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Calculation of Cost per life-year saved by our program so far

“Cost per life-year saved” is a number used in risk analysis to compare the cost-benefit ratios of different interventions in health and safety.  In our case, we are saving babies at birth, when they have a long life ahead of them. This results in quite a lot of life-years saved. The numbers work out to be US$8.40 spent for each life-year saved. Details are below. 

Compare this figure with published figures for some other interventions (most of these numbers pertain to the United States, as those for China are not available).

HIV blood tests for sex workers: US$3.35

Training for Midwives in Kham: US$8.40
Anti retro-viral drugs for HIV+ people: US$1317
Smoking cessation intervention: US$2,587
Chlorination of water supplies: US$4,000
PAP smear every three years: US$4,079
Colonoscopy every ten years: US$7,000
Heart transplant: US$157,000.
Seat belts in the center rear seat of cars: US$1,944,000
Seat belts in school buses: US$2,760,000.
 

The calculation of $8.40 per life-year saved was based on the following assumptions:

• The "half-life" of a working midwife is 10 years.  That is, after 10 years half of all of our trained midwives will have left the profession through retirement, death, or being made obsolete by the arrival of some other health care provider.
• The average midwife saves one baby's life for every five years of practice, or 0.2 baby-lives per year. This is an estimate based on our 2004 interviews.
• The average midwife saves one mother's life in fifty years of practice, or .02 mother-lives per year.  (statistics from Tibet show maternal mortality rates to be about one-tenth infant mortality rates).
• The life expectancy at birth of a Tibetan baby is about 50 years.
• The life expectancy of a 25-year-old woman (i.e. one of child-bearing age) is about 35 years.

Another inputs:

• Number of midwives who have graduated from our program thru 2004: 59
• Monies spent on the program thru 2004:  US$74,000.

Not included: the lives saved by our midwives' other work such as giving injections, dispensing medicines, counseling people to wash more often, etc.

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