Cost of Implementing Complex Community Intervention for Healthier Lifestyle at Five Health Clinics in Malaysia

Abstract

BackgroundA complex community intervention for behavioural change through the use of behaviour change counselling provided by community health promoters (CHPs) and utilisation of an E-health platform was designed to address an increasing number of obese and overweight women entering pregnancy. This paper describes a cost analysis of this novel intervention.MethodsThe analysis was performed from a provider’s perspective, and calculated in Malaysian ringgit (RM). Included were costs for purchase of clients’ progress monitoring equipment, including anthropometric measurement and information technology (IT) equipment; training and education of the CHPs and other healthcare personnel; and cost of contact between the clients and the providers; excluding costs for intervention planning and resource development; and research costs.ResultsAssuming that the intervention is running at a steady state; utilising existing facilities; and does not require additional time; total cost was RM 445,725.51 and average cost per intervention per person RM 3,073.97. About 50% of the total cost was for the purchase of IT equipment, 17% for the maintenance of the system and the remainder for consumables, emoluments and utilities.ConclusionsFindings of this study suggests that implementation of the intervention requires the provider to invest heavily in IT hardware and maintenance of the E-health platform. However, this analysis is likely an under-estimate of the actual cost as it was conducted from a provider’s perspective only and the intervention was assumed to have matured and running at a steady state; which may not be the case as changes were undertaken during its implementation to allow for maximum outcome.Trial registration number: NMRR-15-2333-28679Date of registration: 22 March 2016