Evidence map›Paper›PMID 16282407›Full record

ArticleBMJ (Clinical research ed.)2005

Cost effectiveness analysis of strategies for maternal and neonatal health in developing countries.

Taghreed Adam, Stephen S Lim, Sumi Mehta, Zulfiqar A Bhutta, Helga Fogstad, Matthews Mathai, Jelka Zupan, Gary L Darmstadt

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 145 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
145citing papers in PubMed, 19 pooled it
23.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

145 citing papers in PubMed, 19 syntheses or guidelines pooled it, 368 citations in OpenAlex.

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  18. 60 Million non-facility births: who can deliver in community settings to reduce intrapartum-related deaths?International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2009
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85 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 4 countries.

Taghreed AdamHealth Systems Financing, Evidence and Information for Policy, World Health Organization, Switzerland.
Stephen S Lim
Sumi Mehta
Zulfiqar A Bhutta
Helga Fogstad
Matthews Mathai
Jelka Zupan
Gary L Darmstadt
World Health Organization - Pakistan · PKHealth Effects Institute · USJohns Hopkins University · USWorld Health Organization · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the costs and benefits of interventions for maternal and newborn health to assess the appropriateness of current strategies and guide future plans to attain the millennium development goals.

designCost effectiveness analysis.

settingTwo regions classified by the World Health Organization according to their epidemiological grouping: Afr-E, those countries in sub-Saharan Africa with very high adult and high child mortality, and Sear-D, comprising countries in South East Asia with high adult and high child mortality. DATA SOURCES: Effectiveness data from several sources, including trials, observational studies, and expert opinion. For resource inputs, quantities came from WHO guidelines, literature, and expert opinion, and prices from the WHO choosing interventions that are cost effective database.

main outcome measuresCost per disability adjusted life year (DALY) averted in year 2000 international dollars.

resultsThe most cost effective mix of interventions was similar in Afr-E and Sear-D. These were the community based newborn care package, followed by antenatal care (tetanus toxoid, screening for pre-eclampsia, screening and treatment of asymptomatic bacteriuria and syphilis); skilled attendance at birth, offering first level maternal and neonatal care around childbirth; and emergency obstetric and neonatal care around and after birth. Screening and treatment of maternal syphilis, community based management of neonatal pneumonia, and steroids given during the antenatal period were relatively less cost effective in Sear-D. Scaling up all of the included interventions to 95% coverage would halve neonatal and maternal deaths.

conclusionPreventive interventions at the community level for newborn babies and at the primary care level for mothers and newborn babies are extremely cost effective, but the millennium development goals for maternal and child health will not be achieved without universal access to clinical services as well.

Indexed as

Developing CountriesAfrica South of the SaharaAsia, SoutheasternCost-Benefit AnalysisFemaleHumansInfant MortalityInfant, NewbornMaternal Health ServicesMaternal MortalityPerinatal CarePregnancyQuality-Adjusted Life Years

Identifiers

PMID16282407
PMCPMC1283271
OpenAlexW1965425585

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.