Reducing inequities in maternal and child health in rural Guatemala through the CBIO+﻿ Approach of Curamericas: 10. Summary, cost effectiveness, and policy implications

Table 4 Lives Saved Tool (LiST) estimates of the number of lives saved each year and cost per disability-adjusted life year (DALY) averted by the Curamericas/Guatemala Maternal and Child Health Project, 2011–2015

Number of child lives saved each year
Decline of under-5 mortality:	Estimated U5MR at baseline:	Estimated U5MR in Year 4:	Number of births per year:	Number of deaths per year if U5MR were 54:	Number of deaths per year if U5MR were 42:	Difference (number of lives saved per year):
22%	54 deaths per 1,000 live births	42 deaths per 1,000 live births	2,575	139	108	31
Number of maternal lives saved each year
Decline of maternal mortality:	Estimated MMR at baseline:	Estimated MMR in Year 4:	Number of births per year:	Number of deaths if MMR were 632:	Number of deaths if MMR were 556:
12%	632 deaths per 100,000 live births	556 deaths per 100,000 live births	2,575	16	14	2
Total number of lives saved each year						33
Total Project cost for one year of operation^a						$568,400
Cost per life saved						$17,224
Number of years of life saved^b
	66 years for each under-5 death averted	31*66 = 2,046	50 years for each maternal death averted	2*50 = 100	Total = 2,208	2,146
Cost per year of life saved						$265
Number of DALYs averted each year^c						2,146
Cost per DALY averted						$265

U5MR Under-5 mortality rate, MMR Maternal mortality ratio, DALY Disability-adjusted life-year
^aBased on a per-capita cost of $5.80 for a population of 98,000
^bThe life expectancy at birth for Guatemala in 2015 was 71 years [23]. For these calculations we assume conservatively that each child died at age 2 and would have lived to age 68, producing 66 years of life saved for each child who lived. For each mother who died, we assume conservatively that she died at age 30 and would have lived to age 80, producing 50 years of life saved for each mother who lived. While time discounting at 3% per year was advocated when DALYs were first introduced, the World Health Organization discontinued this in 2010 [24]
^cWe assume conservatively that the mothers and children whose lives were saved would have lived their lives without any disabilities

ISSN: 1475-9276