移动医疗在尼日利亚产前护理和医疗机构分娩中的成本效益。
Cost Effectiveness of Mobile Health for Antenatal Care and Facility Births in Nigeria.
机构信息
Heller School for Social Policy and Management, Brandeis University, US.
Pardee RAND Graduate School, US.
出版信息
Ann Glob Health. 2018 Nov 5;84(4):592-602. doi: 10.9204/aogh.2364.
BACKGROUND
The use of mobile technology in the health sector, often referred to as mHealth, is an innovation that is being used in countries to improve health outcomes and increase and improve both the demand and supply of health care services. This study assesses the actual cost-effectiveness of initiating and implementing the use of the mHealth as a supply side job aid for antenatal care. The study also estimates the cost-effectiveness ratio if mHealth was also used to encourage and track women through facility delivery.
METHODS
The methodology utilized a retrospective, micro-costing technique to extract costing data from health facilities and administrative offices to estimate the costs of implementing the mHealth antenatal care program and estimate the cost of facility delivery for those that used the antenatal care services in the year 2014. Five different costing tools were developed to assist in the costing analysis.
FINDINGS
The results show that the provision of tetanus toxoid vaccination and malaria prophylaxis during pregnancy and improved labor and delivery during facility delivery contributed the most to mortality reductions for women, neonates and stillbirths in mHealth facilities versus non-mHealth facilities. The cost-effectiveness ratio of this program for antenatal care and no demand-side generation for facility delivery is US$13,739 per life saved. The cost-effectiveness ratio adding in an additional demand-side generation for facility births reduces to US$9,806 per life saved.
CONCLUSION
These results show that mHealth programs are inexpensive and save a number of lives for the dollar investment and could save additional lives and funds if women were also encouraged to seek facility delivery.
背景
移动技术在医疗领域的应用，通常被称为移动医疗（mHealth），是一种创新，正在被各国用于改善健康结果，并增加和改善医疗服务的供需。本研究评估了启动和实施使用移动医疗作为产前护理供应方辅助工具的实际成本效益。该研究还估计了如果移动医疗也被用于鼓励和跟踪妇女进行设施分娩的成本效益比。
方法
该方法利用回顾性微观成本核算技术，从卫生设施和行政办公室提取成本数据，以估计实施移动医疗产前护理计划的成本，并估计 2014 年使用产前护理服务的人在设施分娩的成本。开发了五种不同的成本核算工具来协助成本分析。
结果
结果表明，在移动医疗设施中，为孕妇提供破伤风类毒素疫苗接种和疟疾预防，以及改善设施分娩期间的劳动和分娩，对降低妇女、新生儿和死产的死亡率贡献最大。该项目用于产前护理和无设施分娩需求侧产生的成本效益比为每挽救一条生命 13739 美元。如果鼓励妇女也寻求设施分娩，将额外的需求侧生育产生纳入成本效益比，每挽救一条生命的成本降低至 9806 美元。
结论
这些结果表明，移动医疗项目成本低廉，每投资一美元可挽救许多生命，如果鼓励妇女也寻求设施分娩，还可以挽救更多的生命和资金。
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