dc.contributor.author | Hu, Delphine | |
dc.contributor.author | Bertozzi, Stefano M. | |
dc.contributor.author | Gakidou, Emmanuela | |
dc.contributor.author | Hoffman, Daniel | |
dc.contributor.author | Sweet, Steven Goldie | |
dc.contributor.author | Goldie, Sue J. | |
dc.date.accessioned | 2010-11-18T14:26:03Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | Hu, Delphine, Stefano M. Bertozzi, Emmanuela Gakidou, Steve Sweet, and Sue J. Goldie. 2007. The Costs, benefits, and cost-effectiveness of interventions to reduce maternal morbidity and mortality in Mexico. PLoS ONE 2(8). | en_US |
dc.identifier.issn | 1932-6203 | en_US |
dc.identifier.uri | http://nrs.harvard.edu/urn-3:HUL.InstRepos:4578394 | |
dc.description.abstract | Background: In Mexico, the lifetime risk of dying from maternal causes is 1 in 370 compared to 1 in 2,500 in the U.S. Although national efforts have been made to improve maternal services in the last decade, it is unclear if Millennium Development Goal 5 - to reduce maternal mortality by three-quarters by 2015 - will be met. Methodology/Principal Findings: We developed an empirically calibrated model that simulates the natural history of pregnancy and pregnancy-related complications in a cohort of 15-year-old women followed over their lifetime. After synthesizing national and sub-national trends in maternal mortality, the model was calibrated to current intervention-specific coverage levels and validated by comparing model-projected life expectancy, total fertility rate, crude birth rate and maternal mortality ratio with Mexico-specific data. Using both published and primary data, we assessed the comparative health and economic outcomes of alternative strategies to reduce maternal morbidity and mortality. A dual approach that increased coverage of family planning by 15%, and assured access to safe abortion for all women desiring elective termination of pregnancy, reduced mortality by 43% and was cost saving compared to current practice. The most effective strategy added a third component, enhanced access to comprehensive emergency obstetric care for at least 90% of women requiring referral. At a national level, this strategy reduced mortality by 75%, cost less than current practice, and had an incremental cost-effectiveness ratio of $300 per DALY relative to the next best strategy. Analyses conducted at the state level yielded similar results. Conclusions/Significance: Increasing the provision of family planning and assuring access to safe abortion are feasible, complementary and cost-effective strategies that would provide the greatest benefit within a short-time frame. Incremental improvements in access to high-quality intrapartum and emergency obstetric care will further reduce maternal deaths and disability. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Public Library of Science | en_US |
dc.relation.isversionof | doi:10.1371/journal.pone.0000750 | en_US |
dc.relation.hasversion | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1939734/pdf/ | en_US |
dash.license | LAA | |
dc.subject | women's health | en_US |
dc.subject | public health and epidemiology | en_US |
dc.subject | obstetrics | en_US |
dc.subject | evidence-based healthcare | en_US |
dc.title | The Costs, Benefits, and Cost-Effectiveness of Interventions to Reduce Maternal Morbidity and Mortality in Mexico | en_US |
dc.type | Journal Article | en_US |
dc.description.version | Version of Record | en_US |
dc.relation.journal | PLoS ONE | en_US |
dash.depositing.author | Goldie, Sue J. | |
dc.date.available | 2010-11-18T14:26:03Z | |
dash.affiliation.other | SPH^Health Policy and Management | en_US |
dc.identifier.doi | 10.1371/journal.pone.0000750 | * |
dash.authorsordered | false | |
dash.contributor.affiliated | Sweet, Steven | |
dash.contributor.affiliated | Goldie, Sue | |