Estimated Cost of Providing Essential Obstetric Care Packages

Table 01 in Appendix 3 presents the findings of the Prevention of Maternal Mortality Network (PMMN). The alternative models are presented along with the estimated costs and outcomes of the community programmes delivered in hospitals and health centres in West Africa.

Community programmes have a vital place in emergency obstetric care because they can ensure women’s access to such care when needed. In general costs are lowest, and sustainability greatest, in programmes that make use of existing capacity. Otherwise stated, the costs of EOC need not be costly when the necessary facilities, equipment and staff are in place. Renovation of facilities, repair of equipment and training of staff, although not without cost, cost substantially less than developing new facilities.

The cost of improving emergency obstetric care by renovating facilities and equipment varied between US$250 (Leigh, Kandeh, Kanu et al . 1997)- US$1559.3 (Ande, Chiwuzie, Akpala et al . 1997) per additional admission with a blood bank, and US$117 (Oyesola, Shehu, Ikeh et al. 1997)-US$223 (Olukoya, Ogunyemi, Akitoye et al . 1997) without. However, the presence of a functioning blood bank enables the safe conduct of obstetric surgery, significantly reducing the risk of maternal death.

One of the barriers to accessing health care for women in rural areas, not well served by health facilities, is transport: the lack of transport or its exorbitant costs. The most cost-effective model was described in Nigeria (Shehu, Ikeh & Kuna 1997), using trained drivers from the local transport union, with the cost per transportation amounting to US$4.67 per case.

The example of Ghana (Senah, Richardson, Kwofie et al . 1997) indicates that the renovation of an abandoned warehouse to serve as a health centre and provide MCH/FP clinics was highly cost-effective.

Whereas the maternity waiting home concept, although low in cost was ineffective in mobilising community utilisation (Wilson, Collison, Richardson et al . 1997).