Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia
Abstract Background Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the stu...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-017-1906-9 |
| _version_ | 1811237861652955136 |
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| author | Blanca Escribano Ferrer Kristian Schultz Hansen Margaret Gyapong Jane Bruce Solomon A. Narh Bana Clement T. Narh Naa-Korkor Allotey Roland Glover Naa-Charity Azantilow Constance Bart-Plange Isabella Sagoe-Moses Jayne Webster |
| author_facet | Blanca Escribano Ferrer Kristian Schultz Hansen Margaret Gyapong Jane Bruce Solomon A. Narh Bana Clement T. Narh Naa-Korkor Allotey Roland Glover Naa-Charity Azantilow Constance Bart-Plange Isabella Sagoe-Moses Jayne Webster |
| author_sort | Blanca Escribano Ferrer |
| collection | DOAJ |
| description | Abstract Background Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study was to assess the cost-effectiveness of these strategies under programme conditions. Methods A cost-effectiveness analysis was conducted. Appropriate diagnosis and treatment given was the effectiveness measure used. Appropriate diagnosis and treatment data was obtained from a household survey conducted 2 and 8 years after implementation of iCCM in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-5 years who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. Costs data was obtained mainly from the National Malaria Control Programme (NMCP), the Ministry of Health, CHPS compounds and from a household survey. Results Appropriate diagnosis and treatment of malaria, diarrhoea and suspected pneumonia was more cost-effective under the iCCM than under CHPS in the Volta Region, even after adjusting for different discount rates, facility costs and iCCM and CHPS utilization, but not when iCCM appropriate treatment was reduced by 50%. Due to low numbers of carers visiting a CBA in the Northern Region it was not possible to conduct a cost-effectiveness analysis in this region. However, the cost analysis showed that iCCM in the Northern Region had higher cost per malaria, diarrhoea and suspected pneumonia case diagnosed and treated when compared to the Volta Region and to the CHPS strategy in the Northern Region. Conclusions Integrated community case management was more cost-effective than CHPS for the treatment of malaria, diarrhoea and suspected pneumonia when utilized by carers of children under-5 years in the Volta Region. A revision of the iCCM strategy in the Northern Region is needed to improve its cost-effectiveness. Long-term financing strategies should be explored including potential inclusion in the National Health Insurance Scheme (NHIS) benefit package. An acceptability study of including iCCM in the NHIS should be conducted. |
| first_indexed | 2024-04-12T12:31:54Z |
| format | Article |
| id | doaj.art-533e283e99144e0082b26422aeb581e6 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-12T12:31:54Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-533e283e99144e0082b26422aeb581e62022-12-22T03:33:00ZengBMCMalaria Journal1475-28752017-07-0116111810.1186/s12936-017-1906-9Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumoniaBlanca Escribano Ferrer0Kristian Schultz Hansen1Margaret Gyapong2Jane Bruce3Solomon A. Narh Bana4Clement T. Narh5Naa-Korkor Allotey6Roland Glover7Naa-Charity Azantilow8Constance Bart-Plange9Isabella Sagoe-Moses10Jayne Webster11Disease Control Department, London School of Hygiene and Tropical MedicineDepartment of Public Health, University of CopenhagenDodowa Health Research Center, Ghana Health ServiceDisease Control Department, London School of Hygiene and Tropical MedicineDodowa Health Research Center, Ghana Health ServiceSchool of Public Health, University of Health and Allied SciencesNational Malaria Control Programme, Ghana Health ServiceNational Malaria Control Programme, Ghana Health ServiceNational Malaria Control Programme, Ghana Health ServiceNational Malaria Control Programme, Ghana Health ServiceReproductive and Child Health Department, Ghana Health ServiceDisease Control Department, London School of Hygiene and Tropical MedicineAbstract Background Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study was to assess the cost-effectiveness of these strategies under programme conditions. Methods A cost-effectiveness analysis was conducted. Appropriate diagnosis and treatment given was the effectiveness measure used. Appropriate diagnosis and treatment data was obtained from a household survey conducted 2 and 8 years after implementation of iCCM in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-5 years who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. Costs data was obtained mainly from the National Malaria Control Programme (NMCP), the Ministry of Health, CHPS compounds and from a household survey. Results Appropriate diagnosis and treatment of malaria, diarrhoea and suspected pneumonia was more cost-effective under the iCCM than under CHPS in the Volta Region, even after adjusting for different discount rates, facility costs and iCCM and CHPS utilization, but not when iCCM appropriate treatment was reduced by 50%. Due to low numbers of carers visiting a CBA in the Northern Region it was not possible to conduct a cost-effectiveness analysis in this region. However, the cost analysis showed that iCCM in the Northern Region had higher cost per malaria, diarrhoea and suspected pneumonia case diagnosed and treated when compared to the Volta Region and to the CHPS strategy in the Northern Region. Conclusions Integrated community case management was more cost-effective than CHPS for the treatment of malaria, diarrhoea and suspected pneumonia when utilized by carers of children under-5 years in the Volta Region. A revision of the iCCM strategy in the Northern Region is needed to improve its cost-effectiveness. Long-term financing strategies should be explored including potential inclusion in the National Health Insurance Scheme (NHIS) benefit package. An acceptability study of including iCCM in the NHIS should be conducted.http://link.springer.com/article/10.1186/s12936-017-1906-9Home- based careIntegrated community case management (iCCM)MalariaDiarrhoeaPneumoniaChildren under-five |
| spellingShingle | Blanca Escribano Ferrer Kristian Schultz Hansen Margaret Gyapong Jane Bruce Solomon A. Narh Bana Clement T. Narh Naa-Korkor Allotey Roland Glover Naa-Charity Azantilow Constance Bart-Plange Isabella Sagoe-Moses Jayne Webster Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia Malaria Journal Home- based care Integrated community case management (iCCM) Malaria Diarrhoea Pneumonia Children under-five |
| title | Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia |
| title_full | Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia |
| title_fullStr | Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia |
| title_full_unstemmed | Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia |
| title_short | Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia |
| title_sort | cost effectiveness analysis of the national implementation of integrated community case management and community based health planning and services in ghana for the treatment of malaria diarrhoea and pneumonia |
| topic | Home- based care Integrated community case management (iCCM) Malaria Diarrhoea Pneumonia Children under-five |
| url | http://link.springer.com/article/10.1186/s12936-017-1906-9 |
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