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Patient and health system costs of managing pregnancy and birth-related complications in sub-Saharan Africa: a systematic review

Author

Listed:
  • Amani Thomas Mori

    (Centre for International Health, University of Bergen
    University of Bergen
    University of Bergen)

  • Peter Binyaruka

    (Ifakara Health Institute)

  • Peter Hangoma

    (School of Public Health, University of Zambia)

  • Bjarne Robberstad

    (Centre for International Health, University of Bergen
    University of Bergen
    University of Bergen)

  • Ingvild Sandoy

    (Centre for International Health, University of Bergen
    University of Bergen)

Abstract

Background Morbidity and mortality due to pregnancy and childbearing are high in developing countries. This study aims to estimate patient and health system costs of managing pregnancy and birth-related complications in sub-Saharan Africa. Methods A systematic review of the literature was conducted to identify costing studies published and unpublished, from January 2000 to May 2019. The search was done in Pubmed, EMBASE, Cinahl, and Web of Science databases and grey literature. The study was registered in PROSPERO with registration No. CRD42019119316. All costs were converted to 2018 US dollars using relevant Consumer Price Indices. Results Out of 1652 studies identified, 48 fulfilled the inclusion criteria. The included studies were of moderate to high quality. Spontaneous vaginal delivery cost patients and health systems between USD 6–52 and USD 8–73, but cesarean section costs between USD 56–377 and USD 80–562, respectively. Patient and health system costs of abortion range between USD 11–66 and USD 40–298, while post-abortion care costs between USD 21–158 and USD 46–151, respectively. The patient and health system costs for managing a case of eclampsia range between USD 52–231 and USD 123–186, while for maternal hemorrhage they range between USD 65–196 and USD 30–127, respectively. Patient cost for caring low-birth weight babies ranges between USD 38–489 while the health system cost was estimated to be USD 514. Conclusion This is the first systematic review to compile comprehensive up-to-date patient and health system costs of managing pregnancy and birth-related complications in sub-Saharan Africa. It indicates that these costs are relatively high in this region and that patient costs were largely catastrophic relative to a 10 % of average national per capita income.

Suggested Citation

  • Amani Thomas Mori & Peter Binyaruka & Peter Hangoma & Bjarne Robberstad & Ingvild Sandoy, 2020. "Patient and health system costs of managing pregnancy and birth-related complications in sub-Saharan Africa: a systematic review," Health Economics Review, Springer, vol. 10(1), pages 1-15, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00283-y
    DOI: 10.1186/s13561-020-00283-y
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    References listed on IDEAS

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    1. Valéry Ridde & Seni Kouanda & Aristide Bado & Nicole Bado & Slim Haddad, 2012. "Reducing the Medical Cost of Deliveries in Burkina Faso Is Good for Everyone, Including the Poor," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    2. Ivlabèhiré Bertrand Meda & Adama Baguiya & Valéry Ridde & Henri Gautier Ouédraogo & Alexandre Dumont & Seni Kouanda, 2019. "Out-of-pocket payments in the context of a free maternal health care policy in Burkina Faso: a national cross-sectional survey," Health Economics Review, Springer, vol. 9(1), pages 1-14, December.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    4. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    5. Parmar, Divya & Leone, Tiziana & Coast, Ernestina & Murray, Susan Fairley & Hukin, Eleanor & Vwalika, Bellington, 2017. "Cost of abortions in Zambia: a comparison of safe abortion and post abortion care," LSE Research Online Documents on Economics 63643, London School of Economics and Political Science, LSE Library.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Angela Devine’s journal round-up for 28th September 2020
      by Angela Devine in The Academic Health Economists' Blog on 2020-09-28 11:00:07

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