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Accountable Care Reforms Improve Women's And Children's Health In Nepal.

Duncan Maru1, Sheela Maru2, Isha Nirola3

  • 1Duncan Maru is cofounder and chief strategy officer of Possible, in Kathmandu, Nepal. He also is an assistant professor of medicine in the Division of Global Health, Brigham and Women's Hospital; a physician in the Division of General Pediatrics, Department of Medicine, Children's Hospital Boston; and an assistant professor of medicine in the Department of Global Health and Social Medicine, Harvard Medical School, all in Boston, Massachusetts.

Health Affairs (Project Hope)
|November 16, 2017
PubMed
Summary
This summary is machine-generated.

Public-private partnerships improved maternal and child health in Nepal. Key indicators like antenatal care visits and institutional births significantly increased, reducing mortality risks in rural Achham.

Keywords:
Access To CareDeveloping World < International/global health studiesMaternal And Child HealthOrganization and Delivery of CareRural Health Care

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Area of Science:

  • Global Health
  • Health Services Research
  • Public Health Interventions

Background:

  • Public-private partnerships are crucial for healthcare delivery in resource-limited settings.
  • Integrated reproductive, maternal, newborn, and child health (RMNCH) services require innovative delivery models.
  • An accountable care framework can guide service delivery and evaluation.

Purpose of the Study:

  • To describe the implementation of integrated RMNCH services using an accountable care framework.
  • To evaluate the impact of a public-private partnership on key maternal and infant health indicators in rural Nepal.
  • To analyze the cost-effectiveness of innovative healthcare financing and delivery models.

Main Methods:

  • Prospective pre-post study design over eighteen months in Achham district, Nepal.
  • Application of a previously developed accountable care framework.
  • Analysis of population-level indicators including antenatal care visits, institutional birth rates, and postpartum contraception prevalence.

Main Results:

  • Significant improvements observed in population-level indicators: antenatal care visits increased from 83% to 90%, institutional birth rate from 81% to 93%, and postpartum contraception prevalence from 19% to 47%.
  • Intervention cost was $3.40 per capita and $185 per pregnant woman served.
  • The study demonstrated positive outcomes in maternal and infant health indicators.

Conclusions:

  • Public-private partnerships, guided by an accountable care framework, can effectively improve RMNCH services in resource-limited settings.
  • The implemented model shows promise for reducing maternal and infant mortality.
  • Innovative care and financing models are feasible and impactful in rural healthcare contexts.