Banke-Thomas, Aduragbemi ORCID: https://orcid.org/0000-0002-4449-0131, Wilson-Jones, Megan, Madaj, Barbara and van den Broek, Nynke (2017) Economic evaluation of emergency obstetric care training: a systematic review. BMC Pregnancy and Childbirth, 17:403. ISSN 1471-2393 (Print), 1471-2393 (Online) (doi:10.1186/s12884-017-1586-z)

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Abstract

Background
Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings.
Methods
Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness.
Results
Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult.
Conclusions
Economic evaluations of EmOC training are limited. There is a need to scale-up and standardise processes that capture both cost and effectiveness of training and to agree on suitable economic evaluation models that allow for comparability across settings.
Trial registration PROSPERO_CRD42016041911.

Item Type:	Article
Uncontrolled Keywords:	Emergency obstetric care, Training, Economic evaluation, Cost analysis, Cost-effectiveness analysis, Cost-utility analysis, Cost-benefit analysis, Value-for-money
Subjects:	H Social Sciences > HC Economic History and Conditions R Medicine > RG Gynecology and obstetrics R Medicine > RT Nursing
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM) Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families
Related URLs:	Publisher
Last Modified:	08 Apr 2022 13:38
URI:	http://gala.gre.ac.uk/id/eprint/34185

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