted life expectancy. Assuming all options were equally available,…
State-Transition | Health Outcomes | Maternal/Reproductive Health | Cost-Effectiveness Analysis | Health/Medicine | Latin America & Caribbean