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Table 3 Scenario results on the annual health and economic burden of postpartum hemorrhage in Senegal

From: Modeling the economic and health impact of substandard uterotonics in Senegal

 

PPH ≥ 500 ml

PPH ≥ 1000 ml

Additional uterotonic treatment

Blood transfusions

Deaths due to PPH

Total economic burden of PPH

Total OOP costs public

Total OOP costs private

Long term productivity loss

0. Baseline estimate

86,542

21,152

35,250

14,408

447

$19,499,322

$1,774,990

$833,766

$16,890,566

1. No substandard uterotonics

81,540

19,769

29,331

9,643

418

$18,221,486

$1,615,355

$787,498

$15,818,633

Difference

-5,002

-1,383

-5,918

-4,765

-28

-$1,277,836

-$159,634

-$46,268

-$1,071,933

Difference %

-6%

-7%

-17%

-33%

-6%

-7%

-9%

-6%

-6%

2. Quality misoprostol + oxytocin for facility births

75,117

19,005

25,647

8,470

402

$17,273,438

$1,408,674

$678,574

$15,186,190

Difference

-11,425

-2,146

-9,603

-5,938

-45

-$2,225,883

-$366,315

-$155,192

-$1,704,376

Difference %

-13%

-10%

-27%

-41%

-10%

-11%

-21%

-19%

-10%

3. Quality heat-stable carbetocin for facility births

76,250

19,334

26,277

8,669

408

$17,619,801

$1,463,591

$711,814

$15,444,396

Difference

-10,292

-1,818

-8,972

-5,738

-38

-$1,879,521

-$311,398

-$121,952

-$1,446,170

Difference %

-12%

-9%

-25%

-40%

-9%

-10%

-18%

-15%

-9%

4. Misoprostol at reported level of quality for home births

74,344

20,132

35,009

14,231

426

$18,701,065

$1,766,432

$832,082

$16,102,551

Difference

-12,198

-1,020

-241

-177

-21

-$798,257

-$8,557

-$1,685

-$788,015

Difference %

-14%

-5%

-1%

-1%

-5%

-4%

0%

0%

-5%

5. Quality misoprostol for home births

72,005

19,526

34,888

14,139

412

$18,168,530

$1,762,548

$833,887

$15,572,094

Difference

-14,537

-1,626

-362

-269

-35

-$1,330,792

-$12,441

$121

-$1,318,471

Difference %

-17%

-8%

-1%

-2%

-8%

-7%

-1%

0%

-8%

6. All deliveries happen in facilities

70,632

19,117

44,603

18,114

405

$18,475,308

$2,229,428

$951,006

$15,294,874

Difference

-15,910

-2,035

9,353

3,706

-42

-$1,024,014

$454,438

$117,239

-$1,595,692

Difference %

-18%

-10%

27%

26%

-9%

-5%

26%

14%

-9%

7. All deliveries happen in facilities with quality-assured uterotonics

64,110

17,370

36,938

11,933

367

-$16,799,964

$2,023,821

$896,540

$13,879,602

Difference

-22,431

-3,782

1,689

-2,475

-80

-$2,699,358

$248,832

$62,774

-$3,010,964

Difference %

-26%

-18%

5%

-17%

-18%

-14%

14%

8%

-18%

  1. OOP: out-of-pocket; PPH: postpartum hemorrhage
  2. Scenario descriptions: (1) No substandard uterotonics: The uterotonics provided at healthcare facilities are quality assured. (2) Quality misoprostol + oxytocin for facility births: All women in facilities receive both misoprostol and oxytocin, and they are quality assured. (3) Quality heat-stable carbetocin for facility births: All women in facilities receive heat-stable carbetocin and it is quality assured. (4) Misoprostol at reported level of quality for home births: Home birthing women utilize misoprostol at reported level of quality. (5) Quality misoprostol for home births: Home birthing women utilize quality-assured misoprostol. (6) All deliveries happen in facilities: All women are modeled to utilize facility care. The use and quality of uterotonics in facilities remain as baseline. (7) All deliveries happen in facilities with quality-assured uterotonics: All women are modeled to utilize facility care. The use of uterotonics in facilities remains at baseline. The uterotonics provided are quality-assured.