Abstract
ObjectiveEven though postpartum morbidity continues to cause high disease burden in maternal morbidity and mortality across the globe, the literature pertaining to resultant productivity loss is scarce. Hence, the present study aimed at determining the productivity loss and associated cost of episodes of postpartum ill health.MethodsA cross sectional study was conducted in two Medical Officer of Heath areas in the Anuradhapura district, Sri Lanka in 2011, among 407 women residing in Anuradhapura district with an infant aged between 8 to 24 weeks. Validated interviewer administered questionnaires, including the IMMPACT productivity cost tool, were used to collect data on self-reported episodes of postpartum ill health. The productivity loss was calculated as the sum of days lost due to partial and total incapacitation. The adjusted productivity loss for coping strategies was calculated. Productivity cost, both total and adjusted, were calculated based on the mean daily per capita income of the study sample.ResultsOf the 407 participants, 161(39.6%) reported at least one episode of postpartum illness. Hospitalisations were reported by 27 (16.8%) of all symptomatic postpartum women. Common symptoms of postpartum ill health were pain/infection at either episiotomy or surgical site (n = 44, 27.3%), lower abdominal pain (n = 40, 24.8%) and backache (n = 27, 16.8%). The mean productivity loss per episode of ill health was 15 days (SD = 7.8 days) and the mean productivity loss per episode after adjusting for coping strategies was 7.9 days (SD = 4.4 days). The mean productivity cost per an episode was US$ 34.2(95%CI US$ 26.7–41.6) and the mean productivity cost per an episode after adjusting for coping strategies was US$ 18.0 (95%CI US$ 14.1–22.0)ConclusionsThe prevalence of self-reported postpartum ill health, associated productivity loss and cost were high in the study sample and the main contributors were preventable conditions including pain and infection. Thus, effective pain management and proper infection prevention and control measures are important in reducing the burden of postpartum illness and resultant productivity cost.
Highlights
Since maternal and child health is recognised as one of the major areas in the global health agenda with consequent concerted multi-stakeholder efforts to improve maternal health across the globe, the total annual estimated number of global maternal deaths declined from 376,034 in 1990 to 292,982 in 2013 with a substantial declining rate of 3.3% in 2012–13 period [1,2]
The prevalence of self-reported postpartum ill health, associated productivity loss and cost were high in the study sample and the main contributors were preventable conditions including pain and infection
In terms of disease burden, maternal morbidities are cited as the leading cause of Disability-Adjusted Life Years (DALYs) lost among women in reproductive age group in the developing countries [3]
Summary
Since maternal and child health is recognised as one of the major areas in the global health agenda with consequent concerted multi-stakeholder efforts to improve maternal health across the globe, the total annual estimated number of global maternal deaths declined from 376,034 in 1990 to 292,982 in 2013 with a substantial declining rate of 3.3% in 2012–13 period [1,2]. Notwithstanding the significant achievements in relation to the reduction in maternal mortality, it is estimated that for each maternal death, approximately 6.2 women experience severe complications from pregnancy and childbirth [2]. In comparison to the plethora of research pertaining to maternal morbidities during pregnancy, there is a relative paucity of literature pertaining to postpartum morbidities. Greater focus paid on maternal mortality reduction and averting maternal near-misses has served its purpose during the last few decades, which is evident by the improvement in maternal mortality indicators. Despite these improvements, the goal of improving maternal health is identified as a main challenge in global health agenda [8]
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