Department of Community Health, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, KK 19 Avenue 101, Kigali, Rwanda.
Department of Maternal and Child Health, Partners In Health/Inshuti Mu Buzima, KG 9 Ave, 46 Nyarutarama, Kigali, Rwanda.
Int J Qual Health Care. 2019 Jun 1;31(5):359-364. doi: 10.1093/intqhc/mzy179.
To estimate cost-effectiveness of Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) intervention to strengthen the quality of antenatal care at rural health centers in rural Rwanda.
Cost-effectiveness analysis of the MESH-QI intervention using the provider perspective.
Kirehe and Rwinkwavu District Hospital catchment areas, Rwanda.
MESH-QI.
Incremental cost per antenatal care visit with complete danger sign and vital sign assessments.
The total annual costs of standard antenatal care supervision was 10 777.21 USD at the baseline, whereas the total costs of MESH-QI intervention was 19 656.53 USD. Human resources (salary and benefits) and transport drove the majority of program expenses, (44.8% and 40%, respectively). Other costs included training of mentors (12.9%), data management (6.5%) and equipment (6.5%). The incremental cost per antenatal care visit attributable to MESH-QI with all assessment items completed was 0.70 USD for danger signs and 1.10 USD for vital signs.
MESH-QI could be an affordable and effective intervention to improve the quality of antenatal care at health centers in low-resource settings. Cost savings would increase if MESH-QI mentors were integrated into the existing healthcare systems and deployed to sites with higher volume of antenatal care visits.
评估 Mentorship、enhanced Supervision for Healthcare 和 Quality Improvement（MESH-QI）干预措施在加强卢旺达农村卫生中心产前护理质量方面的成本效益。
采用提供者视角对 MESH-QI 干预措施进行成本效益分析。
卢旺达基雷和鲁温卡武区医院集水区。
MESH-QI。
完全危险标志和生命体征评估的每次产前护理就诊的增量成本。
基线时标准产前护理监督的年总成本为 10777.21 美元，而 MESH-QI 干预的总成本为 19656.53 美元。人力资源（工资和福利）和交通推动了项目支出的大部分（分别占 44.8%和 40%）。其他成本包括导师培训（12.9%）、数据管理（6.5%）和设备（6.5%）。归因于 MESH-QI 的每次产前护理就诊的增量成本，对于所有评估项目完成的危险标志为 0.70 美元，生命体征为 1.10 美元。
MESH-QI 可能是一种负担得起且有效的干预措施，可以提高资源匮乏环境中卫生中心的产前护理质量。如果 MESH-QI 导师被整合到现有医疗保健系统中，并部署到产前护理就诊量较高的地点，成本节约将会增加。
