Table 5 Results of impact and cost of investment case analysis in Nepal
From: Investment case for improving maternal and child health: results from four countries
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) | |
Terai cluster | Hypertension (21%), Post-partum Haemorrhage (28%), Unsafe Abortion (7%), Ante-partum Haemorrhage (6%) * | Pneumonia (20%), Birth Asphyxia (10%), Preterm birth (9%), Neonatal Sepsis (8%) † | 23% (17%-28%) | 39% (35%-43%) | 18% (16%-19%) | $1.77 ($1.76-1.77) | $1.69 |
District Cluster IC Strategies: Community based education and promotion by Female Community Health Volunteers (FCHV), additional training for staff on family planning, breastfeeding and immunisation, upgrading health posts into primary health care centres, increased staffing to enable 24 hr facilities, capacity building for local logistical management, introduction of pneumococcal and Pentavalent vaccines, introduction of community based neonatal care | |||||||
31% (27%-35%) | 46% (42%-49%) | 20% (19%-22%) | $2.76 ($2.75-2.77) | $9.02 | |||
NHSPII Strategies: As above with additional NHSPII targets for coverage and infrastructure | |||||||
Hills cluster | Hypertension (21%), Post-partum Haemorrhage (28%), Unsafe Abortion (7%), Ante-partum Haemorrhage (6%) * | Pneumonia (22%), Birth Asphyxia (17%), Preterm birth (16%), Neonatal Sepsis (13%) † | 34% (30%-38%) | 57% (53%-61%) | 33% (31%-36%) | $2.03 ($1.98-2.00) | $0.72 |
District Cluster IC Strategies: Community based education and promotion by FCHV, additional training for staff on family planning, breastfeeding and immunisation, upgrading health posts into primary health care centres, increased staffing to enable 24hr facilities, capacity building for local logistical management, introduction of pneumococcal and Pentavalent vaccines, introduction of community based neonatal care | |||||||
40% (36%-44%) | 62% (58%-66%) | 36% (33%-38%) | $2.42 ($2.18-2.46) | $3.65 | |||
NHSPII Strategies: As above with additional NHSPII targets for coverage and infrastructure | |||||||
Mountains cluster | Hypertension (21%), Post-partum Haemorrhage (28%), Unsafe Abortion (7%), Ante-partum Haemorrhage (6%) * | Pneumonia (32%), Birth Asphyxia (15%), Preterm birth (14%), Neonatal Sepsis (12%) † | 26% (19%-32%) | 40% (30%-49%) | 24% (17%-29%) | $3.65 ($3.56-3.67) | $2.16 |
District Cluster IC Strategies: Community based education and promotion by FCHV, additional training for staff on family planning, breastfeeding and immunisation, upgrading health posts into primary health care centres, increased staffing to enable 24hr facilities, capacity building for local logistical management, introduction of pneumococcal and Pentavalent vaccines, introduction of community based neonatal care | |||||||
40% (35%-45%) | 57% (50%-64%) | 31% (26%-36%) | $4.20 ($4.07-4.28) | $4.02 | |||
NHSPII Strategies: As above with additional NHSPII targets for coverage and infrastructure | |||||||