Assessing value-for-money in maternal and newborn health

News article 3 Aug 2017
UNICEF Ethiopia 2015, Tesfaye

A recent analysis paper, led by CMNH, reviews Value for Money in maternal and newborn health.

Globally, there has been increasing demand by governments and international agencies for implementers and researchers to demonstrate value-for-money (VfM) of global health interventions. Specifically, in maternal and newborn health (MNH), where the focus is on improving pregnancy experience and outcomes for mothers and their newborns throughout the continuum of care, calls for stronger accountability and performance monitoring to ensure VfM have been made by multiple stakeholders. In low- and middle-income countries (LMICs) where the burden of mortality and morbidity is highest, this call comes against the backdrop of increasing donor disbursements (US$2,500 million based on a 2013 estimate) for MNH interventions.  Despite, this increasing call, there is no VfM analysis published in the peer-reviewed literature.

In a recent analysis paper published in the BMJ Global Health, Dr. Adura Banke-Thomas and colleagues, Dr. Barbara Madaj and Prof. Nynke van den Broek from CMNH and Dr. Shubha Kumar from the Institute of Global Health at University of Southern California reviewed the four VfM components (economy, efficiency, effectiveness and cost-effectiveness) and methods, critiqued their applicability, strengths and weakness and proposed approaches to improve VfM assessments using a hypothetical maternal and newborn health example. 

They concluded that to strengthen VfM assessments in maternal and newborn health, researchers and implementers should consider combining either a cost-effectiveness analysis or a cost-utility analysis with a detailed cost analysis and an effectiveness study or use either a cost-benefit analysis or social return on investment analysis independently. Critical contextual information that assess and incorporate cross-cutting themes such as equity, sustainability, scalability and cultural acceptability of the intervention would also be critical to better understand and interpret VfM assessments.

In the era of the United Nations Sustainable Development Goals, when more questions regarding VfM will likely continue to be asked, capacity to demonstrate VfM will ensure that MNH interventions can remain competitive for the limited resources.