The Costs, Benefits, and Cost-Effectiveness of Interventions to Reduce Maternal Morbidity and Mortality in Mexico
Figure 1
Schematic of Natural History Model.
Upper Panel. The ovals represent the key health states used in the model. Nonpregnant 15-year-old women enter the model and are subject to an annual risk of pregnancy. Once pregnant, a woman may experience a miscarriage, elect to undergo an abortion, develop a maternal complication, or have an uncomplicated pregnancy and delivery. A small proportion of nonpregnant women will have severe anemia and subsequently will have a higher risk of mortality from maternal complications. Lower Panel. Every pregnant woman is subject to a risk of developing major maternal complications, such as a sexually transmitted infection with chlamydia or gonorrhea, sepsis, postpartum hemorrhage, severe preeclampsia/eclampsia, or obstructed labor. Each maternal complication is associated with a further risk of death or long-term sequelae (e.g., infertility, severe anemia, neurological sequelae, rectovaginal fistula), which are associated with a decrement in health-related quality of life and costs related to either management or treatment.