Julie M Buser1, Michelle L Munro-Kramer1, Monica Carney2, Alphonso Kofa3, G Gorma Cole3, Jody R Lori1. 1. Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA. 2. Department of Economics and Accounting, College of the Holy Cross, Worcester, MA, USA. 3. Ministry of Health, Bong County Health Team, Suakoko, Bong County, Liberia.
Abstract
OBJECTIVE: To analyze the cost-effectiveness of maternity waiting homes (MWHs) in rural Liberia by examining the cost per life saved and economic effect of MWHs on maternal mortality. METHODS: A cost-effectiveness analysis was used to evaluate costs and economic effect of MWHs on maternal mortality in rural Liberia to guide future resource allocation. A secondary data analysis was performed based on a prior quasi-experimental cohort study of 10 rural primary healthcare facilities, five with a MWH and five without a MWH, that took place from October 30, 2010 to February 28, 2015. RESULTS: Calculations signified a low cost per year of life saved at MWHs in a rural district in Liberia. Total population-adjusted number of women's lives saved over 3 years was 6.25. CONCLUSION: While initial costs were considerable, over a period of 10 or more years MWHs could be a cost-effective and affordable strategy to reduce maternal mortality rates in Liberia. Discussion of the scaling up of MWH interventions for improving maternal outcomes in Liberia and other low- and middle-income countries is justified. Findings can be used to advocate for policy changes to increase the apportionment of resources for building more MWHs in low resource settings.
OBJECTIVE: To analyze the cost-effectiveness of maternity waiting homes (MWHs) in rural Liberia by examining the cost per life saved and economic effect of MWHs on maternal mortality. METHODS: A cost-effectiveness analysis was used to evaluate costs and economic effect of MWHs on maternal mortality in rural Liberia to guide future resource allocation. A secondary data analysis was performed based on a prior quasi-experimental cohort study of 10 rural primary healthcare facilities, five with a MWH and five without a MWH, that took place from October 30, 2010 to February 28, 2015. RESULTS: Calculations signified a low cost per year of life saved at MWHs in a rural district in Liberia. Total population-adjusted number of women's lives saved over 3 years was 6.25. CONCLUSION: While initial costs were considerable, over a period of 10 or more years MWHs could be a cost-effective and affordable strategy to reduce maternal mortality rates in Liberia. Discussion of the scaling up of MWH interventions for improving maternal outcomes in Liberia and other low- and middle-income countries is justified. Findings can be used to advocate for policy changes to increase the apportionment of resources for building more MWHs in low resource settings.