Evidence map›Paper›PMID 26329455›Full record

SynthesisHuman resources for health2015

Costs and cost-effectiveness of community health workers: evidence from a literature review.

Kelsey Vaughan, Maryse C Kok, Sophie Witter, Marjolein Dieleman

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Human resources for health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 16 pooled it
–field-weighted citation impact
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

137 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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  7. Effects of community health worker-based interventions on physical activity levels in children: a systematic review.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2021
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77 more citing papers are in PubMed but not listed here.

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

4 authors.

Kelsey VaughanRoyal Tropical Institute (KIT), P.O. Box 95001, 1090 HA, Amsterdam, The Netherlands. kvaughan@gmail.com.
Maryse C KokRoyal Tropical Institute (KIT), P.O. Box 95001, 1090 HA, Amsterdam, The Netherlands. Maryse.Kok@kit.nl.
Sophie WitterQueen Margaret University, Edinburgh, Scotland. SWitter@qmu.ac.uk.
Marjolein DielemanRoyal Tropical Institute (KIT), P.O. Box 95001, 1090 HA, Amsterdam, The Netherlands. m.dieleman@kit.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study sought to synthesize and critically review evidence on costs and cost-effectiveness of community health worker (CHW) programmes in low- and middle-income countries (LMICs) to inform policy dialogue around their role in health systems.

methodsFrom a larger systematic review on effectiveness and factors influencing performance of close-to-community providers, complemented by a supplementary search in PubMed, we did an exploratory review of a subset of papers (32 published primary studies and 4 reviews from the period January 2003-July 2015) about the costs and cost-effectiveness of CHWs. Studies were assessed using a data extraction matrix including methodological approach and findings.

resultsExisting evidence suggests that, compared with standard care, using CHWs in health programmes can be a cost-effective intervention in LMICs, particularly for tuberculosis, but also - although evidence is weaker - in other areas such as reproductive, maternal, newborn and child health (RMNCH) and malaria.

conclusionNotwithstanding important caveats about the heterogeneity of the studies and their methodological limitations, findings reinforce the hypothesis that CHWs may represent, in some settings, a cost-effective approach for the delivery of essential health services. The less conclusive evidence about the cost-effectiveness of CHWs in other areas may reflect that these areas have been evaluated less (and less rigorously) than others, rather than an actual difference in cost-effectiveness in the various service delivery areas or interventions. Methodologically, areas for further development include how to properly assess costs from a societal perspective rather than just through the lens of the cost to government and accounting for non-tangible costs and non-health benefits commonly associated with CHWs.

Indexed as

Developing CountriesClinical CompetenceCommunicable Disease ControlCommunity Health WorkersCost-Benefit AnalysisHealth Services AdministrationHumansMalariaMaternal-Child Health ServicesOutcome Assessment, Health CarePolicyQuality of Health CareReproductive Health ServicesTuberculosis

Identifiers

PMID26329455
PMCPMC4557864

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.