The costs of a community-based intervention to promote maternal health

Abstract

The costs of community-level interventions are rarely reported, although such insights are needed if intervention research is to be useful to practitioners seeking to understand what might be involved in replicating interventions in different contexts. We report the costs of a 2-year community-based intervention to promote the health of recent mothers in Victoria, Australia. Program of Resources, Information and Support for Mothers was an integrated programme of primary care and community-based strategies. It had health care professional training, health education and community development components as well as an emphasis on creating 'mother-friendly' environments. Costs included the programme costs [primarily the salaries of the community development officers (CDO) in the field] and also 'induced' costs that relate to the CDOs' successes in attracting additional resources to the intervention from the local community. The total cost averaged A$272,490 per rural community and A$313,900 per urban community, equivalent to A$172.40 and A$128.70 per mother, respectively. For every A$10 of public funds initially invested in the project, the CDOs were able to attract a further A$1-2 worth of local resources, predominantly in the form of volunteer time or donated services.

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

“…A further paper was identified during the economic modelling process. 397 It had been excluded at the title and abstract stage as PND or associated terms were not included in the title or abstract. Of the 13 papers identified, 61,174,199,264,[392][393][394][398][399][400] nine described an economic evaluation that was conducted alongside a trial, 53,61,174,199,264,299,392,393,400 three papers described an economic decision model 45,56,394 and one paper described a cost study.…”

“…The population in the screening papers 45,56 was all postnatal women. For the papers broadly evaluating the prevention of PND, the population differed with some studies including all postnatal women 61,199,264,397 and three studies evaluating women who had been identified as at increased risk of developing PND. 61,174,396 …”

“…61,174,199,264,396,397 l Four evaluated different strategies for treating PND 53,392,399,400 and, of these four, two were concerned with the additional cost of treating PND. 53,400 l Two evaluated screening for PND.…”

“…45,56,61,199,392,397,400 Five of these papers used a generic measure, 61,199,392,397,400 whereas the other two used a patient-generated utility value. 45,56 Of those that used a generic measure, two used the SF-6D, 61,392 two used the SF-36 199,397 and one used the SF-12. 400 The SF-36 and SF-12 cannot be used in their basic form to estimate quality-adjusted life-year (QALY) values but can be converted into the SF-6D, which provides values that can be used to estimate QALY values for use in an economic decision model.…”

“…Gold et al 397 evaluated the economic side of the PRISM (Program of Resources, Information and Support for Mothers) trial. The PRISM trial evaluated primary care and community-based strategies to improve the physical and mental health of new mothers.…”