Women's health from a global economic perspective

Neily Zakiyah

Women's health from a global economic perspective

Vertaalde titel van de bijdrage: Gezondheid van vrouwen vanuit een mondiaal economisch perspectief

Neily Zakiyah

FarmacoTherapie, Epidemiologie en Economie

Onderzoeksoutput: Thesis fully internal (DIV)

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Samenvatting

Reproductieve en maternale gezondheid omvat de gezondheid van vrouwen gedurende de vruchtbare jaren, van jongvolwassenheid tot zwangerschap en geboorte. De ‘continuum of care’ benadering onderkent de noodzaak van gezondheidszorgvoorzieningen tijdens de vruchtbare jaren, en is essentieel om reproductieve en maternale gezondheid te verbeteren.
Het doel van dit proefschrift is epidemiologische en economische aspecten te onderzoeken van een aantal gezondheidsinterventies gericht op het verbeteren van de gezondheid van vrouwen, in verschillende settings. Het eerste deel van dit proefschrift richt zich op reproductieve gezondheidsissues, in het bijzonder op het opschalen van gezinsplanning-interventies in landen met lage en middeninkomens, aangezien gezinsplanning in deze landen een hoge prioriteit heeft. Met gebruik van economische evaluaties wordt bevestigd dat opschaling van gezinsplanning-interventies kosten-effectief en mogelijk kostenbesparend zijn, bovenop aanzienlijke gunstige gezondheidseffecten.
Het tweede deel van het proefschrift betreft maternale gezondheid, in het bijzonder zwangerschapshypertensie en pre-eclampsie. We verkennen de associatie tussen het gebruik van antidepressiva en het risico op het ontwikkelen van zwangerschapshypertensie. Het onderliggende mechanisme van deze associatie blijft onduidelijk, maar het is belangrijk dat zowel zorgprofessionals als zwangeren geïnformeerd worden over het risico zodat voor- en nadelen van langdurig antidepressivagebruik tijdens de zwangerschap afgewogen kunnen worden. In dit deel worden ook de economische aspecten van pre-eclampsie onderzocht. Een screeningtest op basis van biomarkers is mogelijk een kosten-effectieve optie voor implementatie in de klinische praktijk.
Het vergt blijvende inspanningen om de gezondheid van vrouwen te verbeteren en om vermijdbare sterfte en ziekte in moeders en vrouwen in het algemeen terug te dringen. Dit proefschrift benadrukt ook de noodzaak om meer en breder onderzoek te doen op het gebied van reproductieve en maternale gezondheid, en om wereldwijd goede en geïntegreerde reproductieve en maternale gezondheidszorgvoorzieningen actief te propageren.

Vertaalde titel van de bijdrage	Gezondheid van vrouwen vanuit een mondiaal economisch perspectief
Originele taal-2	English
Kwalificatie	Doctor of Philosophy
Toekennende instantie	Rijksuniversiteit Groningen
Begeleider(s)/adviseur	Postma, Maarten, Supervisor van Asselt, Thea, Co-supervisor
Datum van toekenning	25-jun.-2018
Plaats van publicatie	[Groningen]
Uitgever	University of Groningen
Gedrukte ISBN's	978-94-034-0648-0
Elektronische ISBN's	978-94-034-0647-3
Status	Published - 2018

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Title and contentsFinal publisher's version, 121 KB
Chapter 1Final publisher's version, 225 KB
Chapter 2Final publisher's version, 328 KB
Chapter 3Final publisher's version, 702 KB
Chapter 4Final publisher's version, 237 KB
Chapter 5Final publisher's version, 262 KB
Chapter 6Final publisher's version, 7,34 MB
Chapter 7Final publisher's version, 174 KB
SummaryFinal publisher's version, 52 KB
SamenvattingFinal publisher's version, 67 KB
AcknowledgementsFinal publisher's version, 96,7 KB
List of publicationsFinal publisher's version, 203 KB
Complete thesisFinal publisher's version, 9,47 MB
PropositionsFinal publisher's version, 47,8 KB

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title = "Women's health from a global economic perspective",

abstract = "Women{\textquoteright}s health is often comprised of both reproductive and maternal health and covers health issues in women{\textquoteright}s reproductive lifespan. In order to improve both reproductive and maternal health, the continuum of care approach which recognizes the need for health service during women{\textquoteright}s reproductive years is needed. The main objective of this thesis is to identify epidemiological aspects as well as economic impact of different health interventions in order to improve women{\textquoteright}s health and well-being in diverse settings.The first section of this thesis covers reproductive health issues, with a focus on scaling up family planning interventions in low and middle-income countries (L-MICs), as improving family planning is still considered priority in this setting. Using the concept of health economic evaluation, the results confirmed that scaling up family planning interventions would be cost-effective and potentially cost-saving along with substantial favorable health outcomes, even in L-MICs with distinctive patterns in contraceptive prevalence, unmet need, and cost-effectiveness thresholds.The second part of the thesis concerns maternal health, in particular, gestational hypertension and pre-eclampsia. We explore the association between antidepressant use and the risk of developing gestational hypertension. Although the underlying mechanism of the association remains unclear, it is present. It is important that both healthcare professionals and patients are informed about this association and carefully consider it in pregnancy management. Additionally, economic evaluation of pre-eclampsia, with a main focus on screening is also assessed in this section. The results indicate that a new screening test using novel biomarkers has the potential to be a cost-effective option for clinical practice. Continuous efforts are warranted in order to improve women{\textquoteright}s health and reduce preventable morbidity and mortality in mothers and women in general. Assessment and implementation of more functional linkages between reproductive and maternal health services should also be more encouraged.",

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N2 - Women’s health is often comprised of both reproductive and maternal health and covers health issues in women’s reproductive lifespan. In order to improve both reproductive and maternal health, the continuum of care approach which recognizes the need for health service during women’s reproductive years is needed. The main objective of this thesis is to identify epidemiological aspects as well as economic impact of different health interventions in order to improve women’s health and well-being in diverse settings.The first section of this thesis covers reproductive health issues, with a focus on scaling up family planning interventions in low and middle-income countries (L-MICs), as improving family planning is still considered priority in this setting. Using the concept of health economic evaluation, the results confirmed that scaling up family planning interventions would be cost-effective and potentially cost-saving along with substantial favorable health outcomes, even in L-MICs with distinctive patterns in contraceptive prevalence, unmet need, and cost-effectiveness thresholds.The second part of the thesis concerns maternal health, in particular, gestational hypertension and pre-eclampsia. We explore the association between antidepressant use and the risk of developing gestational hypertension. Although the underlying mechanism of the association remains unclear, it is present. It is important that both healthcare professionals and patients are informed about this association and carefully consider it in pregnancy management. Additionally, economic evaluation of pre-eclampsia, with a main focus on screening is also assessed in this section. The results indicate that a new screening test using novel biomarkers has the potential to be a cost-effective option for clinical practice. Continuous efforts are warranted in order to improve women’s health and reduce preventable morbidity and mortality in mothers and women in general. Assessment and implementation of more functional linkages between reproductive and maternal health services should also be more encouraged.

AB - Women’s health is often comprised of both reproductive and maternal health and covers health issues in women’s reproductive lifespan. In order to improve both reproductive and maternal health, the continuum of care approach which recognizes the need for health service during women’s reproductive years is needed. The main objective of this thesis is to identify epidemiological aspects as well as economic impact of different health interventions in order to improve women’s health and well-being in diverse settings.The first section of this thesis covers reproductive health issues, with a focus on scaling up family planning interventions in low and middle-income countries (L-MICs), as improving family planning is still considered priority in this setting. Using the concept of health economic evaluation, the results confirmed that scaling up family planning interventions would be cost-effective and potentially cost-saving along with substantial favorable health outcomes, even in L-MICs with distinctive patterns in contraceptive prevalence, unmet need, and cost-effectiveness thresholds.The second part of the thesis concerns maternal health, in particular, gestational hypertension and pre-eclampsia. We explore the association between antidepressant use and the risk of developing gestational hypertension. Although the underlying mechanism of the association remains unclear, it is present. It is important that both healthcare professionals and patients are informed about this association and carefully consider it in pregnancy management. Additionally, economic evaluation of pre-eclampsia, with a main focus on screening is also assessed in this section. The results indicate that a new screening test using novel biomarkers has the potential to be a cost-effective option for clinical practice. Continuous efforts are warranted in order to improve women’s health and reduce preventable morbidity and mortality in mothers and women in general. Assessment and implementation of more functional linkages between reproductive and maternal health services should also be more encouraged.

M3 - Thesis fully internal (DIV)

SN - 978-94-034-0648-0

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