BackgroundThis study estimated the cost effectiveness of community-based therapeutic care (CTC) for children with severe acute malnutrition (SAM) in Sidama Zone, Ethiopia compared to facility based therapeutic feeding center (TFC).MethodsA cost effectiveness analysis comparing costs and outcomes of two treatment programmes was conducted. The societal perspective, which considers costs to all sectors of the society, was employed. Outcomes and health service costs of CTC and TFC were obtained from Save the Children USA (SC/USA) CTC and TFC programme, government health services and UNICEF(in kind supplies) cost estimates of unit costs. Parental costs were estimated through interviewing 306 caretakers. Cost categories were compared and a single cost effectiveness ratio of costs to treat a child with SAM in each program (regardless of outcome) was computed and compared.ResultsA total of 328 patient cards/records of children treated in the programs were reviewed; out of which 306 (157 CTC and 149 TFC) were traced back to their households to interview their caretakers. The cure rate in TFC was 95.36% compared to 94.30% in CTC. The death rate in TFC was 0% and in CTC 1.2%. The mean cost per child treated was $284.56 in TFC and $134.88 in CTC. The institutional cost per child treated was $262.62 in TFC and $128.58 in CTC. Out of these institutional costs in TFC 46.6% was personnel cost. In contrast, majority (43.2%) of the institutional costs in CTC went to ready to use therapeutic food (RUTF). The opportunity cost per caretaker in the TFC was $21.01 whereas it was $5.87 in CTC. The result of this study shows that community based CTC was two times more cost effective than TFC.ConclusionCTC was found to be relatively more cost effective than TFC in this setting. This indicates that CTC is a viable approach on just economic grounds in addition to other benefits such improved access, sustainability and appropriateness documented elsewhere. If costs of RUTF can be reduced such as through local production the CTC costs per child can be further reduced as RUTF constitutes the highest cost in these study settings.
Background: The burden of malnutrition in Ethiopia is the second highest in sub Saharan Africa. According to the recently released Ethiopian Demographic and Health Survey report of 2011, the prevalence of child stunting, underweight and wasting were 44% stunted, 10% wasted and 29% underweight respectively. Objectives: To determine the magnitude and risk factors of malnutrition among 6-59 months children from Community Based Nutrition Program implementing and nonimplementing districts from south east Amhara. Methodology: Descriptive community based, cross sectional study in which a total of 987 children (620 from Community Based Nutrition implementing and 367 from nonimplementing districts) were sampled. A structured questionnaire was administered to mothers or caregivers of the children. Anthropometric measurements were taken following standard procedures. Nutritional status of the children was determined based on Z scores of < −2 or >= −2 Standard Deviation. Logistic regression was used to test significant associations between outcome and factor variables. Setting: Rural communities from Artuma Fursi and Kemissie districts. Results: A total of 987 children of 6-59 months of age and 987 mothers/caregivers had participated in the study, giving a response rate of 99%. The percentage of male and female children in CBNP district was 330 (53.2%) and 290 (46.8%) and that of non Community Based Nutrition Program (CBNP) district was 192 (52.3%) & 175 (47.7%) respectively. The prevalence of stunting, underweight and wasting were 60.6%, 31.1%, 12.6% and 39.0%, 27.5%, 14.7% in CBNP and nonCBNP implementing districts, respectively. The possible risk factors for child B. Tariku et al. 2 malnutrition were area specific and different for the two districts. Conclusion: Child under nutrition is a serious public health problem in both districts, so that holistic programs need to be designed and implemented according to the guidelines.
SummaryThis paper presents the results of an evaluation of community perception of two large-scale, government-run, school-based health programmes delivering anthelmintic drugs to primary school children, in Ghana (80 442 children in 577 schools) and Tanzania (110 000 children in 352 schools). Most teachers (96% in Ghana and 98% in Tanzania) were positive about their role in the programme, including administration of anthelmintic drugs, and parents and children fully accepted their taking on this role. The bene®ts of the programme were apparent to teachers, parents and children in terms of improved health and well-being of the children. Over 90% of parents in both Ghana and Tanzania indicated a willingness to pay for the continuation of drug treatment. The evaluation also highlighted areas that are critical to programme effectiveness, such as communication between schools and parents, the issue of collaboration between the health and education sectors, parents' perception of the importance of helminth infection as a serious and chronic health problem (compared with more acute and life threatening illnesses such as malaria), and who should pay for treatment of side-effects.keywords community perception, Ghana, helminth infection, schistosomiasis, school-based health programmes, Tanzania correspondence C. Maier,
Recent large-scale field trials show that mosquito nets impregnated with insecticide can substantially reduce all-cause mortality in children in malaria-endemic areas in Africa. This paper considers the cost-effectiveness of impregnated nets, initially from the perspective of a government programme which would distribute nets free of charge and organize and fund re-impregnation on an annual basis. The calculations show that with the reductions in all-cause mortality observed in the trials, complete government subsidy of nets through a vertical programme would represent an efficient use of scarce resources for most combinations of assumptions. However, alternative ways of financing and organizing the use of impregnated nets are also possible and may be more cost-effective than vertical delivery. Distribution of nets and insecticide might be less costly than required for a vertical programme by integrating delivery with other types of government health programmes, with private sector delivery systems for other types of products, or with government systems developed for other sectors such as agriculture. Further, not all the costs need to be met by governments, as costs could be shared with donors, NGOs and the beneficiaries. The major conclusion is that impregnated nets would save a large number of lives in malaria endemic areas, they are an efficient use of scare resources, and ways of encouraging their use need to be developed and tested.
The impact on the health of cases was considerable and the costs were high. Every effort should be made to prevent the disease and to identify and control outbreaks quickly.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.