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Predicted effect of regionalised delivery care on neonatal mortality, utilisation, financial risk, and patient utility in Malawi: An agent-based modelling analysis

The Lancet Global Health Jun 17, 2019

Shrime MG, et al. - Via an agent-based stimulation analysis, the researchers intended to assess the effect of obstetric service regionalisation in pregnant women and their newborn babies in Malawi. Reduction in neonatal mortality in scenarios restricting women to give birth in facilities with cesarean section capabilities whereas no change in mortality rate in scenarios restricting women to facilities that provided five or more basic emergency obstetric and neonatal care services were observed. This increase was prominently noted amongst the poor. Hence, it was concluded that this could allow Malawi to meet its goal of halving its neonatal mortality by 2030. However, increased distances to care and worsening financial risks among women would be the cost of such improvement.
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