This paper reviews the evidence on the cost of providing maternal health services, the use of disability-adjusted life years (DALYs) in the evaluation of the cost-effectiveness of these services, and alternative sources of financing maternal health services. The findings suggest that, for most interventions, care can be provided most cheaply at the primary care level. Personnel and drugs are the main components of cost. Community-based studies indicate that for the provision of emergency obstetric care, the focus should be on improving existing facilities. However, cross-study/country comparisons are difficult due to the inconsistency of costing methods and definitions of maternal health. While the use of DALYs as an outcome measure can help to justify the cost-effectiveness of maternal health interventions, compared to interventions, which target other disease areas, DALYs may underestimate the true burden of maternal mortality and undervalue an intervention’s cost-effectiveness due to the infrequency of maternal mortality.
Borghi, J. What is the cost of maternal health care and how can it be financed ? In: Van Lerberghe, W.; Kegels, G.; De Brouwere, V. (Eds), Studies in Health Services Organisation & Policy. ITGPress, Antwerp, Belgium (2001) 243-292. ISBN 90-76070-19-9