Cost-effectiveness of condom uterine balloon tamponade to control severe postpartum hemorrhage in Kenya.

Abstract

OBJECTIVE:

To evaluate the cost-effectiveness of condom uterine balloon tamponade (UBT) for control of severe postpartum hemorrhage (PPH) due to uterine atony versus standard PPH care in Kenya.

METHODS:

A cross-sectional analysis was conducted using cost data collected from 30 facilities in Western Kenya from April 15 to July 16, 2015. Effectiveness data were derived from the published literature. The modeling analysis was performed from the health-system perspective for a cohort of women who gave birth in 2015. Sensitivity analyses tested the robustness of model estimates. Costs were in 2015 US dollars.

RESULTS:

Compared with standard care with no uterine packing, condom UBT could prevent 1255 hospital transfers, 430 hysterectomies, and 44 maternal deaths. At $5 or $15 per UBT device, the incremental cost per disability-adjusted life year (DALY) averted was $26 or $40, respectively. If uterine packing was assumed to be done with standard care, the cost per DALY averted was $164 when the UBT price was $5 and $199 when the price was $15.

CONCLUSION:

Condom UBT was a highly cost-effective intervention for controlling severe PPH. This finding remained robust even when key model inputs were varied by wide margins.

• Authors: Mercy Mvundura, Donald Kokonya, Elizabeth Abu-Haydar, Eunice Okoth, Tara Herrick, James Mukabi, Lucas Carlson, Monica Oguttu, Thomas Burke
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 137 Issue 2 Pg. 185-191 (May 2017) ISSN: 1879-3479 [Electronic] United States
• PMID: 28190262 (Publication Type: Journal Article)
• Copyright: © 2017 International Federation of Gynecology and Obstetrics.

Topics

• Adult
• Condoms (statistics & numerical data)
• Cross-Sectional Studies
• Female
• Humans
• Kenya
• Maternal Health Services (economics)
• Maternal Mortality
• Perinatal Care (economics)
• Postpartum Hemorrhage (economics, mortality, therapy)
• Pregnancy
• Uterine Balloon Tamponade (instrumentation)