applying the net-benefit framework for analyzing and presenting cost-effectiveness analysis of a maternal and newborn health intervention应用净效益分析框架和呈现一个孕产妇和新生儿健康干预的成本效益分析.pdf

Applying the Net-Benefit Framework for Analyzing and Presenting Cost-Effectiveness Analysis of a Maternal and Newborn Health Intervention Sennen Hounton1,2*, David Newlands2 1 Centre MURAZ, Bobo-Dioulasso, Burkina Faso, 2 Immpact, University of Aberdeen, Scotland, United Kingdom Abstract Background: Coverage of maternal and newborn health (MNH) interventions is often influenced by important determinants and decision makers are often concerned with equity issues. The net-benefit framework developed and applied alongside clinical trials and in pharmacoeconomics offers the potential for exploring how cost-effectiveness of MNH interventions varies at the margin by important covariates as well as for handling uncertainties around the ICER estimate. Aim: We applied the net-benefit framework to analyze cost-effectiveness of the Skilled Care Initiative and assessed relative advantages over a standard computation of incremental cost effectiveness ratios. Methods: Household and facility surveys were carried out from January to July 2006 in Ouargaye district (where the Skilled Care Initiative was implemented) and Diapaga (comparison site) district in Burkina Faso. Pregnancy-related and perinatal mortality were retrospectively assessed and data were collected on place of delivery, education, asset ownership, place, and distance to health facilities, costs borne by households for institutional delivery, and cost of standard provision of maternal care. Descriptive and regression analyses were performed. Results: There was a 30% increase in institutional births in the intervention district compared to 10% increase in comparison district, and a significant reduction of perinatal mortality rates (OR 0.75, CI 0.70 20.80) in intervention district. The incremental cost for achieving one additional institutional delivery in Ouargaye district compared to