* Cost-effectiveness analysis of a voucher scheme combined with obstetrical quality improvements: quasi experimental results from Uganda.
- The maternal mortality ratio (MMR) in Uganda has declined significantly during the last 20 years, but Uganda is not on track to reach the millennium development goal of reducing MMR by 75% by 2015. More evidence on the cost-effectiveness of supply- and demand-side financing programs to reduce maternal mortality could inform future strategies. This study analyses the cost-effectiveness of a voucher scheme (VS) combined with health system strengthening in rural Uganda against the status quo. The VS, implemented in 2010, provided vouchers for delivery services at public and private health facilities (HF), as well as round-trip transportation provided by private sector workers (bicycles or motorcycles generally). The VS was part of a quasi-experimental non-randomized control trial. Improvements in institutional delivery coverage (IDC) rates can be estimated using a difference-in-difference impact evaluation method and the number of maternal lives saved is modelled using the evidence-based Lives Saved Tool. Costs were estimated from primary and secondary data. Results show that the demand for births at HFs enrolled in the VS increased by 52.3 percentage points. Out of this value, conservative estimates indicate that at least 9.4 percentage points are new HF users. This 9.4% bump in IDC implies 20 deaths averted, which is equivalent to 1356 disability-adjusted-life years (DALYs) averted. Cost-effectiveness analysis comparing the status quo and VS's most conservative effectiveness estimates shows that the VS had an incremental cost-effectiveness ratio per DALY averted of US$302 and per death averted of US$20 756. Although there are limitations in the data measures, a favourable cost-effectiveness ratio persists even under extreme assumptions. Demand-side vouchers combined with supply-side financing programs can increase attended deliveries and reduce maternal mortality at a cost that is acceptable.
=>新発見の, 新しい, 現代的な, 新参の
Overview of adj new
The adj new has 11 senses (first 5 from tagged texts)
1. (310) new -- (not of long duration; having just (or relatively recently) come into being or been
made or acquired or discovered; "a new law"; "new cars"; "a new comet"; "a new friend"; "a new
year"; "the New World")
2. (36) fresh, new, novel -- (original and of a kind not seen before; "the computer produced a
completely novel proof of a well-known theorem")
3. (11) raw, new -- (lacking training or experience; "the new men were eager to fight"; "raw
recruits")
4. (5) new, unexampled -- (having no previous example or precedent or parallel; "a time of
unexampled prosperity")
5. (3) new -- (other than the former one(s); different; "they now have a new leaders"; "my new car
is four years old but has only 15,000 miles on it"; "ready to take a new direction")
6. new -- (unaffected by use or exposure; "it looks like new")
7. newfangled, new -- ((of a new kind or fashion) gratuitously new; "newfangled ideas"; "she buys
all these new-fangled machines and never uses them")
8. New -- (in use after medieval times; "New Eqyptian was the language of the 18th to 21st
dynasties")
9. Modern, New -- (used of a living language; being the current stage in its development; "Modern
English"; "New Hebrew is Israeli Hebrew")
10. new, young -- ((of crops) harvested at an early stage of development; before complete maturity;
"new potatoes"; "young corn")
11. new -- (unfamiliar; "new experiences"; "experiences new to him"; "errors of someone new to the
job")
Overview of adv new
The adv new has 1 sense (first 1 from tagged texts)
1. (1) newly, freshly, fresh, new -- (very recently; "they are newly married"; "newly raised
objections"; "a newly arranged hairdo"; "grass new washed by the rain"; "a freshly cleaned floor";
"we are fresh out of tomatoes")
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