Saturday, 23 July 2016
Julie Marie Buser, MS, BSN, BA, RN, CPNP1
Katelyn Pitcher, BSN, RN2
Michelle Munro-Kramer, PhD, RN, CNM, FNP-BC3
Jody R. Lori, PHD, RN, CNM, FACNM, FAAN3
(1)Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
(2)University of Michigan, School of Nursing, Ann Arbor, MI, USA
(3)Department of Health Behavior and Biological Sciences, University of Michigan, School of Nursing, Ann Arbor, MI, USA
Background/context of paperMaternal and neonatal morbidity and mortality remains a great concern in low resource settings. Liberia has a maternal mortality ratio of 1,072 deaths per 100,000 live births, ranking them in the top ten for maternal mortality in the world. Liberia also has a high neonatal mortality ratio of 26 deaths per 1,000 live births. Maternity waiting homes (MWHs) are residential dwellings located near health facilities where women stay to await delivery and receive immediate postpartum services. They have been used in a variety of settings as a ‘geographic bridge’ to overcome distance and transportation barriers that can prevent women from receiving timely skilled care at delivery. Although MWHs have demonstrated their value by reducing maternal mortality rates, there is little information on their cost-effectiveness.
Aim of paper
The purpose of this study is to analyse the cost-effectiveness of MWHs in terms of maternal and neonatal lives saved.
Methods
A cost-effective analysis was performed to calculate the cost per life saved and economic effect of MWHs on maternal and neonatal mortality.
Key points for discussion
Results indicate an extremely low cost per maternal and neonatal life saved at MWHs in Liberia.
Conclusion and recommendations
Maternity waiting homes are a highly cost-effective and affordable strategy to reduce maternal and neonatal mortality in Liberia. Discussion to scale-up MWH interventions for improving maternal and neonatal outcomes in Liberia and other low resource settings is warranted. Results can be used to advocate for policy changes at the national level to increase the allocation of resources for building additional MWHs to address the distance barrier faced by pregnant women in accessing skilled care at delivery.
References
Demographic and Health Surveys (DHS) Program. Liberia demographic and health survey 2013. Retrieved from: http://dhsprogram.com/what-we-do/survey/survey-display-435.cfm
Lori, J.R., Munro, M.L., Rominski, S., Williams, G., Dahn, B.T., Boyd, C.J., Moore, J.E. & Gwenegale, W. 2013, "Maternity waiting homes and traditional midwives in rural Liberia", International Journal of Gynecology & Obstetrics, vol. 123, no. 2, pp. 114-118.
World Health Organization (2015). Maternity waiting houses. Retrieved from: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/MSM_96_21/en/
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