Evidence map›Paper›PMID 24626285›Full record

ArticlePloS one2014

Economic analysis of delivering primary health care services through community health workers in 3 North Indian states.

Shankar Prinja, Gursimer Jeet, Ramesh Verma, Dinesh Kumar, Pankaj Bahuguna, Manmeet Kaur, Rajesh Kumar

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 3 pooled it
13.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Shankar PrinjaSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Gursimer JeetSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ramesh VermaDepartment of Community Medicine, Pt. BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Dinesh KumarDepartment of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
Pankaj BahugunaSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Manmeet KaurSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Rajesh KumarSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Post Graduate Institute of Medical Education and Research · INDr. Rajendra Prasad Government Medical College · INPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe assessed overall annual and unit cost of delivering package of services and specific services at sub-centre level by CHWs and cost effectiveness of Government of India's policy of introducing a second auxiliary nurse midwife (ANM) at the sub-centre compared to scenario of single ANM sub-centre.

methodsWe undertook an economic costing of health services delivered by CHWs, from a health system perspective. Bottom-up costing method was used to collect data on resources spent in 50 randomly selected sub-centres selected from 4 districts. Mean unit cost along with its 95% confidence intervals were estimated using bootstrap method. Multiple linear regression model was used to standardize cost and assess its determinants.

resultsAnnually it costs INR 1.03 million (USD 19,381), or INR 187 (USD 3.5) per capita per year, to provide a package of preventive, curative and promotive services through community health workers. Unit costs for antenatal care, postnatal care, DOTS treatment and immunization were INR 525 (USD 10) per full ANC care, INR 767 (USD 14) per PNC case registered, INR 974 (USD 18) per DOTS treatment completed and INR 97 (USD 1.8) per child immunized in routine immunization respectively. A 10% increase in human resource costs results in 6% rise in per capita cost. Similarly, 10% increment in the ANC case registered per provider through-put results in a decline in unit cost ranging from 2% in the event of current capacity utilization to 3% reduction in case of full capacity utilization. Incremental cost of introducing 2nd ANM at sub-centre level per unit percent increase ANC coverage was INR 23,058 (USD 432).

conclusionOur estimates would be useful in undertaking full economic evaluations or equity analysis of CHW programs. Government of India's policy of hiring 2nd ANM at sub-centre level is very cost effective from Indian health system perspective.

Indexed as

Health Care CostsCommunity Health WorkersCost-Benefit AnalysisDelivery of Health CareHumansIndiaPrimary Health Care

Identifiers

PMID24626285
PMCPMC3953597
OpenAlexW2003728556

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.