13. What Is the Cost of Maternal Health Care and How Can it Be Financed?: Introduction

13. What Is the Cost of Maternal Health Care and How Can it Be Financed?

		(introduction...)
		Summary
		Introduction
		Methods
		Cost of Maternal Health Services
		The Use of DALYs for the Evaluation of Maternal Health Interventions
		Trends in Domestic and International Expenditure on Maternal Health Services
		Alternative Financing Methods for Maternal Health Services
		Conclusions
		References
		Appendix 1. Definitions
		Appendix 2. Cost of Specific Components of Maternal Health Care
		Appendix 3
		Appendix 4. Background and Approach to Calculation of DALYs
		Appendix 5

Introduction

This review paper is composed of three sections. The first section reviews the evidence on the cost of maternal health services. While the importance of providing maternal health services is universally recognised there is limited information available on the cost of providing these services. Cost information - both measures of unit cost and cost-effectiveness - serves as a critical input into the processes of setting priorities and allocating resources efficiently. Cost studies of maternal health interventions help to assess how well resources are used in different types of health facilities and can provide policymakers with information on how to improve the efficiency and effectiveness of service delivery as well as to assess how adequately funded these services are (Levin, McEuen, Dymatraczenko et al. 2000). Hence these studies are useful for the development of health financing schemes in-country. To this end country-specific studies are more useful than global estimates based on hypothetical models.

The second section considers the measurement of the effectiveness of maternal health interventions. We discuss the benefits and disadvantages of using the disability-adjusted life year (DALY) in the evaluation of maternal health programmes and examples of its use in the literature. The third section considers the financing of maternal health services. To understand the viability of specific maternal health interventions in the context of resource constrained economies it is important to consider from where the financing will come. We therefore discuss the trend in government and donor expenditure on maternal and child health care and some examples of alternative ways of financing maternal health care.