Cargando…
Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India
An estimated 2.4 million newborn infants died in 2020, 80% of them in sub-Saharan Africa and South Asia. To achieve the Sustainable Development Target for neonatal mortality reduction, countries with high mortality need to implement evidence-based, cost-effective interventions at scale. Our study ai...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309599/ https://www.ncbi.nlm.nih.gov/pubmed/37384595 http://dx.doi.org/10.1371/journal.pgph.0001128 |
_version_ | 1785066472020639744 |
---|---|
author | Haghparast-Bidgoli, Hassan Ojha, Amit Gope, Rajkumar Rath, Shibanand Pradhan, Hemanta Rath, Suchitra Kumar, Amit Nath, Vikash Basu, Parabita Copas, Andrew Houweling, Tanja A. J. Minz, Akay Baskey, Pradeep Ahmed, Manir Chakravarthy, Vasudha Mahanta, Riza Palmer, Tom Skordis, Jolene Nair, Nirmala Tripathy, Prasanta Prost, Audrey |
author_facet | Haghparast-Bidgoli, Hassan Ojha, Amit Gope, Rajkumar Rath, Shibanand Pradhan, Hemanta Rath, Suchitra Kumar, Amit Nath, Vikash Basu, Parabita Copas, Andrew Houweling, Tanja A. J. Minz, Akay Baskey, Pradeep Ahmed, Manir Chakravarthy, Vasudha Mahanta, Riza Palmer, Tom Skordis, Jolene Nair, Nirmala Tripathy, Prasanta Prost, Audrey |
author_sort | Haghparast-Bidgoli, Hassan |
collection | PubMed |
description | An estimated 2.4 million newborn infants died in 2020, 80% of them in sub-Saharan Africa and South Asia. To achieve the Sustainable Development Target for neonatal mortality reduction, countries with high mortality need to implement evidence-based, cost-effective interventions at scale. Our study aimed to estimate the cost, cost-effectiveness, and benefit-cost ratio of a participatory women’s groups intervention scaled up by the public health system in Jharkhand, eastern India. The intervention was evaluated through a pragmatic cluster non-randomised controlled trial in six districts. We estimated the cost of the intervention at scale from a provider perspective, with a 42-month time horizon for 20 districts. We estimated costs using a combination of top-down and bottom-up approaches. All costs were adjusted for inflation, discounted at 3% per year, and converted to 2020 International Dollars (INT$). Incremental cost-effectiveness ratios (ICERs) were estimated using extrapolated effect sizes for the impact of the intervention in 20 districts, in terms of cost per neonatal deaths averted and cost per life year saved. We assessed the impact of uncertainty on results through one-way and probabilistic sensitivity analyses. We also estimated benefit-cost ratio using a benefit transfer approach. Total intervention costs for 20 districts were INT$ 15,017,396. The intervention covered an estimated 1.6 million livebirths across 20 districts, translating to INT$ 9.4 per livebirth covered. ICERs were estimated at INT$ 1,272 per neonatal death averted or INT$ 41 per life year saved. Net benefit estimates ranged from INT$ 1,046 million to INT$ 3,254 million, and benefit-cost ratios from 71 to 218. Our study suggests that participatory women’s groups scaled up by the Indian public health system were highly cost-effective in improving neonatal survival and had a very favourable return on investment. The intervention can be scaled up in similar settings within India and other countries. |
format | Online Article Text |
id | pubmed-10309599 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-103095992023-06-30 Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India Haghparast-Bidgoli, Hassan Ojha, Amit Gope, Rajkumar Rath, Shibanand Pradhan, Hemanta Rath, Suchitra Kumar, Amit Nath, Vikash Basu, Parabita Copas, Andrew Houweling, Tanja A. J. Minz, Akay Baskey, Pradeep Ahmed, Manir Chakravarthy, Vasudha Mahanta, Riza Palmer, Tom Skordis, Jolene Nair, Nirmala Tripathy, Prasanta Prost, Audrey PLOS Glob Public Health Research Article An estimated 2.4 million newborn infants died in 2020, 80% of them in sub-Saharan Africa and South Asia. To achieve the Sustainable Development Target for neonatal mortality reduction, countries with high mortality need to implement evidence-based, cost-effective interventions at scale. Our study aimed to estimate the cost, cost-effectiveness, and benefit-cost ratio of a participatory women’s groups intervention scaled up by the public health system in Jharkhand, eastern India. The intervention was evaluated through a pragmatic cluster non-randomised controlled trial in six districts. We estimated the cost of the intervention at scale from a provider perspective, with a 42-month time horizon for 20 districts. We estimated costs using a combination of top-down and bottom-up approaches. All costs were adjusted for inflation, discounted at 3% per year, and converted to 2020 International Dollars (INT$). Incremental cost-effectiveness ratios (ICERs) were estimated using extrapolated effect sizes for the impact of the intervention in 20 districts, in terms of cost per neonatal deaths averted and cost per life year saved. We assessed the impact of uncertainty on results through one-way and probabilistic sensitivity analyses. We also estimated benefit-cost ratio using a benefit transfer approach. Total intervention costs for 20 districts were INT$ 15,017,396. The intervention covered an estimated 1.6 million livebirths across 20 districts, translating to INT$ 9.4 per livebirth covered. ICERs were estimated at INT$ 1,272 per neonatal death averted or INT$ 41 per life year saved. Net benefit estimates ranged from INT$ 1,046 million to INT$ 3,254 million, and benefit-cost ratios from 71 to 218. Our study suggests that participatory women’s groups scaled up by the Indian public health system were highly cost-effective in improving neonatal survival and had a very favourable return on investment. The intervention can be scaled up in similar settings within India and other countries. Public Library of Science 2023-06-29 /pmc/articles/PMC10309599/ /pubmed/37384595 http://dx.doi.org/10.1371/journal.pgph.0001128 Text en © 2023 Haghparast-Bidgoli et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Haghparast-Bidgoli, Hassan Ojha, Amit Gope, Rajkumar Rath, Shibanand Pradhan, Hemanta Rath, Suchitra Kumar, Amit Nath, Vikash Basu, Parabita Copas, Andrew Houweling, Tanja A. J. Minz, Akay Baskey, Pradeep Ahmed, Manir Chakravarthy, Vasudha Mahanta, Riza Palmer, Tom Skordis, Jolene Nair, Nirmala Tripathy, Prasanta Prost, Audrey Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India |
title | Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India |
title_full | Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India |
title_fullStr | Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India |
title_full_unstemmed | Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India |
title_short | Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India |
title_sort | economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in jharkhand, eastern india |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309599/ https://www.ncbi.nlm.nih.gov/pubmed/37384595 http://dx.doi.org/10.1371/journal.pgph.0001128 |
work_keys_str_mv | AT haghparastbidgolihassan economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT ojhaamit economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT goperajkumar economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT rathshibanand economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT pradhanhemanta economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT rathsuchitra economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT kumaramit economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT nathvikash economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT basuparabita economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT copasandrew economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT houwelingtanjaaj economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT minzakay economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT baskeypradeep economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT ahmedmanir economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT chakravarthyvasudha economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT mahantariza economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT palmertom economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT skordisjolene economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT nairnirmala economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT tripathyprasanta economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia AT prostaudrey economicevaluationofparticipatorywomensgroupsscaledupbythepublichealthsystemtoimprovebirthoutcomesinjharkhandeasternindia |