Strategy | Comparator | Quality | Form of economic evaluation | Measured health effect in | Costing perspective | Used sensitivity analysis | CE result (US$ 2012) | CE measure | GDP-PC (*) | Reference |
---|---|---|---|---|---|---|---|---|---|---|
Cost per DALY averted | ||||||||||
MNH services delivered at home, with community mobilization & HSS | Health system strengthening (HSS) at sub-district level | High | Field-based | Newborn | Societal (also reports programme) | Yes | 126 (societal), 123 (programme) | per DALY averted | 747 | [22] |
Home-based neonatal care by VHWs | No strategy | Low | Field-based | Newborn | Strategy | No | 13 | per DALY averted | 1489 | [39] |
Home-based distribution of IPTp | IPTp distributed during ANC | High | Field-based | Newborn | Societal | Yes | 3 | per DALY averted | 547 | [59] |
Train TBAs & supply clean delivery kits | No strategy | High | Economic Model (primary data) | Newborn | Societal | Yes | 188 (project), 79 (10 year forecast) | per DALY averted | 1469 | [65] |
Distribute malaria ITNs at ANC | No strategy | High | Economic Model (primary data) | Infant | Strategy | Yes | 61 | per DALY averted | 272 | [33] |
Quality improvement collaborative | No strategy | High | Ec Model | Women | Health service provider | Yes | 302 | per DALY averted | 383 | [52] |
Hospital-based promotion of breastfeeding | No strategy | High | Field-based | Newborn | Health service provider (excl. start-up) | No | 164 | per DALY averted | 2264 | [36] |
Cost per QALY gained | ||||||||||
Outreach clinics by facility staff | Facility-based care | Medium | Field-based | Women | Health service provider & direct user (excl. start-up) | No | In site A/site B): 42/40 (S), 171/67 (C) | per QALY gained | 747 | [23] |
Alternative delivery strategies FP & MCH | FP & MCH services provided at home by government fieldworkers | High | Field-based | Women | Health service provider | No | Range (low-high estimate): 87–139 (S1), 28–46 (S2), 68–109 (C) | per QALY gained | 747 | [25] |
1. Community service points | ||||||||||
2. PHC | ||||||||||
Cost per life- year saved (or year of life lost averted) | ||||||||||
Women’s groups & HSS | HSS | Medium | Field-based | Newborn | Strategy | No | 427 (trial), 284 (at scale) | per LYS | 747 | [18] |
1. Women’s groups | No strategy | Medium | Field-based | Women & newborn | Strategy | No | 149 (S1), 43 (S2) | per LYS | 268 | [49] |
2. Peer counselling | ||||||||||
Women’s groups & HSS | HSS | High | Field-based | Newborn | Strategy | Yes | 411, (489 incl. HSS) | per LYS | 707 | [51] |
Women’s groups & HSS | HSS | Medium | Field-based | Newborn | Strategy | Yes | 53, (77 incl. HSS) | per LYS | 1489 | [37] |
Established Emergency Transport | No strategy | High | Field-based | Woman & newborn | Health service provider (excl. start-up) | Yes | 21 | per LYS | 547 | [61] |
Outreach maternal health care | MH care at health post | High | Field-based | Woman & newborn | Societal | Yes | 148-620 | per LYS | 512 | [34] |
Distribute malaria ITNs at ANC | No strategy | High | Economic model (using primary data) | Infant | Strategy | Yes | 56 | per LYS | 272 | [33] |
HIV testing at ANC: | No strategy | High | Economic model | Newborn | Health service provider | Yes | 80 (S1), 37 (S2) | per LYS | 1489 | [38] |
1. nationwide, | ||||||||||
2. in high prevalence states | ||||||||||
Cost per death averted (or cost per life saved) | ||||||||||
Women’s groups & HSS | HSS | Medium | Field-based | Newborn | Strategy | No | 13018 (trial), 8670 (at scale) | per death averted | 747 | [18] |
Women’s groups & HSS | HSS | High | Field-based | Newborn | Strategy | Yes | 11294, (13457 incl. HSS) | per death averted | 707 | [51] |
Women’s groups & HSS | HSS | Medium | Field-based | Newborn | Strategy | Yes | 1457, (2094 incl. HSS) | per death averted | 1489 | [37] |
Women’s groups & Quality improvement at health facilities | No strategy | Low | Field-based | Newborn | Strategy | Yes | 6138 | per death averted | 268 | |
Home-based neonatal care by VHWs | No strategy | Low | Field-based | Newborn | Strategy | No | 294 | per death averted | 1489 | [39] |
Home-based management of birth asphyxia by VHWs | Management of birth asphyxia by trained TBAs | Low | Field-based | Newborn | Equipment only | No | 25 | per death averted | 1489 | [40] |
Train TBAs | No strategy | Low | Inference (from secondary data) | Newborn | Not specified | No | 5744-13294 | per death averted | 747 | [26] |
Train TBAs & supply clean delivery kits | No strategy | High | Economic model (using primary data) | Newborn | Societal | Yes | 4156 (trial), 1988 (10yr forecast) | per death averted | 1469 | [65] |
MNH services delivered at home, with community mobilization & HSS | HSS at sub-district level | High | Field-based | Newborn | Societal (also reports programme) | Yes | 3576 (societal), 3536 (programme) | per death averted | 747 | [22] |
Tetanus toxoid (TT) immunization campaign | TT immunization at routine ANC | High | Field-based | Newborn | Strategy | Yes | 1564 (S), 338–1438 (C) | per death averted | 3557 | [42] |
Outreach maternal health care | MH care at health post | High | Field-based | Woman & newborn | Societal | Yes | 1380-6414 | per death averted | 512 | [34] |
Distribute malaria ITNs at ANC | No strategy | High | Economic model (using primary data) | Infant | Strategy | Yes | 1462 | per death averted | 272 | [33] |
Train midwives in newborn care | No strategy | Medium | Field-based | Newborn | Health service provider | No | 402 | per death averted | 1469 | [64] |
Train new cadre in EmOC: | Obstetricians | High | Field-based | Newborn | Societal | Yes | 14092 (CvS1), 3878 (CvS2), 240 (S2vS1) | per death averted | 634 | [28] |
1. Medical doctors | ||||||||||
2. Clinical officers | ||||||||||
Hospital-based promotion of breastfeeding | Doing nothing | High | Field-based | Newborn | Health service provider (excl. start-up) | No | 6894 | per death averted | 2264 | [36] |
Improved standard of special neonatal care | Doing nothing | Low | Field-based | Newborn | Equipment only | No | 970 | per death averted | 2184 | [56] |
Cost per strategy- specific measure | ||||||||||
Community health education by midwives | No strategy | Low | Field-based | N/A | Strategy | No | 5 | per educational interaction | 946 | [32] |
Promotion of NGO health clinics: | No strategy | High | Inference (from secondary data) | N/A | Strategy | Yes | <1 (S1), 15 (S2) | per additional ANC user | 747 | [21] |
1. National media campaign | ||||||||||
2. National media campaign & local activities | ||||||||||
Establish community contact persons | No strategy | Low | Field-based | N/A | Strategy | No | 259 | per delivery with complications | 1555 | [54] |
 |  |  |  |  |  |  | 7 | per referral |  |  |
 |  |  |  |  |  |  | 37 | per assisted delivery |  |  |
Home-based neonatal care by VHWs | No strategy | Low | Field-based | Newborn | Strategy | No | 14 | per home-visit for neonatal care | 1489 | [39] |
Home-based neonatal care by VHWs | No strategy | Low | Field-based | N/A | Strategy | No | 13 | per home-visit for neonatal care | 1489 | [41] |
Home-based distribution of IPTp | IPTp distributed during ANC | High | Field-based | Newborn | Societal | Yes | 6 (S), 5 (C) | per women receiving full dose of IPTp | 547 | [59] |
Tetanus toxoid (TT) immunization campaign | TT immunization at routine ANC | High | Field-based | Newborn | Strategy | Yes | 20 (S), 7–30 (C) | per woman receiving full TT vaccine | 3557 | [42] |
Vouchers for free MNH care, cash and in-kind transfers | No strategy | Medium | Field-based | N/A | Strategy | Yes | 91 | per additional delivery with qualified provider | 747 | [19] |
Remove user fees for intrapartum care | No strategy | Medium | Field-based | N/A | Health service provider | No | 3 | per normal delivery | 1032 | [57] |
 |  |  |  |  |  |  | 183 | per C-section performed |  |  |
Established emergency transport scheme | No strategy | Low | Field-based | N/A | Strategy | No | 44 | per obstetric emergency transported | 1555 | [55] |
HIV testing at ANC: | No strategy | High | Economic model (using secondary data) | Newborn | Health service provider | Yes | 1060 (S1), 497 (S2) | per HIV infection prevented | 1489 | [38] |
1. nationwide, | ||||||||||
2. in high prevalence states | ||||||||||
Strategies for abortion care: | No strategy | Medium | Economic Model (using secondary data) | N/A | Health service provider | No | 135 (S1), 75 (S2), 102 (S3), 18 (S4) | per abortion case | 547 | [58] |
1 Restricted-conventional | ||||||||||
2. Restricted-recommended | ||||||||||
3. Liberal-conventional | ||||||||||
4. Liberal-recommended | ||||||||||
Bamako Initiative | No strategy | Medium | Inference (from secondary data) | N/A | Health service provider | Yes | 20 (Benin), 39 (Guinea) | per women receiving at least three antenatal visits | B: 752 G: 591 | [27] |
Quality improvement collaborative | No strategy | High | Economic Model | Women | Health service provider | Yes | 155 | per PPH averted, | 383 | [52] |
 |  |  |  |  |  |  | 3 | per delivery |  |  |
Distribute malaria ITN at ANC | No strategy | High | Field-based | N/A | Strategy | No | 13 | per ITN delivered to pregnant women | 862 | [43] |
Introduce HIV testing: | No strategy | Medium | Field-based | N/A | Strategy | No | 4 (S1), 4 (S2) | per person tested for HIV | 946 | [31] |
1. at ANC | ||||||||||
2. at labour | ||||||||||
Syphilis testing at ANC | No strategy | Low | Field-based | Newborn | Strategy | No | 6399 | per adverse pregnancy outcome averted | 1469 | [63] |
Decentralized programme of syphilis control | No strategy | Low | Field-based | Newborn | Strategy | No | 293-346 | per case of congenital syphilis averted | 862 | [45] |
 |  |  |  |  |  |  | 114 | per case of syphilis treated |  |  |
Decentralized programme of syphilis control | No strategy | Low | Field-based | Newborn | Strategy | No | 252 | per case of congenital syphilis averted | 862 | [46] |
 |  |  |  |  |  |  | 137 | per syphilis case treated |  |  |
Syphilis testing at ANC. | No strategy | Low | Field-based | N/A | Strategy | No | 3 (S1), 11 (S2) | per person tested for syphilis | 862 | [44] |
1. on-site | ||||||||||
2. standard clinics (off-site) | ||||||||||
Improve health and family welfare clinics | No strategy | Low | Inference (from primary and secondary data) | N/A | Strategy | No | 14 | per consultation | 747 | [20] |
Initiative to promote facility-birth | No strategy | Medium | Field-based | N/A | Health service provider | Yes | 1602, (201 excl. cost of strategy) | per facility-birth | 634 | [29] |
Initiative to promote facility-birth | No strategy | Medium | Field-based | N/A | Societal | Yes | 209 | per facility-birth | 634 | [30] |
Initiative on evidence-based practice in maternal and infant hospital care | No strategy | Medium | Field-based | N/A | Health service provider | No | 49 | cost saving per birth | 3867 | [62] |
Hospital-based promotion of breastfeeding | No strategy | High | Field-based | Newborn | Health service provider (excl. start-up) | No | 58 | per neonatal case of diarrhoea averted | 2264 | [36] |
 |  |  |  |  |  |  | 24 | per birth |  |  |
Train Assistant Medical Officers in EmOC | Physicians | High | Field-based | N/A | Societal | Yes | 61 (S),225 (C) | per C-section performed | 579 | [50] |
Train new cadre in EmOC: | Obstetricians | High | sField-based | Newborn | Societal | Yes | 248 (S1), 230 (S2), 615 (C) | per C-section performed | 634 | [28] |
1. Medical doctors | ||||||||||
2. Clinical officers | ||||||||||
Programme on obstetric urogenital fistula | No strategy | Low | Field-based | N/A | Societal | No | 1629-1745 | per consultation | 383 | [53] |