Evaluating interventions to reduce maternal mortality: evidence from Peru's PARSalud programme

This paper evaluates the impact of an intervention oriented to reduce maternal mortality in Peru. The paper takes advantage of both spatial and temporal variation in the implementation of the programme to identify its effects. Results suggest a positive impact of the training provided by the programme on the number of deliveries, deliveries using oxytocin, caesarean deliveries, and complicated deliveries, but ambiguous effects of infrastructure investments. Moreover, different types of training had different impacts, internships on perinatal technologies having larger impacts. No effects are found on obstetric complications, but there are positive effects on the number of complicated deliveries attended. Results also show that the programme reduces the incidence of postpartum haemorrhage, the main cause of maternal mortality. As far as cost-effectiveness is concerned, the cost of averting a case of postpartum haemorrhage is about US$3328, compared with the present discounted value of the per-capita Gross Domestic Product over a lifespan of 45 extra years of life - about US$36,700.