Abstract
Maternal health still remains a major challenge in almost all developing countries. In Myanmar, the country met only 62% of its target for the maternal mortality rate (130 per 100,000 live birth) even though proportion of skilled birth attendant (SBA) and antenatal care (ANC) coverage was 80% in 2015. Despite the estimated large maternal complications, most maternal healthcare program ignored the burden of those morbidity because of limited understanding of the incidence and prevalence of morbidity conditions and cost of those morbidity burdens on society. The present study provides a general idea of the scope of obstetric complication, incidence of obstetric complication, and cost of those morbidity burdens on society. We conducted a retrospective incidence-based cost of illness study related to obstetric complication from the healthcare system perspective at 25 bedded township hospital in Yedashae during the fiscal year of 2015–2016. For the cost of obstetric complication, average treatment cost was 26.83 USD (±8.59). When looking by disease category, average treatment cost for incomplete abortion was 35.45 USD (±1.75); pelvic inflammatory disease (PID) was 16.01 USD; pregnancy-induced hypertension (PIH) was 21.02 USD (±4.68); ante-partum hemorrhage (APH) was 14.24(± 0.25); post-partum hemorrhage (PPH) was 27.04 USD (±1.56); prolonged labor was 37.55 USD (±0.42); and septicemia was 16.51 USD (±2.15). Significant predicting variables in obstetric complication cost model were incomplete abortion, prolonged labor, post-partum hemorrhage (PPH), pregnancy induced hypertension (PIH), patient age and septicemia. From this study, we can summarize the most frequently occurred obstetric complication in that township area, actual cost burden of those complications and obstetric complication cost model which can be useful for hospital financial management. This study can be considered as a starting point for cost of illness analysis in Myanmar to prioritize and target specific health problem at a country level for policy maker to set priorities for health care intervention.
Highlights
Efficiency of health care system is important in developing countries that are struggling to improve public health with limited fund
From one year data (2015 fiscal year) of Yedashae township hospital, there was a total of 91 cases of obstetric complication, which consists of 26 cases for incomplete abortion (28.6%); only one case for pelvic inflammatory disease (PID) (1.12%); 23 cases for pregnancy induced hypertension (PIH) (25.3%); 11 cases for ante -partum hemorrhage (APH) (12.1%); 17 cases for post-partum hemorrhage (PPH) (18.7%), 9 cases for prolonged labor (9.9%) and 4 cases for septicemia (4.4%)
We explored according to age group for frequency of overall complication and we found that 64 complication cases (70.3%) were from
Summary
Efficiency of health care system is important in developing countries that are struggling to improve public health with limited fund. This has become more vital in services related with maternal health which still remain major challenges in almost all developing countries [1]. Maternal morbidity is generally defined as any illness or injury caused by or associated with pregnancy or child birth [2]. It stands as a group which constitute one of the leading causes of the burden of disease for women of reproductive age throughout the world and contribute to high level of mortality and disability in developing region [3]. One study in 4 developing countries showed that 58% - 80% of pregnant women developed acute health problem because of pregnancy and of which, 8% - 29% went on to develop chronic health problem [2]
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