Evidence map›Paper›PMID 40261858›Full record

ArticlePLOS global public health2025

Cost-effectiveness results comparing heat-stable carbetocin & other uterotonics in postpartum heamorrhage prevention in Uganda.

Sam Ononge, Othman Kakaire, Jostas Mwembezi, Hadijah Nakatudde, Robert Mutumba, Richard Mugahi

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

6 authors.

Sam OnongeDepartment of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.ORCID https://orcid.org/0000-0002-7561-0167
Othman KakaireDepartment of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
Jostas MwembeziRwenzori Center for Research and Advocacy, Fort-Portal, Uganda.ORCID https://orcid.org/0009-0003-9652-3104
Hadijah NakatuddeReproductive and Infant Health Division Ministry of Health, Kampala, Uganda.
Robert MutumbaReproductive and Infant Health Division Ministry of Health, Kampala, Uganda.
Richard MugahiReproductive and Infant Health Division Ministry of Health, Kampala, Uganda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In Uganda, postpartum haemorrhage (PPH) is responsible for 34% of all institutional maternal deaths. Injectable oxytocin is the preferred uterotonic for prevention of PPH. However, in resource-limited settings, the effectiveness of oxytocin is sub-optimal due to efficacy, quality (cold chain storage requirements), and manufacturing standards (poor quality active pharmaceutical ingredients, lack of sterile manufacturing environment, and low-quality manufacturing processes). This study aimed to assess the cost-effectiveness of heat-stable carbetocin, a quality uterotonic newly recommended by WHO and Ugandan Ministry of Health, compared to standard uterotonics for the prevention of PPH in Uganda. A decision tree model was built to assess the cost-effectiveness of heat-stable carbetocin compared to the current standards of care - oxytocin, misoprostol or oxytocoin+misoprostol combination. The model was applied to a hypothetical annual cohort of birthing women eligible for PPH prevention in Uganda's public health facilities. The evaluation considered direct costs and health outcomes using a public health perspective. The model inputs were obtained through literature review and, whenever referencable information was unavailable or incomplete, from key opinion leaders. Compared to oxytocin, administering heat-stable carbetocin to prevent PPH had a cascading favorable effect and was estimated to avert 57,536 PPH cases, 123 maternal deaths, and 4,203 disability-adjusted life years (DALYs). Heat-stable carbetocin is also cost-saving where the direct cost to the public healthcare system was lower by USD $1,058,353 (UGX 3,998,350,875). The benefits of heat-stable carbetocin were even greater when compared with misoprostol (averted 73,939 PPH events, 273 maternal deaths, and 8,716 DALYs, and lowered public healthcare system costs by USD $2,118,372 [UGX 8,002,996,052]). Heat-stable carbetocin for preventing PPH in Uganda has the potential to reduce PPH events, and subsequently maternal deaths, DALYs, and costs for the public healthcare system. Adopting heat-stable carbetocin will contribute towards achieving the country's Sustainable Development Goal 3.1.

Identifiers

PMID40261858
PMCPMC12013952

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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.