Millions in Annual National Savings Could Be Realized From Improving the Quality of Uterotonic Medications in Sub-Saharan Africa
Author(s)
Yi-Fang A. Lee, MHA1, Colleen Higgins, MSPH1, Petra Procter, MSc2, Sara Rushwan, PhD2, A. Metin Gülmezoglu, MD2, Lester Chinery, PhD2, Sachiko Ozawa, PhD, MHS1;
1UNC Chapel Hill, Chapel Hill, NC, USA, 2Concept Foundation, Geneva, Switzerland
1UNC Chapel Hill, Chapel Hill, NC, USA, 2Concept Foundation, Geneva, Switzerland
OBJECTIVES: Uterotonics like oxytocin and misoprostol are crucial for preventing postpartum hemorrhage (PPH), a leading cause of maternal deaths worldwide. However, in many low- and middle-income countries (LMICs), the prevalence of substandard uterotonics reduces their effectiveness, leading to preventable health issues and cost burden on patients and governments. This study quantifies the benefits of improving uterotonic quality in Ghana, Nigeria, and Senegal.
METHODS: A decision-tree model was used to simulate the effects of substandard uterotonics on PPH risk, diagnosis, costs, and outcomes in three Sub-Saharan African countries. The model included country-specific data on delivery settings, uterotonic quality, and PPH-related costs, sourced from Demographic and Health Surveys, E-MOTIVE trial data, and published literature. Results were standardized to 100,000 births for cross-country comparison.
RESULTS: Enhancing uterotonic quality showed significant health and economic benefits across all countries. In Ghana, improved uterotonic quality resulted in $2 million (13%) annual cost savings and 2,200 (11%) fewer PPH cases per 100,000 births. Nigeria and Senegal saw annual savings of $1.1 million (7%) and $224,000 (7%), with 944 (4%) and 875 (6%) fewer PPH cases, respectively. When scaled by population size, total annual national savings were $89 million in Nigeria, $18.8 million in Ghana, and $1.3 million in Senegal, collectively preventing 100,000 PPH cases annually.
CONCLUSIONS: Ensuring uterotonic quality would yield significant economic and health benefits across all three countries. Poor-quality uterotonics fail to prevent PPH effectively, increasing maternal mortality risks and healthcare costs. Tailored, country-specific interventions are essential to achieve these outcomes, ensuring medication quality and supporting Universal Health Coverage goals.
METHODS: A decision-tree model was used to simulate the effects of substandard uterotonics on PPH risk, diagnosis, costs, and outcomes in three Sub-Saharan African countries. The model included country-specific data on delivery settings, uterotonic quality, and PPH-related costs, sourced from Demographic and Health Surveys, E-MOTIVE trial data, and published literature. Results were standardized to 100,000 births for cross-country comparison.
RESULTS: Enhancing uterotonic quality showed significant health and economic benefits across all countries. In Ghana, improved uterotonic quality resulted in $2 million (13%) annual cost savings and 2,200 (11%) fewer PPH cases per 100,000 births. Nigeria and Senegal saw annual savings of $1.1 million (7%) and $224,000 (7%), with 944 (4%) and 875 (6%) fewer PPH cases, respectively. When scaled by population size, total annual national savings were $89 million in Nigeria, $18.8 million in Ghana, and $1.3 million in Senegal, collectively preventing 100,000 PPH cases annually.
CONCLUSIONS: Ensuring uterotonic quality would yield significant economic and health benefits across all three countries. Poor-quality uterotonics fail to prevent PPH effectively, increasing maternal mortality risks and healthcare costs. Tailored, country-specific interventions are essential to achieve these outcomes, ensuring medication quality and supporting Universal Health Coverage goals.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE524
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Reproductive & Sexual Health