Cost-effectiveness of reducing maternal mortality in Malawi

Abstract: Malawi has one of the highest maternal mortality ratios in the world. The Government of Malawi developed, in 2005, a Road Map with interventions to reduce the maternal mortality and morbidity in the country. Implementations of the programmes have, however, been critically slow. This study investigates the cost-effectiveness of the proposed interventions listed in the Road Map by looking at one district. This was done by gathering information on district-specific needs in order to reach the target coverage of maternal health services. The effectiveness was measured in life-years gained with the percentage of skilled attendance at delivery’s effect on maternal mortality ratio as a proxy for the effects of the programmes. The analysis showed the programmes to be cost-effective with a cost of 1,275 US dollars (2000) per life-year gained. The findings are coherent with those of previous studies of maternal health interventions verifying cost-efficiency. What has been achieved in this study in addition to previous research is a broader inclusion of associated costs such as interventions targeting the human resource crisis in the country.