Table 4

Results of impact and cost of investment case analysis in Orissa (India)
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)
Kendrapara Post-partum Haemorrhage (28%), Sepsis/Infections (11%), Unsafe Abortion (10%), Ante-partum Haemorrhage (9%)* Preterm birth (17%), Diarrhoea (16%), Pneumonia (16%), Neonatal Sepsis (15%), Birth Asphyxia (13%)‡ 34% (30%-38%) 35% (33%-38%) 23% (21%-26%) $1.61 ($1.61-1.63) $1.70
Key Strategies: renovation and construction of sub-health centres, upgrading of emergency maternal and neonatal care facilities, additional training for staff on postnatal care, performance incentives and travel/hardship allowances for staff, workforce planning, supervision and monitoring, ensuring supply of buffer drug stocks, community promotion activities
Rayagada Anaemia (24%), Post-partum Haemorrhage (17%), Sepsis/Infection (17%), Hypertension (14%) † Diarrhoea (18%), Pneumonia (17%), Preterm birth (16%), Neonatal Sepsis (14%), Birth Asphyxia (12%)§ 28% (23%-33%) 35% (32%-38%) 25% (22%-27%) $3.92# $3.56
Key Strategies: as above

* Source: (20) Estimate for EAG states. Sample Registration System, Office of the Registrar General of India. Maternal Mortality in India: 1997–2003: Trends, Causes and Risk Factors. 2006:1–40.

† Source: (21). Data for tribal areas in Orissa and Jharkhand. Barnett S, Nair N, et al. A prospective key informant surveillance system to measure maternal mortality – findings from indigenous populations in Jharkhand and Orissa, India. BMC Pregnancy and Childbirth 2008;8(6):1–8.

‡ Source: (15) State estimate. International Institute for Population Sciences (IIPS). National Family Health Survey (NFHS-3) 2005–06, India. 2007;1(1–540).

§ Source: (15) Tribal regions estimate. International Institute for Population Sciences (IIPS). National Family Health Survey (NFHS-3) 2005–06, India. 2007;1(1–540). # Due to large populations per capita values vary little (not reflected in $US to 2 decimal points)Results are based on point estimates and ranges calculated assuming −/+10% of intervention coverage determined by policymakers.

Jimenez Soto et al.

Jimenez Soto et al. BMC Public Health 2013 13:601   doi:10.1186/1471-2458-13-601

Open Data