Study

Country/ time period

Intervention

Approach

Health facility type

Total Costs

Outcome

Cost per outcome

(Ande et al . 1997)

Nigeria 1992-95

Improve EOC and blood bank

- Restore surgical theatre (repair/ purchase equipment)
- Renovate maternity ward
- Training physicians/midwives in obstetrics and installed emergency drug pack system and set up revolving drug fund²⁴.
Introduce system of blood donation for families of women attending antenatal care.
- Additional staff
- Repair blood bank and standby generator.

District hospital

$12,779 plus $938 per year recurrent salary. Total $15,593.

10 more admissions and 7 deliveries

$1559.3 per admission and $2227.6/delivery

(Djan et al . 1997)

Ghana 1993-95

Also establish running water supply.

Health centre

$30,316

100 more obstetric admission; 43 deliveries; 67 cases of obstetric surgery (OS)

$301 per admission, $705 per delivery, $452.5 per case of OS

(Leigh et al . 1997)

Sierra Leone 1990-95

Posted a physician with obstetric skills and 2^nd physician was trained and nurses and midwives..

District hospital

$38,957 (incl new generator: $16,000)

156 more admissions, 464 obstetric procedures²⁵

$250 per admission and $84 per obstetric procedure.

(Oyesola et al . 1997)

Nigeria 1991-95

Improve EOC no blood bank

- Set up electric supply.

State referral hospital

$12,289

105 more admissions and 21 de-liveries.

$117 per admission and $585 per delivery.

(Olukoya et al . 1997)

Nigeria 1994-95

Secondary referral hospital

$45,505

204 more obstetric admissions

$223 per admission.

(Sabitu et al . 1997)

- Restored ambulance

Secondary facility

$31,827 (incl new staff costs: $7,270)

1241 more deliveries and 2329 additional attendances for ANC²⁶

$25.65 per delivery; $13.67 per ANC visit.

(Gold et al . 1996)

Nigeria 1994

Establishing a bloodbank

- Establish blood bank, backup generator, reagents and sup-plies.
- Refresher training to on e laboratory technician.
- Education campaign to encourage blood donation.

Small hospital

$8,800

14 blood transfusions

$628.57 per transfusion

(Sengeh et al . 1997)

Sierra Leone 1992-93

District hospital

$9,869

197 additional blood units drawn, case fatality rate reduced by 8

$50.01/case of blood; $1233 per death averted.

(Ottong et al . 1997)

Nigeria 1991-94

- Upgrade blood facilities in teaching hospital and secondary facility.
- 15 community mobilisation sessions.

Teaching hospital & secondary referral hospital

$17,531

increase 41 pints of blood and 21 additional blood transfusions

$282.76 per pint transferred.

(Senah et al . 1997)

Ghana 1992-95

Establish MCH/FP clinic

- Renovate an abandoned ware-house
- Equip with beds, refrigerator, safe water supply, drugs and supplies.
- Posted community health nurse and senior nurse-midwife.
- Training of 10 TBAs.

Health centre

$12,550 assume $3000 per year recurrent staff salaries. Total: $24,550

702 antenatal registrants; 86 deliveries.

$34.97 per antenatal registrant; $285.47 per deli-very.

(Samai & Sengeh 1997)

Sierrra Leone 1992-93

Improve transport and communication to EOC

- 4-wheel drive posted to hospital and radio (x10) linking system to primary health units.
- Community education activities.
- Bicycles (x2)

PHU to hospital

$46,836

21 cases referred with vehicle

$2230 per referred case;

(Shehu et al . 1997)

Nigeria 1993-95

- Trained drivers from the local transport union
- Set up a revolving emergency fuel fund.

Home to hospital

$268

56 transportations

$4.79 per case

( Wilson et al . 1997 )

Ghana 1992-94

Maternity waiting home

- Ward of abandoned hospital renovated and furnished: 8 old beds repaired.

maternity waiting home

$10,505

Lack of staff: 25 women ref-erred only 1 stayed.

NA