Evaluation of the Mother and Infant Health Project in Ukraine

This paper exploits a unique opportunity to evaluate the impact of improvement in the quality of prenatal care and labor and delivery services on maternal and infant mortality and morbidity. Since basic medical care has been universally available in Ukraine, implementation of the Mother and Infant Health Project allows addressing quality rather than quantity effect of medical care. Employing program evaluation methods we find that the administrative units (rayons) participating in the Project have exhibited greater improvements in both maternal and infant health compared to the control rayons. Among the infant health characteristics, the MIHP impact is most pronounced for stillbirths, as well as infant mortality and morbidity resulted from deviations in perinatal period and congenital anomalies. As for the maternal health, the MIHP is most effective at combating such complications related blood circulation, veins, and urinary-genital systems, as well as late toxicosis and anemia. The analysis suggests that the effects are due to early attendance of antenatal clinics, lower share of C-sections, and greater share of normal deliveries. Preliminary cost-effectiveness analysis shows enormous benefit per dollar spent on the project: the cost to benefit ratio is one to 85 taking into account both maternal and infant lives saved as well as cost savings due to changes in labor and delivery practices.