Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Alternative strategies to reduce maternal mortality in India: A cost-effectiveness analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Sue J.", "last_name"=>"Goldie", "scopus_author_id"=>"35427013900"}, {"first_name"=>"Steve", "last_name"=>"Sweet", "scopus_author_id"=>"7005992303"}, {"first_name"=>"Natalie", "last_name"=>"Carvalho", "scopus_author_id"=>"57162584300"}, {"first_name"=>"Uma Chandra Mouli", "last_name"=>"Natchu", "scopus_author_id"=>"6505944840"}, {"first_name"=>"Delphine", "last_name"=>"Hu", "scopus_author_id"=>"16636706000"}], "year"=>2010, "source"=>"PLoS Medicine", "identifiers"=>{"sgr"=>"77951747568", "doi"=>"10.1371/journal.pmed.1000264", "pui"=>"358744949", "issn"=>"15491277", "pmid"=>"20421922", "isbn"=>"1549-1676", "scopus"=>"2-s2.0-77951747568"}, "id"=>"c0c97e62-74f3-327b-8298-e81ec04ac651", "abstract"=>"Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India.", "link"=>"http://www.mendeley.com/research/alternative-strategies-reduce-maternal-mortality-india-costeffectiveness-analysis-17", "reader_count"=>191, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>2, "Researcher"=>32, "Student > Doctoral Student"=>14, "Student > Ph. D. Student"=>19, "Student > Postgraduate"=>15, "Student > Master"=>72, "Other"=>11, "Student > Bachelor"=>16, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>5, "Professor > Associate Professor"=>2, "Researcher"=>32, "Student > Doctoral Student"=>14, "Student > Ph. D. Student"=>19, "Student > Postgraduate"=>15, "Student > Master"=>72, "Other"=>11, "Student > Bachelor"=>16, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Agricultural and Biological Sciences"=>16, "Arts and Humanities"=>6, "Business, Management and Accounting"=>7, "Computer Science"=>1, "Economics, Econometrics and Finance"=>12, "Engineering"=>1, "Environmental Science"=>1, "Nursing and Health Professions"=>11, "Mathematics"=>3, "Medicine and Dentistry"=>80, "Psychology"=>4, "Social Sciences"=>39}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>80}, "Social Sciences"=>{"Social Sciences"=>39}, "Psychology"=>{"Psychology"=>4}, "Mathematics"=>{"Mathematics"=>3}, "Unspecified"=>{"Unspecified"=>10}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>6}, "Engineering"=>{"Engineering"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>12}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>16}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>7}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>11}}, "reader_count_by_country"=>{"United States"=>1, "Tanzania"=>1, "Brazil"=>1, "United Kingdom"=>3, "South Africa"=>1, "Ghana"=>1, "Malaysia"=>1, "Nigeria"=>2, "Nepal"=>1, "Indonesia"=>2, "India"=>2}, "group_count"=>14}

CrossRef

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/77951747568"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/77951747568?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=77951747568&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=77951747568&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/77951747568", "dc:identifier"=>"SCOPUS_ID:77951747568", "eid"=>"2-s2.0-77951747568", "dc:title"=>"Alternative strategies to reduce maternal mortality in India: A cost-effectiveness analysis", "dc:creator"=>"Goldie S.", "prism:publicationName"=>"PLoS Medicine", "prism:issn"=>"15491277", "prism:eIssn"=>"15491676", "prism:volume"=>"7", "prism:issueIdentifier"=>"4", "prism:pageRange"=>nil, "prism:coverDate"=>"2010-04-01", "prism:coverDisplayDate"=>"April 2010", "prism:doi"=>"10.1371/journal.pmed.1000264", "citedby-count"=>"47", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"Harvard School of Public Health", "affiliation-city"=>"Boston", "affiliation-country"=>"United States"}], "pubmed-id"=>"20421922", "prism:aggregationType"=>"Journal", "subtype"=>"ar", "subtypeDescription"=>"Article", "source-id"=>"144840", "openaccess"=>"1", "openaccessFlag"=>true}

Facebook

  • {"url"=>"http%3A%2F%2Fjournals.plos.org%2Fplosmedicine%2Farticle%3Fid%3D10.1371%252Fjournal.pmed.1000264", "share_count"=>0, "like_count"=>0, "comment_count"=>0, "click_count"=>0, "total_count"=>0}

Journal Comments | Further Information

Counter

  • {"month"=>"4", "year"=>"2010", "pdf_views"=>"211", "xml_views"=>"11", "html_views"=>"2022"}
  • {"month"=>"5", "year"=>"2010", "pdf_views"=>"173", "xml_views"=>"10", "html_views"=>"1048"}
  • {"month"=>"6", "year"=>"2010", "pdf_views"=>"65", "xml_views"=>"0", "html_views"=>"351"}
  • {"month"=>"7", "year"=>"2010", "pdf_views"=>"40", "xml_views"=>"0", "html_views"=>"379"}
  • {"month"=>"8", "year"=>"2010", "pdf_views"=>"50", "xml_views"=>"1", "html_views"=>"343"}
  • {"month"=>"9", "year"=>"2010", "pdf_views"=>"61", "xml_views"=>"3", "html_views"=>"456"}
  • {"month"=>"10", "year"=>"2010", "pdf_views"=>"50", "xml_views"=>"2", "html_views"=>"338"}
  • {"month"=>"11", "year"=>"2010", "pdf_views"=>"51", "xml_views"=>"0", "html_views"=>"387"}
  • {"month"=>"12", "year"=>"2010", "pdf_views"=>"38", "xml_views"=>"2", "html_views"=>"197"}
  • {"month"=>"1", "year"=>"2011", "pdf_views"=>"55", "xml_views"=>"2", "html_views"=>"220"}
  • {"month"=>"2", "year"=>"2011", "pdf_views"=>"42", "xml_views"=>"0", "html_views"=>"242"}
  • {"month"=>"3", "year"=>"2011", "pdf_views"=>"58", "xml_views"=>"1", "html_views"=>"265"}
  • {"month"=>"4", "year"=>"2011", "pdf_views"=>"37", "xml_views"=>"0", "html_views"=>"228"}
  • {"month"=>"5", "year"=>"2011", "pdf_views"=>"27", "xml_views"=>"1", "html_views"=>"189"}
  • {"month"=>"6", "year"=>"2011", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"133"}
  • {"month"=>"7", "year"=>"2011", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"122"}
  • {"month"=>"8", "year"=>"2011", "pdf_views"=>"42", "xml_views"=>"3", "html_views"=>"216"}
  • {"month"=>"9", "year"=>"2011", "pdf_views"=>"35", "xml_views"=>"0", "html_views"=>"342"}
  • {"month"=>"10", "year"=>"2011", "pdf_views"=>"42", "xml_views"=>"0", "html_views"=>"430"}
  • {"month"=>"11", "year"=>"2011", "pdf_views"=>"54", "xml_views"=>"0", "html_views"=>"396"}
  • {"month"=>"12", "year"=>"2011", "pdf_views"=>"46", "xml_views"=>"9", "html_views"=>"333"}
  • {"month"=>"1", "year"=>"2012", "pdf_views"=>"46", "xml_views"=>"1", "html_views"=>"460"}
  • {"month"=>"2", "year"=>"2012", "pdf_views"=>"54", "xml_views"=>"0", "html_views"=>"387"}
  • {"month"=>"3", "year"=>"2012", "pdf_views"=>"60", "xml_views"=>"1", "html_views"=>"399"}
  • {"month"=>"4", "year"=>"2012", "pdf_views"=>"64", "xml_views"=>"2", "html_views"=>"287"}
  • {"month"=>"5", "year"=>"2012", "pdf_views"=>"66", "xml_views"=>"1", "html_views"=>"351"}
  • {"month"=>"6", "year"=>"2012", "pdf_views"=>"77", "xml_views"=>"2", "html_views"=>"290"}
  • {"month"=>"7", "year"=>"2012", "pdf_views"=>"56", "xml_views"=>"0", "html_views"=>"301"}
  • {"month"=>"8", "year"=>"2012", "pdf_views"=>"29", "xml_views"=>"6", "html_views"=>"263"}
  • {"month"=>"9", "year"=>"2012", "pdf_views"=>"36", "xml_views"=>"0", "html_views"=>"224"}
  • {"month"=>"10", "year"=>"2012", "pdf_views"=>"34", "xml_views"=>"0", "html_views"=>"279"}
  • {"month"=>"11", "year"=>"2012", "pdf_views"=>"49", "xml_views"=>"0", "html_views"=>"233"}
  • {"month"=>"12", "year"=>"2012", "pdf_views"=>"29", "xml_views"=>"0", "html_views"=>"217"}
  • {"month"=>"1", "year"=>"2013", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"304"}
  • {"month"=>"2", "year"=>"2013", "pdf_views"=>"26", "xml_views"=>"2", "html_views"=>"214"}
  • {"month"=>"3", "year"=>"2013", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"306"}
  • {"month"=>"4", "year"=>"2013", "pdf_views"=>"34", "xml_views"=>"0", "html_views"=>"287"}
  • {"month"=>"5", "year"=>"2013", "pdf_views"=>"38", "xml_views"=>"0", "html_views"=>"262"}
  • {"month"=>"6", "year"=>"2013", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"158"}
  • {"month"=>"7", "year"=>"2013", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"166"}
  • {"month"=>"8", "year"=>"2013", "pdf_views"=>"28", "xml_views"=>"6", "html_views"=>"213"}
  • {"month"=>"9", "year"=>"2013", "pdf_views"=>"36", "xml_views"=>"7", "html_views"=>"288"}
  • {"month"=>"10", "year"=>"2013", "pdf_views"=>"25", "xml_views"=>"1", "html_views"=>"352"}
  • {"month"=>"11", "year"=>"2013", "pdf_views"=>"35", "xml_views"=>"1", "html_views"=>"380"}
  • {"month"=>"12", "year"=>"2013", "pdf_views"=>"25", "xml_views"=>"1", "html_views"=>"325"}
  • {"month"=>"1", "year"=>"2014", "pdf_views"=>"27", "xml_views"=>"3", "html_views"=>"323"}
  • {"month"=>"2", "year"=>"2014", "pdf_views"=>"27", "xml_views"=>"1", "html_views"=>"275"}
  • {"month"=>"3", "year"=>"2014", "pdf_views"=>"25", "xml_views"=>"2", "html_views"=>"433"}
  • {"month"=>"4", "year"=>"2014", "pdf_views"=>"33", "xml_views"=>"2", "html_views"=>"500"}
  • {"month"=>"5", "year"=>"2014", "pdf_views"=>"37", "xml_views"=>"0", "html_views"=>"227"}
  • {"month"=>"6", "year"=>"2014", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"193"}
  • {"month"=>"7", "year"=>"2014", "pdf_views"=>"36", "xml_views"=>"0", "html_views"=>"197"}
  • {"month"=>"8", "year"=>"2014", "pdf_views"=>"19", "xml_views"=>"3", "html_views"=>"191"}
  • {"month"=>"9", "year"=>"2014", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"228"}
  • {"month"=>"10", "year"=>"2014", "pdf_views"=>"55", "xml_views"=>"5", "html_views"=>"360"}
  • {"month"=>"11", "year"=>"2014", "pdf_views"=>"33", "xml_views"=>"1", "html_views"=>"389"}
  • {"month"=>"12", "year"=>"2014", "pdf_views"=>"89", "xml_views"=>"3", "html_views"=>"597"}
  • {"month"=>"1", "year"=>"2015", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"251"}
  • {"month"=>"2", "year"=>"2015", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"180"}
  • {"month"=>"3", "year"=>"2015", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"188"}
  • {"month"=>"4", "year"=>"2015", "pdf_views"=>"24", "xml_views"=>"0", "html_views"=>"159"}
  • {"month"=>"5", "year"=>"2015", "pdf_views"=>"22", "xml_views"=>"1", "html_views"=>"157"}
  • {"month"=>"6", "year"=>"2015", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"110"}
  • {"month"=>"7", "year"=>"2015", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"142"}
  • {"month"=>"8", "year"=>"2015", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"135"}
  • {"month"=>"9", "year"=>"2015", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"136"}
  • {"month"=>"10", "year"=>"2015", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"144"}
  • {"month"=>"11", "year"=>"2015", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"179"}
  • {"month"=>"12", "year"=>"2015", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"101"}
  • {"month"=>"1", "year"=>"2016", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"125"}
  • {"month"=>"2", "year"=>"2016", "pdf_views"=>"32", "xml_views"=>"0", "html_views"=>"138"}
  • {"month"=>"3", "year"=>"2016", "pdf_views"=>"69", "xml_views"=>"0", "html_views"=>"207"}
  • {"month"=>"4", "year"=>"2016", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"151"}
  • {"month"=>"5", "year"=>"2016", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"124"}
  • {"month"=>"6", "year"=>"2016", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"96"}
  • {"month"=>"7", "year"=>"2016", "pdf_views"=>"43", "xml_views"=>"0", "html_views"=>"94"}
  • {"month"=>"8", "year"=>"2016", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"97"}
  • {"month"=>"9", "year"=>"2016", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"175"}
  • {"month"=>"10", "year"=>"2016", "pdf_views"=>"37", "xml_views"=>"0", "html_views"=>"204"}
  • {"month"=>"11", "year"=>"2016", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"126"}
  • {"month"=>"12", "year"=>"2016", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"108"}
  • {"month"=>"1", "year"=>"2017", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"132"}
  • {"month"=>"2", "year"=>"2017", "pdf_views"=>"37", "xml_views"=>"1", "html_views"=>"179"}
  • {"month"=>"3", "year"=>"2017", "pdf_views"=>"83", "xml_views"=>"2", "html_views"=>"315"}
  • {"month"=>"4", "year"=>"2017", "pdf_views"=>"31", "xml_views"=>"1", "html_views"=>"403"}
  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"47", "xml_views"=>"4", "html_views"=>"223"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"137"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"158"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"27", "xml_views"=>"1", "html_views"=>"158"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"28", "xml_views"=>"2", "html_views"=>"141"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"23", "xml_views"=>"2", "html_views"=>"209"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"213"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"143"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"19", "xml_views"=>"1", "html_views"=>"116"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"72"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"39", "xml_views"=>"1", "html_views"=>"88"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"14", "xml_views"=>"0", "html_views"=>"119"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"105"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"28", "xml_views"=>"5", "html_views"=>"62"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"21", "xml_views"=>"4", "html_views"=>"85"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"16", "xml_views"=>"1", "html_views"=>"96"}
  • {"month"=>"9", "year"=>"2018", "pdf_views"=>"11", "xml_views"=>"1", "html_views"=>"158"}
  • {"month"=>"10", "year"=>"2018", "pdf_views"=>"20", "xml_views"=>"2", "html_views"=>"90"}
  • {"month"=>"11", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"90"}
  • {"month"=>"12", "year"=>"2018", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"54"}
  • {"month"=>"1", "year"=>"2019", "pdf_views"=>"27", "xml_views"=>"0", "html_views"=>"96"}
  • {"month"=>"2", "year"=>"2019", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"65"}
  • {"month"=>"3", "year"=>"2019", "pdf_views"=>"47", "xml_views"=>"2", "html_views"=>"97"}
  • {"month"=>"4", "year"=>"2019", "pdf_views"=>"39", "xml_views"=>"2", "html_views"=>"136"}
  • {"month"=>"5", "year"=>"2019", "pdf_views"=>"32", "xml_views"=>"0", "html_views"=>"165"}
  • {"month"=>"6", "year"=>"2019", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"78"}

Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/853600"], "description"=>"<p>See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-United2\" target=\"_blank\">[87]</a>. Reduction in direct causes of maternal mortality, including abortion-related complications, postpartum hemorrhage, hypertensive disorders, sepsis, and obstructed labor.</p>a<p>Model-projected cost savings reflect net costs averted over a woman's reproductive lifespan (ages 15–45 y) applied to the current population of 15 y olds in India stratified by rural (75%) and urban (25%) settings <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-United2\" target=\"_blank\">[87]</a>. Future costs discounted 3% annually.</p>b<p>Cost savings for a single representative year of a successfully implemented strategy were calculated using population-level data from India <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-United2\" target=\"_blank\">[87]</a> stratified by rural (75%) and urban (25%) settings, for the current distribution of reproductive age women (ages 15–45 y).</p>c<p>In rural India, model-projected TFR is 2.76, 2.56, 2.36, 2.14 with reductions in unmet need of 25%, 50%, 75%, 100%, respectively.</p>d<p>In urban India, model-projected TFR is 1.94, 1.82, 1.71, 1.59 with reductions in unmet need of 25%, 50%, 75%, 100%, respectively.</p>", "links"=>[], "tags"=>["outcomes", "unmet", "limiting", "spacing"], "article_id"=>524045, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.t004", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Health_and_economic_outcomes_of_family_planning_to_reduce_the_unmet_need_for_limiting_and_spacing_births_and_safe_abortion_in_rural_and_urban_India_/524045", "title"=>"Health and economic outcomes of family planning to reduce the unmet need for limiting and spacing births, and safe abortion, in rural and urban India.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:07:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/853058"], "description"=>"<p>Four strategies that scale up access to critical maternal health services in consecutive phases are designated as upgrade 1, upgrade 2, upgrade 3, and upgrade 4. Shown are the percent increases in facility-based delivery, SBAs, recognition of referral need (by SBA at birthing/health center), transport (to appropriate referral facility), and availability/quality of EmOC (including adequate staff/supplies, appropriate clinical treatment, immediate attention), for rural and urban India. Shifts from home births assume a 70% shift to health centers/birthing centers and a 30% shift to EmOC; for routine births in EmOC, we assume 90% bEmOC and 10% cEmOC. Alternatives evaluated in sensitivity analysis (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#s4\" target=\"_blank\">Results</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>).</p>", "links"=>[], "tags"=>["improvements", "scaling", "maternal"], "article_id"=>523505, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.g002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Stepwise_improvements_in_scaling_up_maternal_services_/523505", "title"=>"Stepwise improvements in scaling up maternal services.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2010-04-20 00:58:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/424434"], "description"=>"<div><h3>Background</h3><p>Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India.</p><h3>Methods and Findings</h3><p>Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five maternal deaths; this approach coupled stepwise improvements in family planning and safe abortion with consecutively implemented strategies that incrementally increased skilled attendants, improved antenatal/postpartum care, shifted births away from home, and improved recognition of referral need, transport, and availability/quality of EmOC. The strategies in this approach ranged from being cost-saving to having incremental cost-effectiveness ratios less than US$500 per year of life saved (YLS), well below India's per capita gross domestic product (GDP), a common benchmark for cost-effectiveness.</p><h3>Conclusions</h3><p>Early intensive efforts to improve family planning and control of fertility choices and to provide safe abortion, accompanied by a paced systematic and stepwise effort to scale up capacity for integrated maternal health services over several years, is as cost-effective as childhood immunization or treatment of malaria, tuberculosis, or HIV. In just 5 y, more than 150,000 maternal deaths would be averted through increasing contraception rates to meet women's needs for spacing and limiting births; nearly US$1.5 billion would be saved by coupling safe abortion to aggressive family planning efforts; and with stepwise investments to improve access to pregnancy-related health services and to high-quality facility-based intrapartum care, more than 75% of maternal deaths could be prevented. If accomplished over the next decade, the lives of more than one million women would be saved.</p><h3></h3><p><em>Please see later in the article for the Editors' Summary</em></p></div>", "links"=>[], "tags"=>["strategies", "maternal", "cost-effectiveness"], "article_id"=>143791, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Alternative_Strategies_to_Reduce_Maternal_Mortality_in_India_A_Cost_Effectiveness_Analysis/143791", "title"=>"Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:03:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/853386"], "description"=>"<p>See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Graham1\" target=\"_blank\">[7]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Mills1\" target=\"_blank\">[14]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Registrar1\" target=\"_blank\">[15]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Adam1\" target=\"_blank\">[17]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Pagel1\" target=\"_blank\">[22]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Hu1\" target=\"_blank\">[23]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-International2\" target=\"_blank\">[28]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Grimes1\" target=\"_blank\">[64]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Harlap1\" target=\"_blank\">[69]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-CahuanaHurtado1\" target=\"_blank\">[73]</a>.</p>a<p>Incidence of elective abortion is 0.170, and 75% are assumed to be unsafe in the base case <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Registrar1\" target=\"_blank\">[15]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Khan1\" target=\"_blank\">[29]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Henshaw1\" target=\"_blank\">[39]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Lule1\" target=\"_blank\">[44]</a>. Case fatality rate (CFR) of safe abortion is 0.000006, representing a 98% reduction in mortality <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Ahman2\" target=\"_blank\">[50]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Koonin1\" target=\"_blank\">[62]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Grimes1\" target=\"_blank\">[64]</a>. For more details on abortion-related assumptions, see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>. Incidence of miscarriage (not shown) is 0.150 <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Harlap1\" target=\"_blank\">[69]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Menken1\" target=\"_blank\">[70]</a>.</p>b<p>Specific examples of nonfatal complications include Sheehan's Syndrome following maternal hemorrhage, fistula resulting from obstructed labor, neurological sequelae from eclampsia, pelvic inflammatory disease (PID). Not shown but included are the risk of infertility from PID (0.086) and the risk of severe anemia following maternal hemorrhage (0.09) <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Hu1\" target=\"_blank\">[23]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Murray1\" target=\"_blank\">[45]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Murray2\" target=\"_blank\">[46]</a>.</p>c<p>CFRs were adjusted based on complication severity (e.g., life threatening complications requiring cEmOC) and underlying severity of anemia <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Brabin1\" target=\"_blank\">[71]</a>. See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>d<p>Estimates for distribution of causes of maternal mortality for India are from India overall estimates from Khan et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Khan1\" target=\"_blank\">[29]</a>, based on the entire Asia region, as well as other data to establish a range for sensitivity analysis <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Mills1\" target=\"_blank\">[14]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Registrar1\" target=\"_blank\">[15]</a>. Cause-specific proportions sum to 66%, reflecting approximately 33% indirect causes, although this varies from 15% to 35% in different studies. Estimates shown reflect adjustment of data from Khan et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Khan1\" target=\"_blank\">[29]</a> such that a distribution is shown for the 66% of direct causes, to compare to model output. Further, anemia was reported to be responsible for 15% of deaths and was assumed to exert mortality impact on direct causes through severity of PPH, sepsis, and unsafe abortion.</p>e<p>Incidence of sepsis reduced by 50% with SBA and clean delivery in birthing center, bEmOC, and cEmOC; and reduced by 25% with SBA and clean delivery at home <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Dolea4\" target=\"_blank\">[37]</a>. Incidence of maternal hemorrhage reduced by 50%–75% depending on expectant versus active management of labor; we assume for the status quo, all cEmOC facilities provide active management, 50% of bEmOC facilities provide active management, and birthing centers/health centers provide expectant management only <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Dolea1\" target=\"_blank\">[34]</a>. Exploratory analyses that estimate the impact of community-based provision of oral misoprostol in birthing centers and at home assume a 25% to 50% reduction in PPH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Pagel1\" target=\"_blank\">[22]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Hofmeyr3\" target=\"_blank\">[72]</a>. For each baseline estimate, sensitivity analysis was conducted across a plausible range based on literature review; references are documented in the <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>f<p>For each baseline estimate, sensitivity analysis was conducted across a plausible range based on literature review; references and assumptions are documented in the <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>g<p>Estimates shown represent average reduction in case fatality rate provided complications necessitating surgery (e.g., cesarean section), blood transfusion, intensive hemodynamic support are treated in cEmOC. Obstructed labor is managed using assisted vaginal delivery with forceps or vacuum and, if necessary, cesarean section; severe pre-eclampsia and eclampsia treated with intravenous hydralazine and magnesium sulfate, in addition to induction of labor or emergency cesarean section when required; sepsis treated with ampicillin, gentamycin, and metronidazole or equivalent regimen followed by an 8-d course of intramuscular gentamycin and oral metronidazole (see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a> for details) <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Graham1\" target=\"_blank\">[7]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-CahuanaHurtado1\" target=\"_blank\">[73]</a>.</p>", "links"=>[], "tags"=>["incidence", "delivery-related"], "article_id"=>523836, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.t001", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Selected_model_parameters_Incidence_and_mortality_of_pregnancy_and_delivery_related_complications_and_impact_of_interventions_/523836", "title"=>"Selected model parameters: Incidence and mortality of pregnancy and delivery-related complications, and impact of interventions.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:03:56"}
  • {"files"=>["https://ndownloader.figshare.com/files/853552"], "description"=>"<p>Reduction in direct causes of maternal mortality, including abortion-related complications, postpartum hemorrhage, hypertensive disorders, sepsis, and obstructed labor.</p>a<p>Transport encompasses the expedient availability of means of transport (e.g., vehicle, cart), fuel (if needed), driver, and interim attendant care. Facility transport represents a weighted average of transport availability from a health center or birthing center to an EmOC facility and from a bEmOC facility to a cEmOC if indicated. Accuracy of referral need recognition at home and in health center with SBA increase, on average, to 60%, 75%, 90%, and 95% (not shown) with upgrade 1, 2, 3, and 4 in both rural and urban India.</p>b<p>Quality refers to the availability and quality of services at EmOC facilities, including adequate staffing and supplies, expedient attention (e.g., without delay to collect fees or requirement for family to bring supplies), and evidence-based clinical practices.</p>c<p>Family planning refers to contraceptive use for limiting and spacing; shown are values representing the reduction in unmet need by 25%, 50%, 75%, and 100% with upgrade 1, 2, 3, and 4, respectively, for both rural and urban India.</p>d<p>Stepwise improvements in maternal health services are assumed to occur in consecutive phases (e.g., first upgrade 1, then upgrade 2, etc.). Therefore, the incremental cost-effectiveness ratio (US$ per YLS) for each upgrade is calculated as the difference in lifetime costs relative to the difference in lifetime effects, compared with the preceding next best strategy. Cost-effectiveness ratios are also expressed as percent of the per capita GDP (US$1,068), shown in the farthest right column, as interventions with cost-effectiveness ratios of less than the per capita GDP are considered very cost-effective according to criteria proposed by the Commission on Macroeconomics and Health <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-World8\" target=\"_blank\">[98]</a>.</p>e<p>Status quo (rural India): 31.1% facility births; 11.6% SBA (home births); transport from home (24.4%), primary-level health center (48.8%), bEmOC (61%); recognition of referral need at home (20%), primary-level health center (40%); availability and quality of EmOC (42.5%); 53% family planning.</p>f<p>Status quo (urban India): 69.4% facility births; 19% SBA (home births); transport from home (44%), primary-level health center (69%), bEmOC (81%); recognition of referral need at home (20%), primary-level health center (40%); availability and quality of EmOC (67.5%); 64% family planning.</p><p>CS, cost saving; ICER, incremental cost-effectiveness ratio.</p>", "links"=>[], "tags"=>["outcomes", "packages", "intrapartum"], "article_id"=>523993, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.t005", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Health_and_economic_outcomes_of_integrated_packages_of_services_intrapartum_care_family_planning_and_safe_abortion_/523993", "title"=>"Health and economic outcomes of integrated packages of services: intrapartum care, family planning, and safe abortion.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:06:33"}
  • {"files"=>["https://ndownloader.figshare.com/files/853497"], "description"=>"<p>See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Mills1\" target=\"_blank\">[14]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Registrar1\" target=\"_blank\">[15]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-International2\" target=\"_blank\">[28]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-World6\" target=\"_blank\">[65]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Ma1\" target=\"_blank\">[68]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Brabin1\" target=\"_blank\">[71]</a>.</p>a<p>Case fatality rates (CFRs) were adjusted based on complication severity (e.g., life threatening complications requiring cEmOC) and underlying severity of anemia <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Brabin1\" target=\"_blank\">[71]</a>. See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>b<p>Routine deliveries in EmOC facilities assume that 90% would be in bEmOC and 10% in cEmOC. Alternative assumptions explored in sensitivity analysis (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>). We calculated the percentage of births with skilled attendance at home by subtracting the percentage delivered in facilities (which we assume are with skilled attendance) from the total of births with skilled attendance: (total skilled delivery−facility based births)/home births; for rural India: (0.391−0.311)/(1−0.311) = 0.116 or 11.6%.</p>c<p>Using the empirically calibrated India model, we parameterized the state-level models for Rajasthan and Uttar Pradesh and adjusted for the TFR as reported in NFHS 3 <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-International2\" target=\"_blank\">[28]</a>. To provide comparison, reported MMRs for Uttar Pradesh include an estimate of 707 from Mills <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Mills1\" target=\"_blank\">[14]</a>, and prior data from SRS including the SRS 2001–2003 estimate of 517 (confidence interval [CI] 461–573), SRS 1999–2001 estimate 539 (481–596), and the SRS 1997–98 (606, CI 544–668) <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Registrar1\" target=\"_blank\">[15]</a>. For Rajasthan, we used the 2001–2003, special survey of deaths using RHIME, which reported 445 (371–519), and SRS 1999–2001, which reported 501 (423–580) <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Registrar1\" target=\"_blank\">[15]</a>.</p><p>BC, birthing center; HC, health center; IUD, intrauterine device; TOL, female sterilization.</p>", "links"=>[], "tags"=>["parameters", "interventions", "maternal", "indicators"], "article_id"=>523946, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.t002", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Selected_model_parameters_and_assumptions_Coverage_of_interventions_and_maternal_health_indicators_by_setting_/523946", "title"=>"Selected model parameters and assumptions: Coverage of interventions and maternal health indicators by setting.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:05:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/853640"], "description"=>"a<p>Family planning refers to contraceptive use for limiting and spacing; shown are values representing the reduction in unmet need by 25%, 50%, 75%, and 100% with upgrades 1, 2, 3, and 4, respectively.</p>b<p>Transport encompasses the expedient availability of means of transport (e.g., vehicle, cart), fuel (if needed), driver, and interim attendant care.</p>c<p>Quality refers to the availability and quality of services at EmOC facilities, including adequate staffing and supplies, and evidence-based clinical practices.</p>d<p>Community-based interventions assume SBA-administered misoprostol for births at home and birthing centers/health centers with a 50% (25%–60%) reduction in PPH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Hofmeyr3\" target=\"_blank\">[72]</a>.</p>e<p>Population-level incremental benefits (lives saved) associated with the community-based misoprostol intervention (compared to the same strategy without the community-based misoprostol intervention). These were calculated by applying model-projected outcomes to population-level data from rural India <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-United2\" target=\"_blank\">[87]</a>. Cost-savings for a single birth cohort of 15-y-old girls (2010) expected to accrue over their reproductive lifespan (age 15–45) ranged from US$128 million to US$190 million.</p>", "links"=>[], "tags"=>["benefits", "community-based", "misoprostol"], "article_id"=>524088, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.t006", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incremental_benefits_of_community_based_misoprostol_in_rural_India_/524088", "title"=>"Incremental benefits of community-based misoprostol in rural India.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:08:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/853448"], "description"=>"<p>See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Sutherland1\" target=\"_blank\">[18]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-World3\" target=\"_blank\">[25]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Iyengar1\" target=\"_blank\">[80]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-UNFPA1\" target=\"_blank\">[88]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Bhat1\" target=\"_blank\">[94]</a>.</p><p>Estimates of costs under current standard of care (2006 US$). Estimates for the base case were country-specific and from UNFPA's Reproductive Health Costing Tools Model (RHCTM) <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-UNFPA1\" target=\"_blank\">[88]</a> and WHO CHOICE/public databases <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-World3\" target=\"_blank\">[25]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-International7\" target=\"_blank\">[89]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Management1\" target=\"_blank\">[91]</a>, unless otherwise specified. Costing details and methods for converting costs to 2006 US$ are provided in the <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>a<p>Ranges for sensitivity analyses established on the basis of assumptions and other published literature documented in the <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>b<p>Antenatal care includes tetanus vaccination, syphilis, gonorrhea, chlamydia screening (and treatment), urinalysis, blood tests, treatment for anemia, counseling (e.g., family planning, spacing, intrapartum care).</p>c<p>Postabortion complications assumed to require manual vacuum aspiration, treatment of sepsis in 25%, surgical repair in 25% <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Duggal1\" target=\"_blank\">[92]</a>.</p>d<p>Total costs reflect skill level of attendant, level of facility, and drugs and supplies. For example, delivery at birthing center (US$14.46) includes personnel (US$6.44), facility (US$4.52), and drugs and supplies (US$3.50). Other assumptions documented in the <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>e<p>Community-based interventions evaluated in sensitivity analysis included SBA-administered misoprostol to reduce incidence of PPH in deliveries at home and in birthing centers. Costs for misoprostol (US$0.99) and training (upper bound, US$3.40) based on assumptions presented in Sutherland and Bishai <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Sutherland1\" target=\"_blank\">[18]</a>; these costs represent the incremental costs above routine SBA delivery.</p>f<p>Transport costs include those incurred from home to a referral facility (bEmoc or cEmOC), and those incurred between facilities when necessary (e.g., bEmOC to cEmOC). Assumptions based on literature <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Iyengar1\" target=\"_blank\">[80]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Borghi1\" target=\"_blank\">[93]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264-Bhat1\" target=\"_blank\">[94]</a> and public access data described in the <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>g<p>Estimates shown represent average total costs using case-specific unit costs weighted by severity. Complications requiring surgery (e.g., cesarean section), blood transfusion, intensive hemodynamic support assumed to require cEmOC. Details of unit cost assumptions for facility-specific treatment documented in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000264#pmed.1000264.s001\" target=\"_blank\">Text S1</a>.</p>h<p>Postpartum care includes examination, iron/folate supplementation, and counseling.</p><p>TBA, traditional birth attendant.</p>", "links"=>[], "tags"=>["public health and epidemiology/global health", "public health and epidemiology/health policy", "public health and epidemiology/health services research and economics", "women's health"], "article_id"=>523894, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.t003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Selected_model_input_costs_/523894", "title"=>"Selected model input costs.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-20 01:04:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/852932"], "description"=>"<p>Upper panel: Model simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications. Case fatality rates for complications depend on severity and comorbidity. General intervention categories (open red boxes) include family planning for spacing or limiting births, antenatal or prenatal care (and treatment of anemia), safe abortion, intrapartum care (e.g., active management of labor), basic and comprehensive EmOC, and postpartum care. Interventions can reduce the incidence or severity of a complication or can reduce the case fatality rate through appropriate treatment. Lower panel: Model reflects the intervention pathway during labor and delivery, including location (home, birthing or health center, bEmOC, cEmOC), attendant (family member, traditional birth attendant [TBA], or SBA), and three potential barriers to effective treatment in the event of a complication, including recognition of referral need, transfer (e.g., transport), and timely quality care in an appropriate EmOC facility. Management of labor and delivery depends on attendant (e.g., SBA, clean delivery) and site (e.g., expectant management in birthing center, active management in EmOC facility), as does access to specific levels of treatment (e.g., blood transfusion only available in cEmOC).</p>", "links"=>[], "tags"=>["public health and epidemiology/global health", "public health and epidemiology/health policy", "public health and epidemiology/health services research and economics", "women's health"], "article_id"=>523375, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.g001", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Schematic_of_the_model_/523375", "title"=>"Schematic of the model.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2010-04-20 00:56:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/853248"], "description"=>"<p>Upper panel. Reduction in maternal deaths and cost-effectiveness with stepwise approaches to improve maternal health in rural Uttar Pradesh. The vertical axis (from bottom to top) shows outcomes associated with increased access to family planning and safe abortion. The horizontal axis (from left to right) displays outcomes associated with investments in high-quality health-center–based intrapartum care, which involved stepwise improvements in SBAs, recognition of referral need, and antenatal/postpartum care, incrementally shifted births away from home, and improved transport, availability, and quality of EmOC. Each cell represents a unique strategy; the reduction in maternal deaths shown is relative to current conditions (far lower left corner). Shading reflects cost-effectiveness ratios, compared to status quo (pink, cost saving; blue, </p>", "links"=>[], "tags"=>["outcomes", "uttar"], "article_id"=>523702, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.g004", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Health_and_economic_outcomes_in_rural_Uttar_Pradesh_/523702", "title"=>"Health and economic outcomes in rural Uttar Pradesh.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2010-04-20 01:01:42"}
  • {"files"=>["https://ndownloader.figshare.com/files/853156"], "description"=>"<p>Averted deaths attributable to unsafe abortion in rural India by addressing need for family planning (green shading) and providing 75% safe abortion (blue shading). Magnitude of additional averted abortion-related deaths with improved access to safe abortion depends on the amount of unmet need for contraception.</p>", "links"=>[], "tags"=>["deaths"], "article_id"=>523609, "categories"=>["Cancer", "Medicine", "Mathematics", "Information And Computing Sciences"], "users"=>["Sue J. Goldie", "Steve Sweet", "Natalie Carvalho", "Uma Chandra Mouli Natchu", "Delphine Hu"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000264.g003", "stats"=>{"downloads"=>0, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Averted_deaths_with_family_planning_and_safe_abortion_/523609", "title"=>"Averted deaths with family planning and safe abortion.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2010-04-20 01:00:09"}

PMC Usage Stats | Further Information

  • {"scanned-page-browse"=>"0", "month"=>"4", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"5", "unique-ip"=>"5", "pdf"=>"3", "year"=>"2010", "figure"=>"1", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"5", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"6", "full-text"=>"143", "year"=>"2010", "pdf"=>"95", "unique-ip"=>"143", "figure"=>"13", "scanned-summary"=>"0", "supp-data"=>"4"}
  • {"scanned-page-browse"=>"0", "month"=>"6", "cited-by"=>"0", "abstract"=>"6", "full-text"=>"77", "unique-ip"=>"85", "pdf"=>"62", "year"=>"2010", "figure"=>"4", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"7", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"14", "full-text"=>"84", "year"=>"2010", "pdf"=>"51", "unique-ip"=>"91", "figure"=>"14", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"scanned-page-browse"=>"0", "month"=>"8", "cited-by"=>"0", "abstract"=>"4", "full-text"=>"71", "unique-ip"=>"72", "pdf"=>"56", "year"=>"2010", "figure"=>"3", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"month"=>"9", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"4", "full-text"=>"75", "year"=>"2010", "pdf"=>"44", "unique-ip"=>"76", "figure"=>"6", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"10", "cited-by"=>"0", "abstract"=>"12", "full-text"=>"70", "unique-ip"=>"81", "pdf"=>"56", "year"=>"2010", "figure"=>"5", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"11", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"4", "full-text"=>"60", "year"=>"2010", "pdf"=>"35", "unique-ip"=>"69", "figure"=>"10", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"12", "cited-by"=>"0", "abstract"=>"2", "full-text"=>"51", "unique-ip"=>"56", "pdf"=>"33", "year"=>"2010", "figure"=>"12", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"1", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"6", "full-text"=>"70", "year"=>"2011", "pdf"=>"46", "unique-ip"=>"75", "figure"=>"3", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"scanned-page-browse"=>"0", "month"=>"2", "cited-by"=>"0", "abstract"=>"3", "full-text"=>"64", "unique-ip"=>"72", "pdf"=>"40", "year"=>"2011", "figure"=>"12", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"month"=>"3", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"2", "full-text"=>"75", "year"=>"2011", "pdf"=>"39", "unique-ip"=>"77", "figure"=>"15", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"4", "cited-by"=>"0", "abstract"=>"1", "full-text"=>"53", "unique-ip"=>"71", "pdf"=>"51", "year"=>"2011", "figure"=>"17", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"5", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"4", "full-text"=>"66", "year"=>"2011", "pdf"=>"27", "unique-ip"=>"78", "figure"=>"20", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"6", "cited-by"=>"0", "abstract"=>"3", "full-text"=>"67", "unique-ip"=>"65", "pdf"=>"33", "year"=>"2011", "figure"=>"9", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"7", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"50", "year"=>"2011", "pdf"=>"15", "unique-ip"=>"42", "figure"=>"6", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"8", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"60", "unique-ip"=>"59", "pdf"=>"37", "year"=>"2011", "figure"=>"7", "scanned-summary"=>"0", "supp-data"=>"3"}
  • {"month"=>"9", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"1", "full-text"=>"57", "year"=>"2011", "pdf"=>"30", "unique-ip"=>"56", "figure"=>"9", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"scanned-page-browse"=>"0", "month"=>"10", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"75", "unique-ip"=>"65", "pdf"=>"29", "year"=>"2011", "figure"=>"3", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"11", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"2", "full-text"=>"62", "year"=>"2011", "pdf"=>"32", "unique-ip"=>"65", "figure"=>"4", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"12", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"43", "unique-ip"=>"44", "pdf"=>"19", "year"=>"2011", "figure"=>"6", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"scanned-page-browse"=>"0", "month"=>"1", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"75", "unique-ip"=>"61", "pdf"=>"34", "year"=>"2012", "figure"=>"7", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"2", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"51", "year"=>"2012", "pdf"=>"26", "unique-ip"=>"49", "figure"=>"11", "scanned-summary"=>"0", "supp-data"=>"2"}
  • {"scanned-page-browse"=>"0", "month"=>"3", "cited-by"=>"0", "abstract"=>"0", "full-text"=>"76", "unique-ip"=>"68", "pdf"=>"25", "year"=>"2012", "figure"=>"10", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"month"=>"4", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"4", "full-text"=>"45", "year"=>"2012", "pdf"=>"33", "unique-ip"=>"54", "figure"=>"4", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"scanned-page-browse"=>"0", "month"=>"5", "cited-by"=>"0", "abstract"=>"2", "full-text"=>"57", "unique-ip"=>"57", "pdf"=>"29", "year"=>"2012", "figure"=>"6", "scanned-summary"=>"0", "supp-data"=>"0"}
  • {"month"=>"6", "scanned-page-browse"=>"0", "cited-by"=>"0", "abstract"=>"4", "full-text"=>"33", "year"=>"2012", "pdf"=>"20", "unique-ip"=>"37", "figure"=>"10", "scanned-summary"=>"0", "supp-data"=>"1"}
  • {"unique-ip"=>"56", "full-text"=>"56", "pdf"=>"15", "abstract"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"10", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"7"}
  • {"unique-ip"=>"41", "full-text"=>"42", "pdf"=>"20", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"8"}
  • {"unique-ip"=>"58", "full-text"=>"54", "pdf"=>"18", "abstract"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2012", "month"=>"9"}
  • {"unique-ip"=>"51", "full-text"=>"51", "pdf"=>"20", "abstract"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2012", "month"=>"10"}
  • {"unique-ip"=>"27", "full-text"=>"24", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"12"}
  • {"unique-ip"=>"42", "full-text"=>"44", "pdf"=>"14", "abstract"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2013", "month"=>"1"}
  • {"unique-ip"=>"41", "full-text"=>"40", "pdf"=>"6", "abstract"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"2"}
  • {"unique-ip"=>"67", "full-text"=>"62", "pdf"=>"19", "abstract"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"10", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2013", "month"=>"3"}
  • {"unique-ip"=>"59", "full-text"=>"59", "pdf"=>"17", "abstract"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2013", "month"=>"4"}
  • {"unique-ip"=>"47", "full-text"=>"40", "pdf"=>"21", "abstract"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"9", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"11"}
  • {"unique-ip"=>"40", "full-text"=>"32", "pdf"=>"16", "abstract"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"5"}
  • {"unique-ip"=>"41", "full-text"=>"31", "pdf"=>"20", "abstract"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"6"}
  • {"unique-ip"=>"32", "full-text"=>"33", "pdf"=>"11", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"7"}
  • {"unique-ip"=>"26", "full-text"=>"25", "pdf"=>"13", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"8"}
  • {"unique-ip"=>"27", "full-text"=>"28", "pdf"=>"10", "abstract"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"9"}
  • {"unique-ip"=>"39", "full-text"=>"42", "pdf"=>"9", "abstract"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"11", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2013", "month"=>"10"}
  • {"unique-ip"=>"37", "full-text"=>"29", "pdf"=>"22", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"11"}
  • {"unique-ip"=>"37", "full-text"=>"33", "pdf"=>"17", "abstract"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"1", "cited-by"=>"1", "year"=>"2013", "month"=>"12"}
  • {"unique-ip"=>"29", "full-text"=>"23", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"1"}
  • {"unique-ip"=>"34", "full-text"=>"39", "pdf"=>"17", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"2"}
  • {"unique-ip"=>"32", "full-text"=>"30", "pdf"=>"10", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"3"}
  • {"unique-ip"=>"33", "full-text"=>"38", "pdf"=>"7", "abstract"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"5"}
  • {"unique-ip"=>"27", "full-text"=>"30", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"6"}
  • {"unique-ip"=>"29", "full-text"=>"26", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2014", "month"=>"4"}
  • {"unique-ip"=>"23", "full-text"=>"20", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"29", "full-text"=>"28", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"42", "full-text"=>"39", "pdf"=>"23", "abstract"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"9", "supp-data"=>"2", "cited-by"=>"3", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"34", "full-text"=>"30", "pdf"=>"9", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"2", "cited-by"=>"1", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"37", "full-text"=>"30", "pdf"=>"14", "abstract"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"32", "full-text"=>"29", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"38", "full-text"=>"44", "pdf"=>"18", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"36", "full-text"=>"34", "pdf"=>"23", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"26", "full-text"=>"26", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"30", "full-text"=>"40", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"29", "full-text"=>"30", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"26", "full-text"=>"24", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"38", "full-text"=>"36", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"11", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"35", "full-text"=>"37", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"44", "full-text"=>"54", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"32", "full-text"=>"29", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"1", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"50", "full-text"=>"52", "pdf"=>"20", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"9", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"44", "full-text"=>"43", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"37", "full-text"=>"37", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"36", "full-text"=>"42", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"54", "full-text"=>"64", "pdf"=>"33", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"9", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"35", "full-text"=>"35", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"13", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"41", "full-text"=>"41", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"39", "full-text"=>"38", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"37", "full-text"=>"35", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"10", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"30", "full-text"=>"30", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"58", "full-text"=>"47", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"12", "supp-data"=>"0", "cited-by"=>"2", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"27", "full-text"=>"33", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"44", "full-text"=>"49", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"30", "full-text"=>"31", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"43", "full-text"=>"37", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"30", "full-text"=>"32", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"53", "full-text"=>"62", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"36", "full-text"=>"43", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"35", "full-text"=>"36", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"19", "full-text"=>"21", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"38", "full-text"=>"46", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"32", "full-text"=>"32", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"50", "full-text"=>"45", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"8", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"26", "full-text"=>"26", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"27", "full-text"=>"25", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"14", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"33", "full-text"=>"34", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"21", "full-text"=>"20", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"3", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"50", "full-text"=>"52", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"31", "full-text"=>"24", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"31", "full-text"=>"29", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"47", "full-text"=>"46", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"30", "full-text"=>"37", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"16", "full-text"=>"15", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"28", "full-text"=>"24", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"38", "full-text"=>"15", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"13", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"54", "full-text"=>"40", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"15", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"51", "full-text"=>"34", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"12", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"32", "full-text"=>"25", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"1", "cited-by"=>"1", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"30", "full-text"=>"20", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"38", "full-text"=>"37", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"33", "full-text"=>"34", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"28", "full-text"=>"30", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}

Relative Metric

{"start_date"=>"2010-01-01T00:00:00Z", "end_date"=>"2010-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences", "average_usage"=>[288, 576, 733, 867, 984, 1087, 1182, 1267, 1346, 1424, 1501, 1577, 1646, 1711, 1778, 1841, 1908, 1970, 2034, 2102, 2162, 2227, 2296, 2359, 2422, 2482, 2550, 2610, 2679, 2747, 2820, 2887, 2955, 3009, 3067, 3130, 3200, 3257, 3322, 3379, 3443, 3507, 3571, 3632, 3683, 3753, 3822, 3877]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[277, 558, 715, 845, 963, 1070, 1166, 1258, 1336, 1410, 1485, 1561, 1638, 1707, 1767, 1834, 1896, 1960, 2030, 2096, 2165, 2229, 2300, 2368, 2425, 2489, 2553, 2617, 2679, 2743, 2814, 2873, 2941, 2995, 3050, 3111, 3169, 3235, 3300, 3363, 3428, 3487, 3548, 3605, 3670, 3726, 3785, 3844]}, {"subject_area"=>"/Medicine and health sciences/Hematology", "average_usage"=>[241, 488, 623, 737, 840, 951, 1047, 1112, 1189, 1261, 1341, 1404, 1474, 1528, 1595, 1658, 1712, 1771, 1829, 1889, 1947, 2000, 2062, 2129, 2201, 2253, 2310, 2364, 2426, 2486, 2561, 2600, 2653, 2711, 2768, 2816, 2876, 2938, 2989, 3047, 3103, 3158, 3193, 3272, 3307, 3368, 3454, 3512, 3566]}, {"subject_area"=>"/People and places", "average_usage"=>[300, 565, 713, 834, 949, 1067, 1154, 1249, 1325, 1400, 1475, 1554, 1619, 1696, 1757, 1821, 1905, 1968, 2034, 2088, 2147, 2218, 2289, 2365, 2434, 2491, 2560, 2618, 2682, 2777, 2842, 2910, 2977, 3035, 3107, 3178, 3250, 3313, 3383, 3445, 3512, 3569, 3631, 3683, 3748, 3818, 3882, 3942]}, {"subject_area"=>"/People and places/Geographical locations", "average_usage"=>[286, 534, 665, 777, 906, 1009, 1091, 1169, 1247, 1314, 1379, 1434, 1509, 1592, 1637, 1729, 1801, 1855, 1922, 1993, 2052, 2098, 2164, 2215, 2277, 2335, 2413, 2485, 2553, 2606, 2699, 2756, 2832, 2892, 2971, 3035, 3093, 3146, 3196, 3251, 3357, 3436, 3472, 3529, 3623, 3679, 3727, 3795, 3866]}, {"subject_area"=>"/Social sciences", "average_usage"=>[365, 646, 813, 929, 1044, 1126, 1205, 1294, 1377, 1449, 1517, 1586, 1660, 1746, 1812, 1886, 1945, 2022, 2094, 2179, 2255, 2320, 2417, 2490, 2571, 2650, 2693, 2787, 2850, 2927, 2994, 3072, 3138, 3216, 3261, 3337, 3393, 3448, 3512, 3606, 3667, 3746, 3811, 3865, 3928, 3988, 4031, 4086]}]}
Loading … Spinner
There are currently no alerts