Cost-effectiveness of a mentorship and quality improvement intervention to enhance the quality of antenatal care at rural health centers in Rwanda

Anatole Manzi*, Jean Claude Mugunga, Laetitia Nyirazinyoye, Hari S. Iyer, Bethany Hedt-Gauthier, Lisa R. Hirschhorn, Joseph Ntaganira

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To estimate cost-effectiveness of Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) intervention to strengthen the quality of antenatal care at rural health centers in rural Rwanda. Design: Cost-effectiveness analysis of the MESH-QI intervention using the provider perspective. Setting: Kirehe and Rwinkwavu District Hospital catchment areas, Rwanda. Intervention: MESH-QI. Main outcome measures: Incremental cost per antenatal care visit with complete danger sign and vital sign assessments. Results: The total annual costs of standard antenatal care supervision was 10 777.21 USD at the baseline, whereas the total costs of MESH-QI intervention was 19 656.53 USD. Human resources (salary and benefits) and transport drove the majority of program expenses, (44.8% and 40%, respectively). Other costs included training of mentors (12.9%), data management (6.5%) and equipment (6.5%). The incremental cost per antenatal care visit attributable to MESH-QI with all assessment items completed was 0.70 USD for danger signs and 1.10 USD for vital signs. Conclusions: MESH-QI could be an affordable and effective intervention to improve the quality of antenatal care at health centers in low-resource settings. Cost savings would increase if MESH-QI mentors were integrated into the existing healthcare systems and deployed to sites with higher volume of antenatal care visits.

Original languageEnglish (US)
Article numbermzz179
Pages (from-to)359-364
Number of pages6
JournalInternational Journal for Quality in Health Care
Volume31
Issue number5
DOIs
StatePublished - Jun 1 2019

Keywords

  • Antenatal care
  • Cost-effectiveness
  • Mentorship
  • Quality improvement
  • Rwanda

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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