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Economic Analysis of a Maternal and Neonatal Health Improvement Intervention in Niger

Economic Analysis of a Maternal and Neonatal Health Improvement Intervention in Niger. Edward Broughton, PhD, MPH EnCompass , LLC ebroughton@urc-chs.com www.hciproject.org. Objectives. What question we were asking Outline intervention to improve MNH Results Limitations What’s next.

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Economic Analysis of a Maternal and Neonatal Health Improvement Intervention in Niger

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  1. Economic Analysis of a Maternal and Neonatal Health Improvement Intervention in Niger Edward Broughton, PhD, MPH EnCompass, LLC ebroughton@urc-chs.com www.hciproject.org

  2. Objectives • What question we were asking • Outline intervention to improve MNH • Results • Limitations • What’s next

  3. Distribution of labor Implementers: Dr. Maina Boucar and Niger team Researcher

  4. Intervention • Implement active management of 3rd stage of labor • Implement essential newborn care • Collaborative improvement among 33 facilities • MOH partnership • 2 years 89,000 vaginal deliveries

  5. Research Question • Is it cost-effective to not allow mothers and babies to die? • What does it mean to be “cost-effective”? • Compared to what? • What is the cost-effectiveness of intervening compared to going nothing? • From perspective of: • funders (USAID & MOH) • MOH

  6. Pre-intervention: • 1 in 7 women die in childbirth (lifetime risk)1 • Post-partum hemorrhage is leading cause of death2 1: World Bank 2005 2: WHO, 2006

  7. Changes associated with intervention

  8. Attributability

  9. Changes associated with intervention

  10. Costs per delivery (HCI implementing) Intervention 2008 Post Pre 2006 MOH $ 35 + $ 0.81 $ 28 USAID/HCI $ 2.12 $ 6.53 Additional cost per patient for intervention = $2.45

  11. Costs per delivery (MOH implementing) Intervention 2008 Post Pre 2006 MOH $ 35 + $ 0.81 $ 28 MOH (intervention) $ 4.58 Additional cost per patient for intervention = --$1.67

  12. Cost-effectiveness Analysis Incremental cost-effectiveness ratio = Added costs Added effects ICER (HCI intervention) = $ 2.45 = $286 / DALY 0.0086 ICER (MOH intervention) = -$1.67 = Dominated 0.0086

  13. Limitations • Weak case for attributability • Assuming MOH can do intervention • Didn’t include newborn outcomes • Some cost data questionable

  14. Publishing (IJHCQA)?

  15. Thank you !

  16. ebroughton@urc-chs.com • www.hciproject.org

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