Immpact

Initiative for maternal mortality programme assessment (Immpact) (Dugald Baird Centre, University of Aberdeen)

Enhanced methods and tools were used to generate new evidence on the effectiveness and cost-effectiveness of strategies to reduce maternal mortality and severe morbidity that are supportive of and supported by health systems and communities. In addition, the implications of alternative strategies for equity goals and sustainability were identified. By providing realistic methods for measuring trends and differentials in maternal outcomes, policy makers will be able to track the effects of initiatives within and beyond the health sector. These will include health-systems strengthening, budget support, and poverty reduction strategies. Stronger capacity in-country will ensure that this evidence, together with the enhanced methods and tools, are utilised both within and well beyond the duration of Impact.

Outcome and Translation

Evaluations of maternal health policy interventions were conducted in Burkina Faso, Ghana and Indonesia. The results of these evaluations were used by the respective Ministries of Health in policy re-design. Wider contributions regarding the interplay between health policy and household economic factors in maternal outcomes have arisen from direct dialogue with UK ministers, other Governments and advocacy groups. A toolkit for measurement of maternal mortality, morbidity and economic outcomes was produced and is freely available for use by other researchers worldwide - http://www.immpact-international.org/toolkit/. Research capacity strengthening in low income countries has been conducted through a series of training courses in research methods.

HERU researchers involved in this research project: Paul McNamee

External Collaborators: W Graham, M Hall, C Bullough, J Hussein (Division of Applied Health Sciences, University of Aberdeen); W Smith (Department of Population Health, University of Aberdeen) and J Cairns (London School of Hygiene and Tropical Medicine (LSHTM)

Publications

Graham, W., Cairns, J., Bhattacharya, S., Bullough, C., Quayyum, Z. and Rogo, K. (2006) 'Maternal and Peri-natal Conditions', In: Disease Control Priorities in Developing Countries (2nd Edition), 499-530. New York: Oxford University Press.

Newlands, D., McNamee, P., Quayyum, Z., Chikwama, C., Ternent, L., Belemsaga, D., Asante, F., Daniels, A., Megraini, A. and Nadjib, M. (2006) 'Economic Outcomes', Final report to IMMPACT.

Ternent, L., McNamee, P., Belemsaga, D., Belemsaga, D., Daniels, A. and Newlands, D. (2006) 'The valuation of maternal outcomes using discrete choice and contingent valuation methods', Report to IMMPACT.

Ensor, T., Nadjib, M., Quayyum, Z. and Megraini, A. (2008) 'Public funding for community based skilled delivery care in Indonesia: to what extent are the poor benefited,' European Journal of Health Economics, 9 (4), 385-392.

Newlands, D., Yugbare-Belemsaga, D., Ternent, L., Hounton, S. and Chapman, G. (2008) 'Assessing the costs and cost-effectiveness of a Skilled Care Initiative in rural Burkina Faso', Tropical Medicine and International Health, 13 (Supplement 1), 61-67

Ensor, T., Quayyum, Z., Nadjib, M. and Sucahya, P. (2009) 'Level and determinants of incentives for village midwives in Indonesia', Health Policy and Planning, 24, 26 - 35.

McNamee, P., Ternent, L. and Hussein, J. (2009) 'Barriers in accessing maternal health care: evidence from low and middle income countries', Expert Review of Pharmacoeconomics and Outcomes Research, 9 (1), 41-48

Quayyum, Z., Nadjib, M., Ensor, T. and Sucahya, P.K. (2010) 'Expenditure on obstetric care and the protective effect of insurance on the poor: lessons from two Indonesian districts', Health Policy and Planning, 25(3), 237-247

Presentations

Newlands D, McNamee, P, Asante, F, and Quayyum, Z. (2007) 'The economic outcomes of maternal mortality and morbidity. 'Delivering safer motherhood: sharing the evidence', Initiative for Maternal Mortality Programme Assessment (IMMPACT)Royal College of Obstetricians and Gynaecologists (RCOG) Symposium, London, February 2007.

Quayyum, Z. (2007) 'The direct costs of safe motherhood programmes', Initiative for Maternal Mortality Programme Assessment (IMMPACT) Royal College of Obstetricians and Gynaecologists (RCOG) Symposium, London, February 2007.

Ternent, L.(2007) 'Willingness to pay for maternal health care: a gender perspective', Initiative for Maternal Mortality Programme Assessment (IMMPACT) Royal College of Obstetricians and Gynaecologists (RCOG) Symposium, London, February 2007.

McNamee, P. and Quayyum, Z. (2007) 'Cost effectiveness of maternal and perinatal health interventions: lessons from DCPP and IMMPACT', West African Health Organisation Annual Meeting, Accra, June 2007.

Nadjib, M., Quayyum, Z., Ensor, T., Susilawati, PK. and Sucahya, AM. (2007) 'Cost of obstetric care and economic consequences for the households: are poor mother protected? Lessons from two districts in Indonesia', iHEA, Copenhagen, July 2007.

Quayyum, Z., Tim, E., Mardiati, N., Purwa, KS. and Eko, P. (2007) 'Do poor mothers have access to village level midwifery services and public facilities for obstetric care? Evidence from two districts in Indonesia', iHEA, Copenhagen, July, 2007.

Sucahya, P.K., Quayyum, Z., Mardiati, N., Purwa, KS. and Ensor, T. (2007) 'Costing village midwifery services in two districts of Indonesia: lessons for efficiency and cost-effectiveness analysis of community level midwifery care as safe motherhood strategy', iHEA, Copenhagen, July 2007.

McNamee, P. (2008) The economic outcomes of maternal mortality and morbidity', Centre for Social Studies, Surat, India, 2008.

McNamee, P. (2008) 'The economic outcomes of maternal mortality and morbidity', Indian Institute of Management, Ahmedabad, India, 2008.

Quayyum, Z. and Smith, MD. Efficiency of community level midwifery care in Indonesia: a stochastic frontier analysis. HESG. Aberdeen. August 2008.

Quayyum, Z. and Smith, MD. (2008) 'Interventions to reduce maternal mortality and economic implications for scaling them up and adopting in low and middle income settings: Lessons from IMMPACT Project in three countries', International Conference on Scaling Up: An Essential Strategy for Attaining Good Health for All, Dhaka, Bangladesh, December 2008.