Accountable care reforms improve women's and children's health in Nepal

Duncan Maru, Sheela Maru, Isha Nirola, Jonathan Gonzalez-Smith, Andrea Thoumi, Prajwol Nepal, Pushpa Chaudary, Indira Basnett, Krishna Udayakumar, Mark McClellan

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Over the past decade the Ministry of Health of Nepal and the nonprofit Possible have partnered to deliver primary and secondary health care via a public-private partnership. We applied an accountable care framework that we previously developed to describe the delivery of their integrated reproductive, maternal, newborn, and child health services in the Achham district in rural Nepal. In a prospective pre-post study, examining pregnancies at baseline and 541 pregnancies in follow-up over the course of eighteen months, we found an improvement in population-level indicators linked to reducing maternal and infant mortality: receipt of four antenatal care visits (83 percent to 90 percent), institutional birth rate (81 percent to 93 percent), and the prevalence of postpartum contraception (19 percent to 47 percent). The intervention cost $3.40 per capita (at the population level) and $185 total per pregnant woman who received services. This study provides new analysis and evidence on the implementation of innovative care and financing models in resource-limited settings.

Original languageEnglish
Pages (from-to)1965-1972
Number of pages8
JournalHealth Affairs
Volume36
Issue number11
DOIs
StatePublished - 1 Nov 2017
Externally publishedYes

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