Safe motherhood interventions in low-income countries: an economic justification and evidence of cost effectiveness

Abstract

It is estimated that 1600 women die world-wide each day as a result of problems during pregnancy or childbirth. A large proportion of these deaths is preventable. This article examines the economic case for investing in safe motherhood interventions, and reviews key evidence of the cost effectiveness of safe motherhood interventions. According to one study, antenatal and maternal services comprise two of the six most cost effective sets of health interventions in low-income countries. However, little detailed evidence exists regarding the relative cost effectiveness of antenatal care, post-abortion care and essential obstetric care. Despite this there is clear evidence that interventions such as substituting manual vacuum aspiration for dilatation and curettage can result in significant savings both for health facilities and patients. The paper estimates first that 26% of maternal deaths are avoidable through antenatal/community-based interventions, costing around 30% of the WHO Mother Baby Package; and secondly that access to quality essential obstetric care can prevent a further 48% of maternal deaths, consuming 24% of total Mother Baby Package costs. Further work on the cost effectiveness of safe motherhood interventions would provide useful information for policy makers concerned with reducing maternal mortality in the most efficient manner possible.