Midwife-led birthing centres in Bangladesh, Pakistan and Uganda: an economic evaluation of case study sites.
BMJ Glob Health
; 9(3)2024 Mar 28.
Article
em En
| MEDLINE
| ID: mdl-38548343
ABSTRACT
INTRODUCTION:
Achieving the Sustainable Development Goals to reduce maternal and neonatal mortality rates will require the expansion and strengthening of quality maternal health services. Midwife-led birth centres (MLBCs) are an alternative to hospital-based care for low-risk pregnancies where the lead professional at the time of birth is a trained midwife. These have been used in many countries to improve birth outcomes.METHODS:
The cost analysis used primary data collection from four MLBCs in Bangladesh, Pakistan and Uganda (n=12 MLBC sites). Modelled cost-effectiveness analysis was conducted to compare the incremental cost-effectiveness ratio (ICER), measured as incremental cost per disability-adjusted life-year (DALY) averted, of MLBCs to standard care in each country. Results were presented in 2022 US dollars.RESULTS:
Cost per birth in MLBCs varied greatly within and between countries, from US$21 per birth at site 3, Bangladesh to US$2374 at site 2, Uganda. Midwife salary and facility operation costs were the primary drivers of costs in most MLBCs. Six of the 12 MLBCs produced better health outcomes at a lower cost (dominated) compared with standard care; and three produced better health outcomes at a higher cost compared with standard care, with ICERs ranging from US$571/DALY averted to US$55 942/DALY averted.CONCLUSION:
MLBCs appear to be able to produce better health outcomes at lower cost or be highly cost-effective compared with standard care. Costs do vary across sites and settings, and so further exploration of costs and cost-effectiveness as a part of implementation and establishment activities should be a priority.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Centros de Assistência à Gravidez e ao Parto
/
Tocologia
Limite:
Female
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Humans
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Newborn
/
Pregnancy
País/Região como assunto:
Africa
/
Asia
Idioma:
En
Revista:
BMJ Glob Health
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Austrália