ArticleGlobal health, science and practice2019
The Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and Zambia.
Article in Global health, science and practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia.BMC health services research · 2024Pooled it
- Estimating the impact and cost-effectiveness of antenatal care approaches in 24 low- and middle-income countries: a modelling study.BMC global and public health · 2026Article
- Cost of implementation and maintenance of maternal and perinatal death surveillance and response: a scoping review.BMC pregnancy and childbirth · 2025Article
- Integration of a Patient-Centered mHealth Intervention (Support-Moms) Into Routine Antenatal Care to Improve Maternal Health Among Pregnant Women in Southwestern Uganda: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- Economic analysis of a new four-panel rapid screening test in antenatal care in Kenya, Rwanda, and Uganda.BMC health services research · 2023Article
- Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ Approach of Curamericas: 10. Summary, cost effectiveness, and policy implications.International journal for equity in health · 2023Article
- A qualitative evaluation and conceptual framework on the use of the Birth weight and Age-at-death Boxes for Intervention and Evaluation System (BABIES) matrix for perinatal health in Uganda.BMC pregnancy and childbirth · 2023Article
- Article
- Cost-effectiveness of the dual prevention pill for contraception and HIV pre-exposure prophylaxis.Frontiers in reproductive health · 2023Article
- Patient and health system costs of managing pregnancy and birth-related complications in sub-Saharan Africa: a systematic review.Health economics review · 2020Review
- Health equity and COVID-19: global perspectives.International journal for equity in health · 2020Article
- The potential health and revenue effects of a tax on sugar sweetened beverages in Zambia.BMJ global health · 2020Article
- Saving Mothers, Giving Life: It Takes a System to Save a Mother (Republication).Global health, science and practice · 2019Article
- Saving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and Zambia.Global health, science and practice · 2019Article
- Sustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and Zambia.Global health, science and practice · 2019Article
- Saving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private Partnership.Global health, science and practice · 2019Article
- Saving Mothers, Giving Life: It Takes a System to Save a Mother.Global health, science and practice · 2019Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The primary objective of this study was to estimate the costs and the incremental cost-effectiveness of maternal and newborn care associated with the Saving Mothers, Giving Life (SMGL) initiative-a comprehensive district-strengthening approach addressing the 3 delays associated with maternal mortality-in Uganda and Zambia. To assess effectiveness, we used a before-after design comparing facility outcome data from 2012 (before) and 2016 (after). To estimate costs, we used unit costs collected from comparison districts in 2016 coupled with data on health services utilization from 2012 in SMGL-supported districts to estimate the costs before the start of SMGL. We collected data from health facilities, ministerial health offices, and implementing partners for the year 2016 in 2 SMGL-supported districts in each country and in 3 comparison non-SMGL districts (2 in Zambia, 1 in Uganda). Incremental costs for maternal and newborn health care per SMGL-supported district in 2016 was estimated to be US$845,000 in Uganda and $760,000 in Zambia. The incremental cost per delivery was estimated to be $38 in Uganda and $95 in Zambia. For the districts included in this study, SMGL maternal and newborn health activities were associated with approximately 164 deaths averted in Uganda and 121 deaths averted in Zambia in 2016 compared to 2012. In Uganda, the cost per death averted was $10,311, or $177 per life-year gained. In Zambia, the cost per death averted was $12,514, or $206 per life-year gained. The SMGL approach can be very cost-effective, with the cost per life-year gained as a percentage of the gross domestic product (GDP) being 25.6% and 16.4% in Uganda and Zambia, respectively. In terms of affordability, the SMGL approach could be paid for by increasing health spending from 7.3% to 7.5% of GDP in Uganda and from 5.4% to 5.8% in Zambia.
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