Abstract
This study investigates the long term economic impact of severe obstetric complications for women and their children in Burkina Faso, focusing on measures of food security, expenditures and related quality of life measures. It uses a hospital based cohort, first visited in 2004/2005 and followed up four years later. This cohort of 1014 women consisted of two main groups of comparison: 677 women who had an uncomplicated delivery and 337 women who experienced a severe obstetric complication which would have almost certainly caused death had they not received hospital care (labelled a “near miss” event). To analyze the impact of such near miss events as well as the possible interaction with the pregnancy outcome, we compared household and individual level indicators between women without a near miss event and women with a near miss event who either had a live birth, a perinatal death or an early pregnancy loss. We used propensity score matching to remove initial selection bias. Although we found limited effects for the whole group of near miss women, the results indicated negative impacts: a) for near miss women with a live birth, on child development and education, on relatively expensive food consumption and on women’s quality of life; b) for near miss women with perinatal death, on relatively expensive foods consumption and children’s education and c) for near miss women who had an early pregnancy loss, on overall food security. Our results showed that severe obstetric complications have long lasting consequences for different groups of women and their children and highlighted the need for carefully targeted interventions.
Highlights
The reduction of maternal mortality has been high on the international development agenda through the Millennium Development Goal 5 [1]
Looking at statistically significant coefficients after matching, we found that child development measured through the height of the index child was significantly affected, 4-5 years after their mothers were hit by the near miss event
Besides studying effects of severe obstetric complications on the consumption of relatively expensive food items, we investigated their effects on food security, as measured by the use of strategies to cope with foods shortages, strategies that were described by Maxwell in his paper in 1996 [41]
Summary
The reduction of maternal mortality has been high on the international development agenda through the Millennium Development Goal 5 [1]. Maternal mortality ratio reductions have been reported around the world [3]. Each year, more than 270,000 women still die while in pregnancy or childbirth, with a large part of these deaths taking place in SubSaharan Africa [4]. More notable for this study, millions of women who survive severe obstetric complications in developing countries experience high levels of physical and mental morbidity [5,6,7,8,9,10,11]. The economic costs incurred by poor households due to these complications often lead to a significant economic burden and processes of impoverishment
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