ArticleBulletin of the World Health Organization2015
Cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya.
Article in Bulletin of the World Health Organization, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of scope and quality of health economic evaluations conducted in Ethiopia.Health policy and planning · 2022Pooled it
- Cost-effectiveness of maternal and neonatal health interventions in Ethiopia: a systematic review and meta-analysis.Health economics review · 2026Review
- Maternal and child healthcare coverage and trends: refugee vs. non-refugee districts in Uganda.Conflict and health · 2026Article
- Costs and cost-effectiveness of community health worker programs on reproductive, maternal, newborn and child health in low- and middle-income countries (2015-2024): A scoping review.PLOS global public health · 2026Article
- Article
- Cost analysis of probiotic/synbiotic supplementation in infants in rural Kenya: a study from the PROSYNK trial.BMJ paediatrics open · 2025Article
- Cost-effectiveness analysis in primary care research: A practical guide for early-career researchers.African journal of primary health care & family medicine · 2025Article
- Costs and cost-effectiveness of integrated horizontal community health worker programmes in low- and middle-income countries (2015-2024): a scoping literature review.BMJ global health · 2025Article
- Implementation status, drivers and barriers to the sick children quality of care improving interventions in the Oromia region, Ethiopia: case study design.BMC health services research · 2025Article
- Exploring the Potential Causal Relationship Between Health Insurance Coverage and Child Nutritional Status in Pakistan: Evidence from PDHS-2018.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Ethiopian Health Extension Workers' Training Status and Perceived Competency.Ethiopian journal of health sciences · 2023Article
- Article
- Human resource time commitments and associated costs of Community Caregiver outreach team operations in South Africa.PloS one · 2023Article
- Contested notions of challenges affecting Community Health Workers in low- and middle-income countries informed by the Silences Framework.Human resources for health · 2022Article
- Causal relationship between health insurance and overall health status of children: Insights from Pakistan.Frontiers in public health · 2022Article
- Compensation models for community health workers: Comparison of legal frameworks across five countries.Journal of global health · 2021Review
- Article
- How should community health workers in fragile contexts be supported: qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo.Human resources for health · 2020Article
- Cost-effectiveness of inhaled oxytocin for prevention of postpartum haemorrhage: a modelling study applied to two high burden settings.BMC medicine · 2020Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectiveTo assess the cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya.
methodsIncremental cost-effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. Life years gained were estimated based on coverage of reproductive, maternal, neonatal and child health services. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. For Indonesia, coverage of health service interventions was estimated from routine data. We used the Lives Saved Tool to estimate the number of lives saved from changes in reproductive, maternal, neonatal and child health-service coverage. Gross domestic product per capita was used as the reference willingness-to-pay threshold value.
findingsThe estimated incremental cost per life year gained was 82 international dollars ($)in Kenya, $999 in Ethiopia and $3396 in Indonesia. The results were most sensitive to uncertainty in the estimates of life-years gained. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective.
conclusionCommunity-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. Community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness.
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