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Table 2 Background epidemiological and program data

From: Optimizing treatment for the prevention of pre-eclampsia/eclampsia in Nepal: is calcium supplementation during pregnancy cost-effective?

Parameter

Base case

Low

High

Distribution for PSA

Maternal careseeking

 ANC, at least one visit

84.8% [35]

63.60%

100%

Beta

 Facility deliveries in government sector

26.0% [35]

19.5%

32.5%

Beta

Screening procedures

 Blood pressure

86.4% [35]

64.80%

100%

Beta

 Urine sample

55.9% [35]

41.9%

69.9%

Beta

 Blood sample

45.3% [35]

34.0%

56.63%

Beta

Eclampsia epidemiology

 Incidence of eclampsia

4.30% [9]

3.23%

5.38%

Beta

 Eclampsia as direct maternal cause of death

21.0% [10]

15.8%

26.3%

Beta

 Mean age of eclampsia patients

23.4 [38]

17.7 [38]

29.2 [38]

–

Treatment

 MgSO4 for PE/E management

68.9%a

51.7%

95.8%

Beta

 Cesarean delivery

55.31% [46]

41.5%

69.1%

Beta

Maternal risk ratios for PE/E

 Calcium supplementation

0.45 [15]

0.31 [15]

0.65 [15]

Beta

 MgSO4, standard regimen

0.19 [19]

0.14 [19]

0.24 [19]

Beta

 Cesarean delivery

0.55 [25]

0.41 [25]

0.69 [25]

Beta

Still birth rates

 Vaginal birth

1.37%a

1.03%

1.71%

Beta

 Cesarean delivery

0.43%a

0.32%

0.54%

Beta

 Vaginal birth among PE/E cases

14.3%a

10.7%

17.9%

Beta

 Cesarean delivery among PE/E cases

9.77%a

7.33%

12.2%

Beta

Disability-adjusted life years (DALYs)

 DALYs averted per individual (maternal)

24.9b

15.6c

31.8d

–

 DALYs averted per individual (newborn)

29.0b

16.4c

32.3d

–

Pilot Program Data, Dailekh District, 2013

 Maternal careseeking

  ANC, at least one visit

94.6%

71.0%

100%

Beta

 Calcium regimen compliance

  Full compliance

67.3%

50.5%

84.1%

–

  Partial or low compliance

32.7%

24.5%

40.9%

–

 Gestational age among women receiving calcium

  4–5 months (300 calcium tablets)

82.2%

61.7%

95%

–

  6–7 months (200 calcium tablets)

13.8%

25.6%

2.5%

–

  8–9 months (100 calcium tablets)

4.0%

12.8%

2.5%

–

 Screening procedures

  Blood pressure

98%

73.5%

100%

Beta

  Urine test

97%

72.8%

100%

Beta

  1. aSource: Jhpiego/MCHIP
  2. bDiscount rate 3% + no age weighting
  3. cDiscount rate 6% + age weighting
  4. dDiscount rate 3% + age weighting