Disease Burden and the Productivity Loss of Maternal Morbidities During Antenatal Period

Background

The disease burden and economic impact of maternal morbidities are often neglected due to global focus on maternal mortality. Objective of the present study was to estimate the productivity loss associated with maternal morbidities during pregnancy.

Methods

A household survey was carried out using two stage cluster sampling technique with probability proportionate to size, to select representative sample of currently pregnant mothers. Study was carried out in Anuradhapura district, Sri Lanka. We used the Immpact tool kit for productivity loss assessment of pregnant mothers. Translation and cultural adaptation of Immpact productivity cost tool kit was carried out using Murray and Sumathipala method.

Results

Of the 466 pregnant women studied, 421 (90.3%) reported that they had at least one ill health condition during the pregnant period. Commonest morbidities reported were; nausea and vomiting -325(69.7%),  backache -152(32.6%), vertigo 112(24.0%) and heartburn/ regurgitation 107(23.0%). Of the 421 pregnant women reported ill health conditions 260 (61.8%) women sought medical treatment for these illnesses. Total number episodes that needed treatment seeking were 373. During the last episode of ill health, total number of days lost due to absenteeism was 3,356 (32.9% of total loss) and the days lost due to presenteeism was 6,832.8 (67.1% of the total loss). Loss of productivity due to hospital admission (246 days) was only 2.4% of the total loss. Estimated loss of productivity due to the most recent episode of ill health condition, among currently pregnant mothers was 21,864 days per 1000 pregnant women and 28,861 days per 1000 episodes of ill health conditions.

Conclusions

This study provides strong evidence that mild to moderate maternal morbidities poses major threat to maternal health with substantial burden and loss of productivity, which in turn causing a major economic burden.