title: The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh.
abstract: BACKGROUND
  Maternal and neonatal death review (MNDR) introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals). This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012.
  
  
  METHODS
  MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31stDec 2012.
  
  
  RESULTS
  Overall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT) in the first year (2010). In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011) and 6,622,166 BDT (270,735 $INT, during 2012). The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT).
  
  
  CONCLUSIONS
  Programmatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.
authors.affiliation: Department of Public Health Science, School of Health Sciences, Örebro University, Sweden; Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
authors.forename: Animesh
authors.initials: A
authors.lastname: Biswas
authors.affiliation: Centre for Injury Prevention and Research (CIPRB) , Dhaka, Bangladesh.
authors.forename: Abdul
authors.initials: A
authors.lastname: Halim
authors.affiliation: Centre for Injury Prevention and Research (CIPRB) , Dhaka, Bangladesh.
authors.forename: Fazlur
authors.initials: F
authors.lastname: Rahman
authors.affiliation: Department of Public Health Science, School of Health Sciences, Örebro University , Sweden.
authors.forename: Charli
authors.initials: C
authors.lastname: Eriksson
authors.affiliation: Department of Public Health Science, School of Health Sciences, Örebro University , Sweden.
authors.forename: Koustuv
authors.initials: K
authors.lastname: Dalal
keywords: Bangladesh; Cost; Death review; Maternal and neonatal health