This study calculated the net benefit of using active management of the
third stage of labour (AMTSL) rather than expectant management of the
third stage of labour (EMTSL) for mothers in Guatemala and Zambia.
Probabilities of events were derived from opinions of experts, publicly
available data, and published literature. Costs of clinical events were
calculated based on national price lists, observation of resources used
in AMTSL and EMTSL, and expert estimates of resources used in managing
postpar\uadtum haemorrhage and its complications, including
transfusion. A decision tree was used for modelling expected costs
associated with AMTSL or EMTSL. The base case analysis suggested a
positive net benefit from AMTSL, with a net cost-saving of US18,000inGuatemala(with100livessaved)andUS 145,000 in Zambia (with 467
lives saved) for 100,000 births. Facilities have strong economic
incentives to adopt AMTSL if uterotonics are available