Accountable Care Reforms Improve Women's And Children's Health In Nepal.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Maru, D; Maru, S; Nirola, I; Gonzalez-Smith, J; Thoumi, A; Nepal, P; Chaudary, P; Basnett, I; Udayakumar, K; McClellan, M

Published Date

  • November 2017

Published In

Volume / Issue

  • 36 / 11

Start / End Page

  • 1965 - 1972

PubMed ID

  • 29137510

Pubmed Central ID

  • PMC5940362

Electronic International Standard Serial Number (EISSN)

  • 1544-5208

International Standard Serial Number (ISSN)

  • 0278-2715

Digital Object Identifier (DOI)

  • 10.1377/hlthaff.2017.0579


  • eng