Increasing midwives, obstetricians, and family planning could prevent 69% of total deaths if scaled up to 99% of the national population, shows a new study published in PLoS One. The study used the Lives Saved Tool to model the potential maternal, fetal, and newborn lives and costs saved by scaling up midwifery and obstetrics services, including family planning, in 58 low- and middle-income countries.
The study explored the impact of typical midwifery and obstetrics interventions if scaled to either 60% of the national population (modest coverage) or 99% (universal coverage). It found that even a modest scale-up of midwifery services including family planning, reduced maternal, fetal, and neonatal deaths by 34%.
The analysis showed that increasing midwifery alone or integrated with obstetrics is more cost-effective than scaling up obstetrics alone; when family planning was included, the midwifery model was almost twice as cost-effective as the obstetrics model, at $2,200 versus $4,200 per death averted.
The most effective strategy was the most comprehensive: increasing midwives, obstetricians, and family planning could prevent 69% of total deaths under universal scale-up, yielding a cost per death prevented of just $2,100.
About the Lives Saved Tool (LiST)
LiST is a software application that estimates the impact on mortality of selected maternal, neonatal, and child health interventions when scaled up. This tool allows users to set up scenarios with different coverage levels and to estimate the impact of different intervention packages for their countries, states or districts. These scenarios provide a structured format for policy makers to combine the current evidence about effectiveness of interventions for maternal, neonatal, and child health interventions with information about cause of death and current coverage of interventions to inform their decision-making, prioritise investments and evaluate existing programmes.
Bartlett L, Weissman E, Gubin R, et al. The Impact and Cost of Scaling up Midwifery and Obstetrics in 58 Low- and Middle-Income Countries. PLoS One. 2014 Jun 18;9(6):e98550. doi: 10.1371/journal.pone.0098550. eCollection 2014