an Eldis Resource
Estimating the cost of scaling-up maternal and newborn health interventions to reach universal coverage: methodology and assumptions
Achieving MDG 5: Strategies to ensure better maternal and newborn health
Authors:
; Department of Making Pregnancy Safer; Health Systems Financing for the World Health Report 2005
Publisher:
World Health Organization , 2005
The focus of this working paper is on providing all the relevant background information on the methodology, key parameters and assumptions used to estimate the costs of expanding the coverage of skilled maternal and newborn health (MNH) care at facilities towards universal access, which is defined here as 95% coverage. The cost estimates presented in this report are only indicative, as many factors may influence the expansion of coverage and the actual costs of services.
Key results of costing exercise:
• Although effective maternal and newborn health interventions are known, countries with low coverage of skilled attendance at childbirth and limited capacity for emergency obstetric care will experience difficulties in effectively scale-up MNH care.
• To meaningfully increase coverage in the medium to long term requires new commitments to training and retaining staff and improving the supportive health system.
• Scaling-up the 67 MNH interventions will not only require significant increase in expenditures, but an ambitious and realistic scale-up plan and strategy that takes into account the present levels of coverage, and the relative strengths and capacity of the health systems (including human resource needs) in each country.
• It will take considerable efforts for countries with very weak health systems to build up their capacity to reach the desired and needed coverage levels.
• In countries with a low HSC rating, the challenges that impede increasing coverage must be identified and targeted, particularly accessibility, human resource inputs, and the supply of commodities and drugs.
• Reaching rural, underserved and poor populations requires particular attention and participatory demand creation may be necessary.
• Short to long term strategies will need to be developed and implemented in parallel to ensure the attainment of universal coverage of skilled care is sustained.
• Providing universal coverage and access to care during pregnancy, childbirth, the postpartum and post-natal period. This is also important to address and improve equity in health.
• Political will is essential to ensure universal coverage and financial protection. The largest effort is needed in the poorest and most aid-dependent countries.
• The results obtained will be slowest in the countries where the largest effort is made – that is necessary in order to reduce the growing gap between countries and to move towards achieving the MDGs in all countries of the world.
