Cargando…
The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review
INTRODUCTION: Maternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective. METHODS: We searched...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309188/ https://www.ncbi.nlm.nih.gov/pubmed/32565428 http://dx.doi.org/10.1136/bmjgh-2020-002371 |
_version_ | 1783549164621135872 |
---|---|
author | Banke-Thomas, Aduragbemi Abejirinde, Ibukun-Oluwa Omolade Ayomoh, Francis Ifeanyi Banke-Thomas, Oluwasola Eboreime, Ejemai Amaize Ameh, Charles Anawo |
author_facet | Banke-Thomas, Aduragbemi Abejirinde, Ibukun-Oluwa Omolade Ayomoh, Francis Ifeanyi Banke-Thomas, Oluwasola Eboreime, Ejemai Amaize Ameh, Charles Anawo |
author_sort | Banke-Thomas, Aduragbemi |
collection | PubMed |
description | INTRODUCTION: Maternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective. METHODS: We searched multiple peer-reviewed databases (including African Journal Online, CINAHL Plus, EconLit, Popline, PubMed, Scopus and Web of Science) and grey literature for relevant articles published from year 2000. Articles meeting our inclusion criteria were selected with quality assessment done using relevant cost-focused criteria of the Consolidated Health Economic Evaluation Reporting Standards checklist. For comparability, disaggregated costs data were inflated to 2019 US$ equivalents. Costs and cost drivers were systematically compared. Where heterogeneity was observed, narrative synthesis was used to summarise findings. RESULTS: Twenty-two studies were included, with most studies costing vaginal and/or caesarean delivery (11 studies), antenatal care (ANC) (9) and postabortion care (PAC) (8). Postnatal care (PNC) has been least costed (2). Studies used different methods for data collection and analysis. Quality of peer-reviewed studies was assessed average to high while all grey literature studies were assessed as low quality. Following inflation, estimated provision cost per service varied (ANC (US$7.24–US$31.42); vaginal delivery (US$14.32–US$278.22); caesarean delivery (US$72.11–US$378.940; PAC (US$97.09–US$1299.21); family planning (FP) (US$0.82–US$5.27); PNC (US$5.04)). These ranges could be explained by intercountry variations, variations in provider type (public/private), facility type (primary/secondary) and care complexity (simple/complicated). Personnel cost was mostly reported as the major driver for provision of ANC, skilled birth attendance and FP. Economies of scale in service provision were reported. CONCLUSION: There is a cost savings case for task-shifting and encouraging women to use lower level facilities for uncomplicated services. Going forward, consensus regarding cost component definitions and methodologies for costing maternal health services will significantly help to improve the usefulness of cost analyses in supporting policymaking towards achieving Universal Health Coverage. |
format | Online Article Text |
id | pubmed-7309188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-73091882020-06-23 The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review Banke-Thomas, Aduragbemi Abejirinde, Ibukun-Oluwa Omolade Ayomoh, Francis Ifeanyi Banke-Thomas, Oluwasola Eboreime, Ejemai Amaize Ameh, Charles Anawo BMJ Glob Health Original Research INTRODUCTION: Maternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective. METHODS: We searched multiple peer-reviewed databases (including African Journal Online, CINAHL Plus, EconLit, Popline, PubMed, Scopus and Web of Science) and grey literature for relevant articles published from year 2000. Articles meeting our inclusion criteria were selected with quality assessment done using relevant cost-focused criteria of the Consolidated Health Economic Evaluation Reporting Standards checklist. For comparability, disaggregated costs data were inflated to 2019 US$ equivalents. Costs and cost drivers were systematically compared. Where heterogeneity was observed, narrative synthesis was used to summarise findings. RESULTS: Twenty-two studies were included, with most studies costing vaginal and/or caesarean delivery (11 studies), antenatal care (ANC) (9) and postabortion care (PAC) (8). Postnatal care (PNC) has been least costed (2). Studies used different methods for data collection and analysis. Quality of peer-reviewed studies was assessed average to high while all grey literature studies were assessed as low quality. Following inflation, estimated provision cost per service varied (ANC (US$7.24–US$31.42); vaginal delivery (US$14.32–US$278.22); caesarean delivery (US$72.11–US$378.940; PAC (US$97.09–US$1299.21); family planning (FP) (US$0.82–US$5.27); PNC (US$5.04)). These ranges could be explained by intercountry variations, variations in provider type (public/private), facility type (primary/secondary) and care complexity (simple/complicated). Personnel cost was mostly reported as the major driver for provision of ANC, skilled birth attendance and FP. Economies of scale in service provision were reported. CONCLUSION: There is a cost savings case for task-shifting and encouraging women to use lower level facilities for uncomplicated services. Going forward, consensus regarding cost component definitions and methodologies for costing maternal health services will significantly help to improve the usefulness of cost analyses in supporting policymaking towards achieving Universal Health Coverage. BMJ Publishing Group 2020-06-21 /pmc/articles/PMC7309188/ /pubmed/32565428 http://dx.doi.org/10.1136/bmjgh-2020-002371 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Banke-Thomas, Aduragbemi Abejirinde, Ibukun-Oluwa Omolade Ayomoh, Francis Ifeanyi Banke-Thomas, Oluwasola Eboreime, Ejemai Amaize Ameh, Charles Anawo The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
title | The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
title_full | The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
title_fullStr | The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
title_full_unstemmed | The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
title_short | The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
title_sort | cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309188/ https://www.ncbi.nlm.nih.gov/pubmed/32565428 http://dx.doi.org/10.1136/bmjgh-2020-002371 |
work_keys_str_mv | AT bankethomasaduragbemi thecostofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT abejirindeibukunoluwaomolade thecostofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT ayomohfrancisifeanyi thecostofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT bankethomasoluwasola thecostofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT eboreimeejemaiamaize thecostofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT amehcharlesanawo thecostofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT bankethomasaduragbemi costofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT abejirindeibukunoluwaomolade costofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT ayomohfrancisifeanyi costofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT bankethomasoluwasola costofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT eboreimeejemaiamaize costofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview AT amehcharlesanawo costofmaternalhealthservicesinlowincomeandmiddleincomecountriesfromaprovidersperspectiveasystematicreview |