Women's Health: An Alternative Perspective for Choosing Interventions

Winikoff, Beverly

doi:10.2307/1966552

Cited by 22 publications

(7 citation statements)

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“…Although it is obvious that the determinants of maternal and infant health are closely related, there are very few works where the issue of maternal and infant health is considered jointly (Winikoff, 1988;Conway and Kutinova, 2006). Moreover, most of the economic literature (both theoretical and empirical, likewise in developed and developing countries) focuses on infant health almost completely ignoring the issue of maternal health.…”

Section: Related Literaturementioning

confidence: 99%

Evaluation of the impact of the Mother and Infant Health Project in Ukraine

Nizalova

Vyshnya

2010

Health Economics

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This paper exploits a unique opportunity to evaluate the impact of the quality change in the labor and delivery services brought about by the Mother and Infant Health Project in Ukraine. Employing program evaluation methods, we find that the administrative units participating in the Project have exhibited greater improvements in both maternal and infant health compared to the control ones. Among the infant health characteristics, the MIHP impact is most pronounced for infant mortality resulting from deviations in perinatal period. As for the maternal health, the MIHP is the most effective at combating anemia, blood circulation and urinary-genital system complications, and late toxicosis. The analysis suggests that the effects are due to early attendance of antenatal clinics, lower share of C-sections, and greater share of normal deliveries. Preliminary cost-effectiveness analysis shows enormous benefit per dollar spent on the project: the cost to benefit ratio is one to 97 taking into account both maternal and infant lives saved as well as cost savings due to the changes in labor and delivery practices.

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Section: Related Literaturementioning

confidence: 99%

Evaluation of the impact of the Mother and Infant Health Project in Ukraine

Nizalova

Vyshnya

2010

Health Economics

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“…And perhaps surprisingly, this oversight also largely extends to the medical literature. In a series of papers [23][24][25], Winikoff has repeatedly pointed out this gap, noting that '. .…”

Section: Maternal Health: Medical Literaturementioning

confidence: 99%

Maternal health: does prenatal care make a difference?

Conway

Kutinova

2006

Health Econ.

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This research attempts to close an important gap in health economics regarding the efficacy of prenatal care and policies designed to improve access to that care, such as Medicaid. We argue that a key beneficiary-- the mother-- has been left completely out of the analysis. If prenatal care significantly improves the health of the mother, then concluding that prenatal care is 'ineffective' or that the Medicaid expansions are a 'failure' is premature. This paper seeks to rectify the oversight by estimating the impact of prenatal care on maternal health and the associated cost savings. We first set up a joint maternal-infant health production framework that informs our empirical analysis. Using data from the National Maternal and Infant Health Survey, we estimate the effects of prenatal care on several different measures of maternal health such as body weight status and excessive hospitalizations. Our results suggest that receiving timely and adequate prenatal care may increase the probability of maintaining a healthy weight after the birth and, perhaps for blacks, of avoiding a lengthy hospitalization after the delivery. Given the costs to society of obesity and hospitalization, these are benefits worth exploring before making conclusions about the effectiveness of prenatal care-- and Medicaid.

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“…Anaemia is very common amongst women of reproductive age in developing countries. In Africa it has been estimated that two-thirds of all pregnant and half of all non-pregnant women are anaemic (Winikoff, 1988). The Table summarizes some estimates of anaemia and severe anaemia in pregnancy, from a number of different settings.…”

Section: Prevalence and Definition Of Anaemia And Severe Anaemia In Pmentioning

confidence: 99%

Malaria in pregnancy: its relevance to safe-motherhood programmes

Shulman¹

1999

Annals of Tropical Medicine And Parasitology

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Severe anaemia in pregnancy is an important contributor to maternal and perinatal morbidity and mortality. In sub-Saharan Africa severe anaemia in pregnancy is very common, the main causes being iron and folate deficiency, malaria, hookworm infestation and advanced HIV infection. Though most of these causes are preventable, the overall prevalence of anaemia has not changed over many years. This is probably due to a mixture of reasons, including operational problems and inadequate interventions. In addition, a true effect on severe anaemia may have been missed if the only measure taken is of the overall prevalence of anaemia. One cause of anaemia that has been neglected by safe-motherhood programmes has been malaria in pregnancy. In endemic areas, malaria in pregnancy is usually asymptomatic and often associated with a negative peripheral-blood film. Hence the condition needs to be treated and prevented as a matter of routine in all women at risk of infection. A trial conducted in Kenya demonstrated that intermittent treatment with the antimalarial sulfadoxine-pyrimethamine (SP), given a couple of times during pregnancy when women attend for antenatal care, can reduce severe anaemia in primigravidae by 39%. The results of this study demonstrate the important contribution of malaria to severe anaemia in pregnancy in areas of endemic transmission. Intermittent treatment with SP in pregnancy has also been shown to be effective in improving birthweight. Though questions remain about the optimal way to deliver this intervention to different groups of women, we cannot afford to wait for all of the answers. The degree to which malaria contributes to severe anaemia in pregnancy is now clear. In Kenya intermittent SP is now policy for pregnant women from malarious areas. The challenge now is for this regimen to be successfully implemented as part of an integrated programme of anaemia control in pregnancy.

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Women's Health: An Alternative Perspective for Choosing Interventions

Cited by 22 publications

References 0 publications

Evaluation of the impact of the Mother and Infant Health Project in Ukraine

Evaluation of the impact of the Mother and Infant Health Project in Ukraine

Maternal health: does prenatal care make a difference?

Malaria in pregnancy: its relevance to safe-motherhood programmes

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