Table 2.
Results of impact and cost of investment case analysis in Philippines
| |
Key causes of death |
Impact (% Reduction over 5 years) |
Cost ($US) |
||||
|---|---|---|---|---|---|---|---|
| Maternal | Under-5 | Maternal mortality ratio | Neonatal mortality rate | Under-5 mortality rate | Annual marginal recurrent cost (per capita) | First year capital cost (per capita) | |
| Pasay City |
Post-partum Haemorrhage (34%), Ante-partum Haemorrhage (33%), Hypertension (33%)* |
Neonatal Sepsis (20%), Preterm birth (15%), Congenital Abnormalities (15%), Pneumonia (11%) § |
13% (11%-15%) |
5% (4%-6%) |
5% (4%-7%) |
$0.73 ($0.61-0.92) |
$0.05 |
| Key Strategies: Improved regulation and engagement with private sector, review of health facility reimbursement practices, training of clinical staff in family planning, IMCI, nutrition and monitoring and evaluation procedures, training in emergency neonatal care for private providers, revitalisation of community health teams to actively provide routine health services and health promotion, and improved commodity supply | |||||||
| 13% (12%-16%) |
5% (4%-6%) |
5% (4%-7%) |
$1.29 ($1.19-1.49) |
$0.74 |
|||
| Facility Construction Scenario Strategies: As above, with additional construction of 2 public Lying-In clinics | |||||||
| Northern Samar |
Post-partum Haemorrhage (64%), Hypertension (18%), Ante-partum Haemorrhage (9%), Sepsis/Infection (9%) † |
Pneumonia (19%), Diarrhoea (10%), Neonatal Sepsis (10%), Preterm birth (8%), Congenital Abnormalities (8%) § |
39% (32%-46%) |
25% (20%-29%) |
17% (14%-19%) |
$2.20 ($2.01-2.40) |
$2.72 |
| Key Strategies: Training of clinical staff in IMCI, nutrition and essential maternal and newborn care, establishment of community health teams to actively provide routine health services and health promotion, establishment of insurance membership services, campaign for facility based delivery including monitoring of compliance with applicable regulations, upgrading of hospital and primary health care facilities, recruitment of additional midwives and improved commodity supply processes | |||||||
| Eastern Samar |
Hypertension (33%), Sepsis/Infection (28%), Post-partum Haemorrhage (22%), Ante-partum Haemorrhage (17%) ‡ |
Neonatal Sepsis (16%), Pneumonia (14%), Congenital Abnormalities (13%), Preterm birth (12%), Diarrhoea (7%) § |
45% (40%-50%) |
26% (23%-28%) |
20% (18%-22%) |
$5.15 ($4.70-5.44) |
$7.12 |
| Key Strategies: Training of clinical staff in essential maternal and newborn care, establishment of community health teams to actively provide routine health services and health promotion, establishment of insurance membership services, campaign for facility based delivery including monitoring of compliance with applicable regulations, upgrading of hospital and upgrading and construction of primary health care facilities, recruitment of additional midwives and improved commodity supply processes | |||||||
* Source: (2) Pasay City Health Office. Pasay City Vital Statistics. Manila, Philippines: Department of Health2008.
† Source : (9) North Samar Provincial Health Office. Annual Report. Manila, Philippines: Department of Health2008.
‡ Source: (10) East Samar Provincial Health Office. Maternal Death Review. Manila, Philippines: Department of Health2009.
§ Source: (17) Provincial Estimate Department of Health- National Epidemiology Center. The 2004 Philippine Health Statistics. Manila: Department of Health; 2004.
Results are based on point estimates and ranges calculated assuming −/+10% of intervention coverage determined by policymakers.