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Table 5 Input parameters used to model costs. Up-front costs were modelled for the inhaled oxytocin product only. All costs are in 2017 USD

From: Cost-effectiveness of inhaled oxytocin for prevention of postpartum haemorrhage: a modelling study applied to two high burden settings

  Bangladesh Ethiopia
Value Source Value Source
Intervention up-front costs
Advocacy costsa $ 321,105 MoH informant $ 80,563 MoH informant
Up-front training costsa $ 96,255 MoH informant and health sector plan [16] $ 39,531 MoH informant
Health worker training costs (per facility)a $ 226 Health sector plan [16] $ 324 MoH informant
Number of facilities providing delivery care for each delivery setting
Setting 1 78 Health Bulletin [28], Health facility survey [15] 95 EmONC assessment 2016 [17]
Setting 2 471 Health Bulletin [28], Health facility survey [15] 3567 EmONC assessment 2016 [17]
Setting 3 1828 Health Bulletin [28], Health facility survey [15] N/Ab  
Ongoing PPH prevention costs
Drug cost (per dose)
Injectable oxytocin $ 0.34c Drug administration informant $ 0.37d Public supply agency informant
Misoprostol $ 0.34e Drug administration informant $ 0.60f International drug price indicator
Inhaled oxytocin $ 0.50g Assumption $ 0.50g Assumption
Disposal costs (per 100 doses)
Injectable oxytocin $ 1.33 Sarker et al. 2015 [43] $ 0.28 Sarker et al. 2015 [43]
Misoprostol $ - Assumption $ - Assumption
Inhaled oxytocin $ 1.42 Sarker et al. 2015 [43] $ 0.42 Sarker et al. 2015 [43]
Wastage rates
Injectable oxytocin 5% Pecenka et al. 2017 [44] 5% Pecenka et al. 2017 [44]
Misoprostol 5% Vlassoff et al. 2016 [45] 5% Vlassoff et al. 2016 [45]
Inhaled oxytocin 7% Local clinicians 7% Local clinicians
PPH treatment costs
% of PPH cases after a facility birth that receive treatmenth 90% Assumption 90% Assumption
% of PPH cases after a home birth that seek treatment in a facilityh
Public 32.8% BMMS 2016 [13] 50.5% Worku et al. 2013 [46]
Private 44.1% BMMS 2016 [13] 1.6% Worku et al. 2013 [46]
Average length of hospital stay
Mild 2 days Hospital administrators 2 days Hospital administrators
Severe 5 days Hospital administrators 5 days Hospital administrators
Cost of treating mild PPHa
Public $79 Hospital administrators and clinicians $31 Akalu et al. 2012 [31]
Pearson et al. 2011 [32]
Lara et al. 2007 [33]
Private $122 Hospital administrators and clinicians $73 Akalu et al. 2012 [31]
Pearson et al. 2011 [32]
Lara et al. 2007 [33]
Cost of treating severe PPHa
Public $176 Hospital administrators and clinicians $199 Akalu et al. 2012 [31]
Pearson et al. 2011 [32]
Lara et al. 2007 [33]
Private $272 Hospital administrators and clinicians $356 Akalu et al. 2012 [31]
Pearson et al. 2011 [32]
Lara et al. 2007 [33]
  1. MoH Ministry of Health, EmONC Emergency Obstetric and Neonatal Care, PPH postpartum haemorrhage, BMMS Bangladesh Maternal Mortality Survey
  2. aSee appendix (Additional file 1) for more detail. Varied by ± 25% of base case in sensitivity analysis (uniform distribution of probabilistic sensitivity analysis)
  3. bAssume HEW attend trainings at health centres rather than health posts
  4. cTwo × 5 IU ampoules (0.14 USD each) plus one syringe and needle (0.07 USD)
  5. dOne × 10 IU ampoule (0.34 USD each) plus syringe and needle (0.03 USD)
  6. eTwo × 200 μg tablets at 0.17 USD each
  7. fThree × 200 μg at 0.20 USD per tablet
  8. gVaried in a sensitivity analysis from 0.25 to 1.00 USD (uniform distribution for probabilistic sensitivity analysis)
  9. hVaried the total care-seeking by ± 10 percentage points of base case in sensitivity analysis (uniform distribution for probabilistic sensitivity analysis). Distribution across private/public facilities maintained at same proportion as base case