Cost-effective safe motherhood interventions in low-income countries: a review

This paper reviews studies providing evidence of the cost-effectiveness of safe motherhood interventions in low-income countries. The economic case for investing in safe motherhood interventions is also examined. It is estimated that 1,600 women die globally each day as a result of problems during pregnancy or childbirth. A large proportion of these deaths is preventable. According to the World Bank, antenatal and maternal services comprise two of the six most cost-effective sets of health nterventions in low-income countries. Due to the problem of linking programme interventions with outcomes however, few cost-effectiveness studies currently exist. Despite this certain interventions are more cost-effective than others, such as substituting manual vacuum aspiration for dilatation and curettage when dealing with incomplete abortion. It is estimated that 26% of maternal deaths are avoidable through antenatal/community-based interventions, costing around 30% of the World Health Organisation’s Mother Baby Package. Ensuring access to high quality essential obstetric care can prevent a further 58% of maternal deaths, consuming 24% of total Mother Baby Package costs. Current evidence suggests that targeting investments on essential obstetric services would reap the greatest efficiency gains.