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...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001128 |
| _version_ | 1797694158545092608 |
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| author | Hassan Haghparast-Bidgoli Amit Ojha Rajkumar Gope Shibanand Rath Hemanta Pradhan Suchitra Rath Amit Kumar Vikash Nath Parabita Basu Andrew Copas Tanja A J Houweling Akay Minz Pradeep Baskey Manir Ahmed Vasudha Chakravarthy Riza Mahanta Tom Palmer Jolene Skordis Nirmala Nair Prasanta Tripathy Audrey Prost |
| author_facet | Hassan Haghparast-Bidgoli Amit Ojha Rajkumar Gope Shibanand Rath Hemanta Pradhan Suchitra Rath Amit Kumar Vikash Nath Parabita Basu Andrew Copas Tanja A J Houweling Akay Minz Pradeep Baskey Manir Ahmed Vasudha Chakravarthy Riza Mahanta Tom Palmer Jolene Skordis Nirmala Nair Prasanta Tripathy Audrey Prost |
| author_sort | Hassan Haghparast-Bidgoli |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-12T02:53:53Z |
| format | Article |
| id | doaj.art-223b75a3e6d64c3b9aea483bd3de757c |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T02:53:53Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-223b75a3e6d64c3b9aea483bd3de757c2023-09-03T15:25:43ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0136e000112810.1371/journal.pgph.0001128Economic evaluation of participatory women's groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India.Hassan Haghparast-BidgoliAmit OjhaRajkumar GopeShibanand RathHemanta PradhanSuchitra RathAmit KumarVikash NathParabita BasuAndrew CopasTanja A J HouwelingAkay MinzPradeep BaskeyManir AhmedVasudha ChakravarthyRiza MahantaTom PalmerJolene SkordisNirmala NairPrasanta TripathyAudrey ProstAn 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.https://doi.org/10.1371/journal.pgph.0001128 |
| spellingShingle | Hassan Haghparast-Bidgoli Amit Ojha Rajkumar Gope Shibanand Rath Hemanta Pradhan Suchitra Rath Amit Kumar Vikash Nath Parabita Basu Andrew Copas Tanja A J Houweling Akay Minz Pradeep Baskey Manir Ahmed Vasudha Chakravarthy Riza Mahanta Tom Palmer Jolene Skordis Nirmala Nair Prasanta Tripathy Audrey Prost Economic evaluation of participatory women's groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India. PLOS Global Public Health |
| 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 |
| url | https://doi.org/10.1371/journal.pgph.0001128 |
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