Date Published: March 20, 2019
Publisher: Public Library of Science
Author(s): A. Thi Win Shwe, Arthorn Riewpaiboon, Usa Chaikledkaew, Sitaporn Youngkong, David N. Hackney.
Maternal health still remains a major challenge in almost all developing countries. In Myanmar, the country met only 62% of its target for the maternal mortality rate (130 per 100,000 live birth) even though proportion of skilled birth attendant (SBA) and antenatal care (ANC) coverage was 80% in 2015. Despite the estimated large maternal complications, most maternal healthcare program ignored the burden of those morbidity because of limited understanding of the incidence and prevalence of morbidity conditions and cost of those morbidity burdens on society. The present study provides a general idea of the scope of obstetric complication, incidence of obstetric complication, and cost of those morbidity burdens on society. We conducted a retrospective incidence-based cost of illness study related to obstetric complication from the healthcare system perspective at 25 bedded township hospital in Yedashae during the fiscal year of 2015–2016. For the cost of obstetric complication, average treatment cost was 26.83 USD (±8.59). When looking by disease category, average treatment cost for incomplete abortion was 35.45 USD (±1.75); pelvic inflammatory disease (PID) was 16.01 USD; pregnancy-induced hypertension (PIH) was 21.02 USD (±4.68); ante-partum hemorrhage (APH) was 14.24(± 0.25); post-partum hemorrhage (PPH) was 27.04 USD (±1.56); prolonged labor was 37.55 USD (±0.42); and septicemia was 16.51 USD (±2.15). Significant predicting variables in obstetric complication cost model were incomplete abortion, prolonged labor, post-partum hemorrhage (PPH), pregnancy induced hypertension (PIH), patient age and septicemia. From this study, we can summarize the most frequently occurred obstetric complication in that township area, actual cost burden of those complications and obstetric complication cost model which can be useful for hospital financial management. This study can be considered as a starting point for cost of illness analysis in Myanmar to prioritize and target specific health problem at a country level for policy maker to set priorities for health care intervention.
Efficiency of health care system is important in developing countries that are struggling to improve public health with limited fund. This has become more vital in services related with maternal health which still remain major challenges in almost all developing countries .
The present study provides the actual information about cost of obstetric complication and can summarize frequently occurring complication at that area. Even though there were some limitation, cost estimation of this study was done from actual treatment given in that hospital on an annual base rather than using theoretical estimation. So, we can estimate actual cost burden of illness on society at that township and use those data for hospital financial management even though it cannot be representative for the whole country. We can consider this study as a starting point for future cost of illness analysis in Myanmar and can go further comprehensive study from society perspective to prioritize and target specific health problem as a country level for policy maker to set priorities for health care intervention.