Research Article: Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

Date Published: April 20, 2010

Publisher: Public Library of Science

Author(s): Sue J. Goldie, Steve Sweet, Natalie Carvalho, Uma Chandra Mouli Natchu, Delphine Hu, Zulfiqar A. Bhutta

Abstract: A cost-effectiveness study by Sue Goldie and colleagues finds that better family planning, provision of safe abortion, and improved intrapartum and emergency obstetrical care could reduce maternal mortality in India by 75% in 5 years.

Partial Text: Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India, which has the highest burden of maternal mortality for any single country [1],[2]. Although the inclusion of maternal mortality reduction in the United Nations’ Millennium Development Goals (MDGs) reflects the importance of improving maternal health as a key mechanism in reducing poverty and promoting social and economic growth, global progress has been suboptimal [2]–[4]. Several factors may be changing the landscape for maternal health in India in particular [5]. These factors include more information on maternal mortality measures [6],[7], an increasing number of studies evaluating interventions [8], renewed determination on the part of the maternal health and public health communities [9], and, most importantly, the emergence of maternal mortality reduction as a clear priority on the Indian national political agenda [5],[10]–[12].

We have identified several strategic options that would cost-effectively reduce maternal mortality in both rural and urban India. Our principal findings are that early intensive efforts to improve family planning and provide safe abortion, accompanied by a systematic stepwise effort to scale up intrapartum and EmOC, could reduce maternal mortality by 75%. Despite the inherent uncertainty in data and assumptions used in the analysis, four critical themes emerge as robust.



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