Health Economic Evaluation on Point of Care Antenatal Ultrasound in Rural and Remote Communities Globally: A Scoping...

There are significant global discrepancies in the provision of maternal healthcare with many women from under-resourced countries and rural communities having inferior access to such services. Within rural and remote communities and low-resource areas, point-of-care ultrasound (PoCUS) has the potential to improve health outcomes through early screening of pregnancies and identification of high risk and complicated pregnancies to enable timely retrievals and/or transfers to hospital settings.

This scoping review aims to explore the evidence available regarding the costs and economic assessment of PoCUS within under-resourced settings for the use of antenatal care (ANC).

Scopus, Medline and Embase, alongside grey literature, were comprehensively searched and studies were included if the interventional method was PoCUS for pregnant women undergoing ANC in a developing country or rural setting.

From a total of 688 identified articles, six articles met the inclusion criteria. Studies were from multinational settings or relating to Asia or Africa. All included articles reported that patient outcomes were improved with PoCUS alongside ANC. Two articles focused on: a hypothetical cost-effectiveness estimate in Nepal, and a multinational cost-analysis over 3 years post implementation across five countries. Three articles highlighted various resource usage and cost considerations. There was a recorded increase in antenatal attendance and a reduction in maternal and neonatal mortality with the introduction of PoCUS for routine ANC examinations.

Although PoCUS integration within the examined settings showed improved patient outcomes, further investigation is needed into the long-term economic costs/benefits to assess the cost-effectiveness of implementation.