Abstract
This study compared the costs of providing antenatal, delivery and postnatal care in the home and in a basic obstetric facility in rural Bangladesh. The average costs were estimated by interviewing midwives and from institutional records. The main determinants of cost in each setting were also assessed. The cost of basic obstetric care in the home and in a facility was very similar, although care in the home was cheaper. Deliveries in the home took more time but this was offset by the capital costs associated with facility-based care. As use-rates increase, deliveries in a facility will become cheaper. Antenatal and postnatal care was much cheaper to provide in the facility than in the home. Facility-based delivery care is likely to be a cheaper and more feasible method for the care provider as demand rises. In settings where skilled attendance rates are very low, home-based care will be cheaper.
Highlights
Skilled attendance during pregnancy and childbirth has been promoted as the single most effective means of successfully reducing maternal mortality in poorer countries, with the maximum coverage being most desirable [1]
In many countries, a large number of women continue to deliver in the home without the presence of an adequatelytrained or equipped care provider
In Bangladesh, for example, only 12% of women deliver with a skilled attendant, only one in five women makes three or more antenatal visits [2], and very few have any postnatal care [3]
Summary
Skilled attendance during pregnancy and childbirth has been promoted as the single most effective means of successfully reducing maternal mortality in poorer countries, with the maximum coverage being most desirable [1]. In many countries, a large number of women continue to deliver in the home without the presence of an adequatelytrained or equipped care provider. In Bangladesh, for example, only 12% of women deliver with a skilled attendant, only one in five women makes three or more antenatal visits [2], and very few have any postnatal care [3]. The Government of Bangladesh has made it a national priority to increase skilled attendance at delivery to address the high levels of maternal mor-. Starting in early 2003, the Government, with support of the World Health Organization and the United Nations Population Fund, has trained basic healthcare workers (female health assistants and family welfare assistants) to conduct delivery and provide postnatal and neonatal care in the home [9]. A few developing countries, including Indonesia [10] and Bangladesh [11], have tried to promote deliveries in the home with trained midwives
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
