Cost-effectiveness and affordability of community mobilisation through women's groups and quality improvement in health facilities (MaiKhanda trial) in Malawi

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Tyck till om SwePub Sök här!

Sökning: onr:"swepub:oai:DiVA.org:umu-117032" > Cost-effectiveness ...

1 av 1
Föregående post
Nästa post
Till träfflistan

Cost-effectiveness and affordability of community mobilisation through women's groups and quality improvement in health facilities (MaiKhanda trial) in Malawi

Colbourn, Tim (författare): UCL Institute for Global Health, London, UK

Pulkki-Brännström, Anni-Maria, 1983- (författare): Umeå universitet,Epidemiologi och global hälsa,UCL Institute for Global Health, London, UK

Nambiar, Bejoy (författare): UCL Institute for Global Health, London, UK

visa fler...

Kim, Sungwook (författare): UCL Institute for Global Health, London, UK

Bondo, Austin (författare): Capital City, Lilongwe 3, Malawi

Banda, Lumbani (författare): Capital City, Lilongwe 3, Malawi

Makwenda, Charles (författare): Capital City, Lilongwe 3, Malawi

Batura, Neha (författare): UCL Institute for Global Health, London, UK

Haghparast-Bidgoli, Hassan (författare): UCL Institute for Global Health, London, UK

Hunter, Rachael (författare): London, UK

Costello, Anthony (författare): UCL Institute for Global Health, London, UK

Baio, Gianluca (författare): London, UK

Skordis-Worrall, Jolene (författare): UCL Institute for Global Health, London, UK

visa färre...

(creator_code:org_t)

2015-01-10
2015
Engelska.
Ingår i: Cost Effectiveness and Resource Allocation. - : BioMed Central (BMC). - 1478-7547. ; 13

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://umu.diva-por... (primary) (Raw object); https://resource-all...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

BACKGROUND: Understanding the cost-effectiveness and affordability of interventions to reduce maternal and newborn deaths is critical to persuading policymakers and donors to implement at scale. The effectiveness of community mobilisation through women's groups and health facility quality improvement, both aiming to reduce maternal and neonatal mortality, was assessed by a cluster randomised controlled trial conducted in rural Malawi in 2008-2010. In this paper, we calculate intervention cost-effectiveness and model the affordability of the interventions at scale.METHODS: Bayesian methods are used to estimate the incremental cost-effectiveness of the community and facility interventions on their own (CI, FI), and together (FICI), compared to current practice in rural Malawi. Effects are estimated with Monte Carlo simulation using the combined full probability distributions of intervention effects on stillbirths, neonatal deaths and maternal deaths. Cost data was collected prospectively from a provider perspective using an ingredients approach and disaggregated at the intervention (not cluster or individual) level. Expected Incremental Benefit, Cost-effectiveness Acceptability Curves and Expected Value of Information (EVI) were calculated using a threshold of $780 per disability-adjusted life-year (DALY) averted, the per capita gross domestic product of Malawi in 2013 international $.RESULTS: The incremental cost-effectiveness of CI, FI, and combined FICI was $79, $281, and $146 per DALY averted respectively, compared to current practice. FI is dominated by CI and FICI. Taking into account uncertainty, both CI and combined FICI are highly likely to be cost effective (probability 98% and 93%, EVI $210,423 and $598,177 respectively). Combined FICI is incrementally cost effective compared to either intervention individually (probability 60%, ICER $292, EIB $9,334,580 compared to CI). Future scenarios also found FICI to be the optimal decision. Scaling-up to the whole of Malawi, CI is of greatest value for money, potentially averting 13.0% of remaining annual DALYs from stillbirths, neonatal and maternal deaths for the equivalent of 6.8% of current annual expenditure on maternal and neonatal health in Malawi.CONCLUSIONS: Community mobilisation through women's groups is a highly cost-effective and affordable strategy to reduce maternal and neonatal mortality in Malawi. Combining community mobilisation with health facility quality improvement is more effective, more costly, but also highly cost-effective and potentially affordable in this context.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

Cost-effectiveness
Affordability
Community mobilisation
Women's groups
Quality improvement
MaiKhanda
Scale-up
Future scenarios
Malawi

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

Hitta via bibliotek

Cost Effectiveness and Resource Allocation (Sök värdpublikationen i LIBRIS)

Till lärosätets databas

1 av 1
Föregående post
Nästa post
Till träfflistan

Hitta mer i SwePub

Av författaren/redakt...: Colbourn, Tim; Pulkki-Brännströ ...; Nambiar, Bejoy; Kim, Sungwook; Bondo, Austin; Banda, Lumbani; visa fler...; Makwenda, Charle ...; Batura, Neha; Haghparast-Bidgo ...; Hunter, Rachael; Costello, Anthon ...; Baio, Gianluca; Skordis-Worrall, ...; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Folkhälsovetensk ...

Artiklar i publikationen: Cost Effectivene ...

Av lärosätet: Umeå universitet

Sök utanför SwePub

Sök vidare i:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se