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Cost‐effectiveness of a quality improvement collaborative for obstetric and newborn care in Niger

Edward Broughton (Based at USAID Health Care Improvement Project, University Research Co., Bethesda, Maryland, USA)
Zakari Saley (Based at USAID Health Care Improvement Project, University Research Co., Niamey, Niger)
Maina Boucar (Based at USAID Health Care Improvement Project, University Research Co., Niamey, Niger)
Dondi Alagane (Based at USAID Health Care Improvement Project, University Research Co., Niamey, Niger)
Kathleen Hill (Based at USAID Health Care Improvement Project, University Research Co., Bethesda, Maryland, USA)
Aicha Marafa (Based at USAID Health Care Improvement Project, University Research Co., Niamey, Niger)
Yaroh Asma (Based at Directorate of Maternal, Newborn and Child Health, Ministry of Health, Niamey, Niger)
Karimou Sani (Based at USAID Health Care Improvement Project, University Research Co., Niamey, Niger)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 15 March 2013

Abstract

Purpose

The purpose of this paper is to describe a quality improvement collaborative conducted in 33 Nigerian facilities to improve maternal and newborn care outcomes by increasing compliance with high‐impact, evidence‐based care standards. Intervention costs and cost‐effectiveness were examined and costs to the Niger Health Ministry (MoH) were estimated if they were to scale‐up the intervention to additional sites.

Design/methodology/approach

Facility‐based maternal care outcomes and costs from pre‐quality improvement collaborative baseline monitoring data in participating facilities from January to May 2006 were compared with outcomes and costs from the same facilities from June 2008 to September 2008. Cost data were collected from project accounting records. The MoH costs were determined from interviews with clinic managers and quality improvement teams. Effectiveness data were obtained from facilities' records.

Findings

The average delivery‐cost decreased from $35 before to $28 after the collaborative. The USAID/HCI project's incremental cost was $2.43/delivery. The collaborative incremental cost‐effectiveness was $147/disability‐adjusted life year averted. If the MoH spread the intervention to other facilities, substantive cost‐savings and improved health outcomes can be predicted.

Practical implications

The intervention achieved significant positive health benefits for a low cost. The Niger MoH can expect approximately 50 per cent return on its investment if it implements the collaborative in new facilities. The improvement collaborative approach can improve health and save health care resources.

Originality/value

This is one of the first studies known to examine collaborative quality improvement and economic efficiency in a developing country.

Keywords

Citation

Broughton, E., Saley, Z., Boucar, M., Alagane, D., Hill, K., Marafa, A., Asma, Y. and Sani, K. (2013), "Cost‐effectiveness of a quality improvement collaborative for obstetric and newborn care in Niger", International Journal of Health Care Quality Assurance, Vol. 26 No. 3, pp. 250-261. https://doi.org/10.1108/09526861311311436

Publisher

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Emerald Group Publishing Limited

Copyright © 2013, Emerald Group Publishing Limited