15 December 2017
Community based maternal newborn care can be delivered at less than $1 per person say health economists
Cape Town, South Africa | The first multi-country economic analysis of community-based maternal newborn care (CBMNC) in six sub-Saharan African countries and Bolivia, has shown that community based interventions are affordable and can reduce neo-natal mortality rates.
Although maternal and child mortality rates have been halved, between 2000 and 2015, poor progress has been made in the reduction of neonatal mortality rates. In 2015, almost half of the deaths in children under five occurred during the neonatal period, 98% of which occurred in low-to-middle-income countries (LMICs) where many of these babies died at home.
“Community-based care is particularly critical to achieving universal health coverage for hard to reach populations, especially in light of the low level of facility use by the poorer population,” says study Principal Investigator and health economist at the South African Medical Research Council (SAMRC) Emmanuelle Daviaud. “CBMNC is instrumental in addressing both the mortality outcomes and behaviours which improve the health of mothers and babies and as such, determining its feasibility is imperative in improving these lives.”
Community-based maternal newborn care (CBMNC) can be instrumental in improving newborn survival. However, few studies have analysed the content of care, cadres, commodities and cost effectiveness of CBMNC. The Multi country analyses of community based maternal newborn care study, in its examination of CBMNC programs in Ethiopia, Ghana, South Africa, Tanzania and Uganda, asked key economic questions relating to – amongst others - costs of the program; their time implications; scale-up implications and budgetary implications. It found that CBMNC can be delivered for less than $1 per person, making it highly cost effective even if resulting in a very achievable reduction of one neonatal death per 1000 live births (less than 5% of neonatal mortality) in all the assessed countries including South Africa.
The community intervention programmes studied focused on pregnancy and post natal home visits with education about the health risks associated with neo natal and post natal care and included, in Ethiopia, treatment for infections at health posts.
The results showed that in South Africa, home visits contributed to an increase in breast feeding, reaching a rate not achieved through clinics-based interventions. Whilst lower than in other countries in the study, the neonatal mortality in South-Africa remains high for a medium income country. .
The study report, published in Health Policy and Planning, covers an overview analysis across countries as well as individual country papers and provides a comparative analysis of cost of commodities for community based interventions.
Access report online: https://academic.oup.com/heapol/article/32/suppl_1/i1/4283080
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