The cost of emergency obstetric care: concepts and issues

Emergency obstetric care (EmOC), like any health intervention, requires resources, and resources are almost always limited. This forces decision makers to take into account the costs (and effectiveness) of EmOC provision and compare them with the costs (and effectiveness) of other health interventions. This is not inordinately complicated, but it does require paying attention to the fact that EmOC services require different types of inputs and are produced in facilities that also provide other health care services. This paper discusses the basic concepts underlying the costing of EmOC services, and the essential issues one must take into account while assessing the cost-effectiveness of EmOC interventions. A definition of EmOC provision cost is offered and then explained by progressively refining a simple measure of expenditures on all that is used to provide EmOC services. Thereupon the process of collecting cost data and calculating costs is outlined using a simple spreadsheet format, and issues related to the analysis of costs and cost-effectiveness are discussed.