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Is hygiene promotion cost-effective? A case study in Burkina Faso

Tropical Medicine and International Health, 2002; 7(11):960-9
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Social and Mathematical Epidemiology
SaME Modelling & Economics

pub_id
12390603
pubmedid
12390603
ISI
178801500010
reference_type
Journal Article
author
Borghi, J.; Guinness, L.; Ouedraogo, J.; Curtis, V.
title
Is hygiene promotion cost-effective? A case study in Burkina Faso
secondary_title
Tropical Medicine and International Health
ISBNISSN
1360-2276
volume
7
number
11
pages
960-9
year
2002
abstract
OBJECTIVES: To estimate the incremental cost-effectiveness of a large-scale urban hygiene promotion programme in terms of reducing the incidence of childhood diarrhoeal disease in Bobo-Dioulasso, Burkina Faso. METHODS: Total and incremental costs of the programme were estimated retrospectively from the perspectives of the provider, from the households who change their behaviour as a result of the programme and from society (the sum of the two). The programme effects were derived from an intervention study that estimated the impact on handwashing with soap after handling child stools through a time-series method of observing 37 319 mothers. Using data from the literature, the associated reductions in childhood morbidity and mortality were estimated. The direct medical savings and indirect savings of caregiver time and lost productivity associated with child death were estimated from interviews with households and health workers. The cost and outcome data were combined to provide an estimate of the cost per mother who starts handwashing with soap as a result of the programme and the cost per case of childhood diarrhoea averted. RESULTS: The total provider cost (including start-up and 3-year running costs) was $302 507. Core programme activities accounted for 31% of the cost, administration 40%. The total cost to the 7286 households associated with changing behaviour during the 3 years of programme implementation was $160 125 ($7.3 per year per household). An estimated 8638 cases of diarrhoea, 864 outpatient consultations, 324 hospital referrals and 105 deaths were averted by the programme during this time. Savings to the provider from reduced treatment costs were estimated at $10 716 and savings to the households from averted treatment cost were $9136, resulting in a total saving to society of $19 852, increasing to $393 967 if indirect savings are included. The incremental provider cost per case of diarrhoea averted was $33.8. The incremental cost to society was $51.3 falling to $7.9 if indirect savings are included. If the programme were to be replicated elsewhere, savings in the international research input and start-up costs could reduce provider costs to $26.9 per case of diarrhoea averted. The annual cost of the programme represents 0.001% of the national health budget for Burkina Faso. The direct annual cost of implementing the programme at the household level represents 1.3% of annual household income. CONCLUSION: Hygiene promotion reduces the occurrence of childhood diarrhoea in Burkina Faso at less than 1% of the Ministry of Health budget and less than 2% of the household budget, and could be widely replicated at lower cost.
keywords
Burkina Faso Child Child Health Services Child, Preschool Cost-Benefit Analysis Diarrhea/*economics/*prevention & control Female Handwashing Health Promotion/*economics Human Hygiene/*education Infant Outcome Assessment (Health Care) Program Evaluation Sensitivity and Specificity Support, Non-U.S. Gov't
secondary_author
place_published
publisher
number_of_volumes
tertiary_author
tertiary_title
edition
date
Nov
type_of_work
subsidiary_author
alternate_title
call_number
accession_number
12390603
custom_1
WOS OK
custom_2
Unknown
custom_3
custom_4
10.1046/j.1365-3156.2002.00954.x
custom_5
Free
custom_6
10
label
2016-10-19
notes
Journal Article
url
author_address
Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK. jo.borghi@lshtm.ac.uk
library
12390603 954
date_accepted
date_online
created
2003-07-30 10:35:51
modified
2016-07-08 00:00:00
library

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