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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…
Health Outcomes | Mathematical Models | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | Global -
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…
Health Outcomes | Evidence Synthesis | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | Global -
DataPublication 2023Trends in Maternal Mortality 2000 to 2020
This report presents global, regional, and country-level estimates and trends for maternal mortality between 2000 …
This report presents global, regional, and country-level estimates and trends for maternal mortality between 2000 and 2020 produced by the United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG).* The estimates are intended to inform progress in maternal mortality to support national efforts to meet Sustainable Development Goal (SDG) target 3.1, to reduce maternal mortality to less than 70 maternal deaths per 100,000 live births by 2030. The report is accompanied by a set of country…
Health Outcomes | Evidence Synthesis | Mathematical Models | Maternal/Reproductive Health | Health/Medicine | Global -
ArticlePublication 2019CEA of Maternal and Neonatal Health Interventions
This article, published in Health Policy and Planning, examines the cost-effectiveness of several maternal and …
This article, published in Health Policy and Planning, examines the cost-effectiveness of several maternal and neonatal health (MNH) interventions in an Ethiopian setting. The authors employ a static life table model to estimate the health impact of a 20% increase in intervention coverage relative to baseline. The results indicate that many MNH interventions are highly cost-effective. This evidence can be useful to inform the ongoing essential health services package revision in Ethiopia.
Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Costs and Benefits of Integrated RMNCH
This chapter assesses the costs and benefits of delivering a set of integrated reproductive, maternal, …
This chapter assesses the costs and benefits of delivering a set of integrated reproductive, maternal, newborn and child health interventions in countries with high child and maternal mortality to demonstrate that very high returns can be achieved through this investment and to underscore the importance of an accurate assessment of those returns. This includes the full range of costs involved in delivering integrated care and the full range of benefits that flow from the interventions.…
Priority Setting/Ethics | Costing Methods | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Economics/Finance | Health/Medicine | Global -
ReportPublication 2016DCP3: Reproductive, Maternal, Newborn, and Child Health
This report from the World Bank is the second volume of the Disease Control Priorities, …
This report from the World Bank is the second volume of the Disease Control Priorities, Third Edition (DCP3) series. It focuses primarily on maternal conditions, childhood illnesses, and malnutrition, addressing topics from maternal mortality and morbidity, to acute illness and undernutrition in children under five, to the transition to older childhood and the illnesses that accompany this transition. The Disease Control Priorities Network (DCP) promotes and supports the use of economic evaluation for priority setting…
Costing Methods | Health Outcomes | Evidence Synthesis | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Global Governance | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2016Inequalities in Maternal and Child Health Utilization
This article, published in BMC Health Services Research, aims to measure changes in inequality in …
This article, published in BMC Health Services Research, aims to measure changes in inequality in access to maternal and child health (MCH) interventions and the effect of primary health care (PHC) facilities expansion on the inequality in access to care in Ethiopia. The authors utilize The Demographic and Health Survey datasets from Ethiopia (2005 and 2011) to calculate changes in utilization of MCH interventions and child morbidity and estimate concentration and horizontal inequity indices. The…
Maternal/Reproductive Health | Child/Nutrition | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Key Messages from DCP3, Volume 2: Reproductive, Maternal, Newborn, and Child Health
This review article from The Lancet summarizes the analyses from volume two of Disease Control Priorities, Third Edition …
This review article from The Lancet summarizes the analyses from volume two of Disease Control Priorities, Third Edition (DCP3), published by the World Bank, entitled Reproductive, Maternal, Newborn, and Child Health. The volume identifies essential cost-effective health interventions that can be scaled up to reduce maternal, newborn and child deaths, and stillbirths. In this article, the authors summarize the key findings and estimate the effect and cost of expanded implementation of those preventative and therapeutic health interventions. They note…
Costing Methods | Health Outcomes | Evidence Synthesis | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Global Governance | Economics/Finance | Health/Medicine | Global -
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…
Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Social Determinants | Health Systems | Economics/Finance | Education/Labor | Health/Medicine | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2016Reproductive, Maternal, Newborn, and Child Health: Key Messages from DCP3
As part of the Disease Control Priorities, Third Edition, the World Bank has published a …
As part of the Disease Control Priorities, Third Edition, the World Bank has published a volume on Reproductive, Maternal, Newborn and Child Health that identifies essential cost-effective health interventions that can be scaled-up now to reduce maternal, newborn and child deaths, and stillbirths. This article summarizes the key findings and estimates the impact and cost of expanded implementation of these interventions. Scaling up all preventive and therapeutic health interventions in these integrated packages from current…
Costing Methods | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Health/Medicine | Global -
ReviewPublication 2016Review: CEA for Maternal, Newborn, Child Health
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions …
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions to improve reproductive, maternal, newborn, and child health. Interventions for newborn health, treatment of febrile illness, immunization against preventable diseases, and micronutrient interventions remain among the most cost-effective and affordable. Other studies explore how to provide existing interventions using new platforms to increase outreach or decrease cost per person covered, or both. Interventions provided in the community may achieve both purposes to…
Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Education/Labor | Health/Medicine | Global -
ArticlePublication 2014'Big Push' To Reduce Maternal Mortality in Uganda and Zambia
In the past decade, “big push” global health initiatives financed by international donors have aimed …
In the past decade, “big push” global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts from Uganda and Zambia. The authors evaluate the first six to twelve months of the program’s implementation, its ownership…
Health Outcomes | Health Systems | Government/Law | Health/Medicine | Sub-Saharan Africa -
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,…
Health Outcomes | Evidence Synthesis | 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…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | 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…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2012Value of Family Planning for Improving Maternal Health in Rural Afghanistan
This article, published in the Afghanistan Journal of Public Health, uses a model designed to …
This article, published in the Afghanistan Journal of Public Health, uses a model designed to simulate the natural history of pregnancy and associated maternal mortality and morbidity contextualized to Afghanistan to assess the cost-effectiveness of family planning in the rural Maywand district of Kandahar. Using total fertility rate, pregnancy-related complications, maternal mortality ratio, lifetime risk of maternal death, and proportionate mortality ratio as outcomes, the model finds that increasing family planning from 8% to 30-50% could…
Health Outcomes | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Policy/Regulation | Health/Medicine | Asia & Pacific -
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 | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Economics/Finance | Health/Medicine | Global | Asia & Pacific -
ArticlePublication 2010Cost-Effectiveness of Alternative Pregnancy Termination Strategies in Nigeria and Ghana
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, …
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, the authors developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women. The model was used to compare the costs and benefits of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). The results showed that…
State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Culture/Society | 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,…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Health/Medicine | Latin America & Caribbean -
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.…
Costing Methods | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2007Cost Effectiveness of Interventions to Reduce Maternal Mortality in Mexico
This article, published in PloS One, uses maternal mortality data from Mexico to examine trends …
This article, published in PloS One, uses maternal mortality data from Mexico to examine trends in the provision of maternal health services and the trajectory towards reaching the Millennium Development Goal 5 (MDG 5). The authors developed a model of the natural history of pregnancy and pregnancy related complications and simulated a cohort of 15-year-old women over their lifetime based on national data. The model produced clinical outcomes, costs, and cost-effectiveness of the current standard…
Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Economics/Finance | Health/Medicine | Latin America & Caribbean
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