Methods for evaluating effectiveness and cost-effectiveness of a Skilled Care Initiative in rural Burkina Faso
| Autor: | Cynthia Stanton, Vincent De Brouwere, Nicolas Meda, Brahima Bassane, Sennen Hounton, Issiaka Sombié, Peter Byass |
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| Rok vydání: | 2008 |
| Předmět: |
Program evaluation
education.field_of_study Cost effectiveness business.industry Population Public Health Environmental and Occupational Health Psychological intervention Developing country Verbal autopsy Infectious Diseases Environmental protection Environmental health Health care Medicine Parasitology business education Health policy |
| Zdroj: | Tropical Medicine & International Health. 13:14-24 |
| ISSN: | 1360-2276 |
| DOI: | 10.1111/j.1365-3156.2008.02083.x |
| Popis: | INTRODUCTION This paper aims to describe the design, methods and approaches used to assess the effectiveness and cost-effectiveness of the Skilled Care Initiative in reducing pregnancy-related and perinatal mortality in Ouargaye district, Burkina Faso. METHODS The evaluation used a quasi-experimental design, mixed methods and a composite of tools to compare mortality and severe morbidity (near-miss) of women in reproductive age, perinatal mortality, facility functionality, perceived quality of care, utilisation of maternal health services, and costs borne by families and the health care system for maternal health care in Ouargaye and Diapaga districts. Structured questionnaires and interview guides were developed, pre-tested and piloted prior to the main survey. The evaluation was carried out from January to July 2006. A household census was used to retrospectively assess pregnancy-related and perinatal mortality over the previous 5 years, and causes of pregnancy-related death were identified using a newly developed and tested probabilistic model for interpreting verbal autopsy data. Data were directly entered into Personal Digital Assistant devices at the point of interview. Analyses included univariate and multivariate regressions and incremental cost-effectiveness ratios. RESULTS A population census covering over half a million people, three qualitative surveys and facility surveys in 47 health centres have been carried out. CONCLUSION A partnership with key stakeholders and the use of mixed methods proved feasible for evaluating complex safe motherhood strategies, and the use of hand-held computers proved possible for direct data capture, even in this remote rural environment. |
| Databáze: | OpenAIRE |
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