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A systematic review of economic evaluations of neonatal and maternal healthcare in immigrant and ethnic minority women.

BACKGROUND
less access to appropriate care during pregnancy for immigrant/ethnic minority women can lead to worse health outcomes and higher costs for health services.


OBJECTIVES
to conduct a systematic review of studies on the economic evaluation of maternal and child healthcare among immigrants and racial/ethnic minority groups in advanced economy countries.


METHODS
the main biomedical/economic bibliographic databases and institutional sources were searched. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.


RESULTS
encouraging breastfeeding and reducing inappropriate hospital use/length of hospital stay proved potentially able to reduce costs. Most studies showed a cost reduction if immigrant and ethnic minority women were included both in national and targeted programmes, such as nutritional programmes or case management. Screening campaigns targeting immigrants and ethnic minority groups were more cost-effective than broader, universal or non-screening strategies. Screenings were cost-effective when extended to newborns/relatives of pregnant women (Chagas disease) and were cost-effective for unvaccinated women in low-vaccination rates regions (rubella), immigrant women reporting no/uncertain vaccination history (varicella), and first-generation immigrants (HCV).


DISCUSSION
promoting inclusion in pregnancy healthcare programmes or in targeted screening campaigns could be effective in cost saving for health services.