TY - JOUR
T1 - Cost-effectiveness of misoprostol to control postpartum hemorrhage in low-resource settings
AU - Bradley, S. E.K.
AU - Prata, N.
AU - Young-Lin, N.
AU - Bishai, D. M.
N1 - Funding Information:
This work was supported in part by the Bill and Melinda Gates Institute for Reproductive Health at the Johns Hopkins Bloomberg School of Public Health.
PY - 2007/4
Y1 - 2007/4
N2 - Objective: To test the cost-effectiveness of training traditional birth attendants (TBAs) to recognize postpartum hemorrhage (PPH) and administer a rectal dose of misoprostol in areas with low access to modern delivery facilities. Method: A cost-effectiveness analysis, modeling two hypothetical cohorts of 10,000 women each giving birth with TBAs: one under standard treatment (TBA referral to hospital after blood loss ≥ 500 ml), and one attended by TBAs trained to recognize PPH and to administer 1000 μg of misoprostol at blood loss ≥ 500 ml. Result: The misoprostol strategy could prevent 1647 cases of severe PPH (range: 810-2920) and save $115,335 in costs of referral, IV therapy and transfusions (range: $13,991-$1,563,593) per 10,000 births. By preventing severe disease and saving money, it dominates the standard approach. Conclusion: Training TBAs to administer misoprostol to treat PPH has the potential to both save money and improve the health of mothers in low-resource settings.
AB - Objective: To test the cost-effectiveness of training traditional birth attendants (TBAs) to recognize postpartum hemorrhage (PPH) and administer a rectal dose of misoprostol in areas with low access to modern delivery facilities. Method: A cost-effectiveness analysis, modeling two hypothetical cohorts of 10,000 women each giving birth with TBAs: one under standard treatment (TBA referral to hospital after blood loss ≥ 500 ml), and one attended by TBAs trained to recognize PPH and to administer 1000 μg of misoprostol at blood loss ≥ 500 ml. Result: The misoprostol strategy could prevent 1647 cases of severe PPH (range: 810-2920) and save $115,335 in costs of referral, IV therapy and transfusions (range: $13,991-$1,563,593) per 10,000 births. By preventing severe disease and saving money, it dominates the standard approach. Conclusion: Training TBAs to administer misoprostol to treat PPH has the potential to both save money and improve the health of mothers in low-resource settings.
KW - Cost-effectiveness
KW - Maternal morbidity
KW - Postpartum hemorrhage, misoprostol
KW - Traditional birth attendants
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U2 - 10.1016/j.ijgo.2006.12.005
DO - 10.1016/j.ijgo.2006.12.005
M3 - Article
C2 - 17316646
AN - SCOPUS:33847670259
SN - 0020-7292
VL - 97
SP - 52
EP - 56
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -