Table 3 Cost-effectiveness of training in economic obstetric care (EmOC)

Walker et al., 2002

Cost-Effectiveness Analysis

Healthcare provider

Change in scores for skills

Cost per additional skilled midwife

All programmes resulted in statistically significant improvements (P = 0.03) in the skills of healthcare providers.

Advanced LSS: US$49.7 per 1% increase in mean skill scores and US$3210.9 per % point increase in the number of competent facility midwives.Basic LSS: US$60.7 per % point increase in mean skill scores and US$5651.5 per % point increase in the numbers of competent village midwives.Village midwives internship: US$154.0 per % point increase in mean skill scores and US$4060.8 per % point increase in the number of competent village midwives.

Not clear whether the training programmes were more or less cost-effective than other safe motherhood interventions because the nature of the outcome measures hindered comparison.

Done

Osei et al., 2005

Cost-Effectiveness Analysis

Not defined

Knowledge change of provider on how to conduct labour and delivery,Performance with regard to managing obstetric and other complications

Knowledge changeSelf-paced Learning (SPL): 17% change from baseline to endlineResidential (R): −5%Performance changeSPL: 6% performance change from baseline to endlineR: 4% performance change from baseline to endline

Knowledge changeSPL: US$69 per provider per % point change R: Not calculated due to the negative change in the indicator from baseline to endline.Performance changeSPL: US$101 per provider per % point changeR: US$138 per provider per % point change

Not reported

Not done

Boulenger & Dmytraczenko, 2007

Cost-Effectiveness Analysis

Government

Cost of skilled care per delivery

–

The average annual cost of the skilled care per delivery with a skilled birth attendant was US$15.0 for Tanzania, and US$10.6 for Kenya. The cost per capita was US$1.7 for Tanzania, and US$0.6 for Kenya.

Not possible to compare to similar interventions.

Not done

Kruk et al., 2007

Cost-Effectiveness Analysis

Modified societal perspective

Cost of surgeries conducted

–

The resulting cost per surgery for surgical technicians is US$38.87 versus US$144.1 for physicians.

Surgical technicians retained a substantial cost advantage in all the scenarios.

Done

Manasyan et al., 2011

Cost-Effectiveness Analysis, Cost-Utility Analysis

Not defined

Number of lives saved

97 lives saved. All-cause 7-day neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 after training (relative risk: 0.59 (0.48–0.77); P < .001) and was associated with a decrease in deaths caused by birth asphyxia (3.4–1.9 per 1000; P = .02) and infection (2.1–1.0 per 1000; P = .02)

The intervention costs were US$208 per life saved and US$5.24 per disability-adjusted life-year averted.

Considered value for money as Gross Domestic Product (GDP) per person in Zambia was about $1500.

Not done