Premium
Cost‐effectiveness of misoprostol to control postpartum hemorrhage in low‐resource settings
Author(s) -
Bradley S.E.K.,
Prata N.,
YoungLin N.,
Bishai D.M.
Publication year - 2007
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2006.12.005
Subject(s) - misoprostol , medicine , referral , obstetrics , blood loss , pregnancy , postpartum haemorrhage , childbirth , emergency medicine , surgery , abortion , nursing , genetics , biology
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.