ArticleHealth services insights2025
Economic Evaluation of Free Prevention of Mother-to-Child Transmissions (PMTCT) Services to Non-South African Women Living in South Africa.
Article in Health services insights, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Approximately 1.33 million pregnancies are recorded in South Africa annually. About 30% of all pregnant women are HIV positive, posing a serious risk to unborn children. However, effective interventions such as prevention of mother-to-child transmissions (PMTCT) services have been shown to significantly reduce the risk of mother-to-child or vertical transmission. Migrant women in South Africa face challenges in accessing [free] healthcare services. This study aims to assess the cost-effectiveness of providing free PMTCT services to migrant women living in South Africa. We employed cost-effectiveness analysis methodology to establish the cost and outcomes (averted pediatric infections and averted disability-adjusted life years (DALYs)) associated with free PMTCT services for migrant women. The comparator was provision of only antenatal care (ANC) while the intervention was ANC + PMTCT services. A Microsoft Excel-based decision tree model was designed to achieve the study objectives. Data on costs and health outcomes for each intervention was sourced from the literature on HIV/AIDS. The prevalence-based study is conducted from a public sector healthcare payer perspective. Provision of ANC + PMTCT services to migrants will prevent 14 562 new infections among 52 762 HIV positive pregnant women. The estimated total expected cost of ANC + PMTCT service was US$52 889 per 1000 live births compared to US$191 000 for ANC only per 1000 live births. The expected cost for the do-nothing scenario was US$73 535 per 1000 live births. The expected health benefit (ie, averted DALYs) associated with do-nothing scenario, ANC, and ANC + PMTCT were 277, 265 and 76 DALYs, respectively. ANC + PMTCT service provision produces the lowest DALYs at lower cost thereby producing cost-saving of US$733/DALY averted per 1000 live births. Further, an average of US$1.5 million would be required annually to achieve 100% coverage of HIV+ migrant women. Therefore, provision of ANC and PMTCT services to migrant women is cost-effective when compared to not offering PMTCT services and allows the government to avoid the long-term cost of antiretroviral therapy (ART) provision.
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