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 mu...
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BMJ Publishing Group
2020-06-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/6/e002371.full |
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| author | Aduragbemi Banke-Thomas Ejemai Amaize Eboreime Ibukun-Oluwa Omolade Abejirinde Oluwasola Banke-Thomas Charles Anawo Ameh Francis Ifeanyi Ayomoh |
| author_facet | Aduragbemi Banke-Thomas Ejemai Amaize Eboreime Ibukun-Oluwa Omolade Abejirinde Oluwasola Banke-Thomas Charles Anawo Ameh Francis Ifeanyi Ayomoh |
| author_sort | Aduragbemi Banke-Thomas |
| collection | DOAJ |
| 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 | Article |
| id | doaj-art-c12df89b972e41abaa431b4fb35d83a5 |
| institution | DOAJ |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-c12df89b972e41abaa431b4fb35d83a52025-08-20T02:50:04ZengBMJ Publishing GroupBMJ Global Health2059-79082020-06-015610.1136/bmjgh-2020-002371The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic reviewAduragbemi Banke-Thomas0Ejemai Amaize Eboreime1Ibukun-Oluwa Omolade Abejirinde2Oluwasola Banke-Thomas3Charles Anawo Ameh4Francis Ifeanyi Ayomoh5LSE Health, London School of Economics and Political Science, London, UK12 Department of Planning, Research & Statistics, NPHCDA, Abuja, NigeriaInstitute for Health System Solutions and Virtual Care, Women`s College Hospital, Toronto, Ontario, Canada3 Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA5 Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United KingdomHealth Policy, Federal Ministry of Health, Abuja, Federal Capital Territory, NigeriaIntroduction 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.https://gh.bmj.com/content/5/6/e002371.full |
| spellingShingle | Aduragbemi Banke-Thomas Ejemai Amaize Eboreime Ibukun-Oluwa Omolade Abejirinde Oluwasola Banke-Thomas Charles Anawo Ameh Francis Ifeanyi Ayomoh The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review BMJ Global Health |
| 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 |
| url | https://gh.bmj.com/content/5/6/e002371.full |
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