Trial reportPloS one2015
Cost-Effectiveness of Peer Counselling for the Promotion of Exclusive Breastfeeding in Uganda.
Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 8 of them syntheses that pooled 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.
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.
Who cites it
30 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Support for healthy breastfeeding mothers with healthy term babies.The Cochrane database of systematic reviews · 2022Pooled it
- Measurement of benefits in economic evaluations of nutrition interventions in low- and middle-income countries: A systematic review.Maternal & child nutrition · 2022Pooled it
- Economic Evaluations of Child Nutrition Interventions in Low- and Middle-Income Countries: Systematic Review and Quality Appraisal.Advances in nutrition (Bethesda, Md.) · 2022Pooled it
- Economic evaluation of interventions to address undernutrition: a systematic review.Health policy and planning · 2021Pooled it
- Cost-effectiveness evidence for strategies to promote or support breastfeeding: a systematic search and narrative literature review.BMC pregnancy and childbirth · 2020Pooled it
- Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis.BMC infectious diseases · 2020Pooled it
- Support for healthy breastfeeding mothers with healthy term babies.The Cochrane database of systematic reviews · 2017Pooled it
- Interventions for promoting the initiation of breastfeeding.The Cochrane database of systematic reviews · 2016Pooled it
- Cost-benefit analysis of a multicomponent breastfeeding promotion and support intervention in a developing country.PloS one · 2024Trial
- Trial
- Socio-cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes - a qualitative study.International journal for equity in health · 2021Trial
- The cost of the training and supervision of community health workers to improve exclusive breastfeeding amongst mothers in a cluster randomised controlled trial in South Africa.BMC health services research · 2020Trial
- Trial
- Are Economic Evaluations of Task Shifting Too Narrow in Focus? A Rapid Review.PharmacoEconomics · 2025Review
- Influence of peer discussions on trust in recommendations for prevention of mother-to-child transmission (PMTCT) of HIV.PloS one · 2024Article
- Article
- Cost-benefit analysis of a multicomponent breastfeeding promotion and support intervention in a developing country.medRxiv : the preprint server for health sciences · 2023Article
- The effectiveness and sustainability of peer support interventions for persons living with HIV: a realist synthesis.BMJ global health · 2023Review
- HIV in Three Groups of Young People from Medellín: General Population, Organizations for People with Socioeconomic Vulnerability, and Men Who Have Sex with Other Men.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Peer Education and Peer Counselling for Health and Well-Being: A Review of Reviews.International journal of environmental research and public health · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity based breastfeeding promotion programmes have been shown to be effective in increasing breastfeeding prevalence. However, there is limited data on the cost-effectiveness of these programmes in sub-Saharan Africa. This paper evaluates the cost-effectiveness of a breastfeeding promotion intervention targeting mothers and their 0 to 6 month old children.
methodsData were obtained from a community randomized trial conducted in Uganda between 2006-2008, and supplemented with evidence from several studies in sub-Saharan Africa. In the trial, peer counselling was offered to women in intervention clusters. In the control and intervention clusters, women could access standard health facility breastfeeding promotion services (HFP). Thus, two methods of breastfeeding promotion were compared: community based peer counselling (in addition to HFP) and standard HFP alone. A Markov model was used to calculate incremental cost-effectiveness ratios between the two strategies. The model estimated changes in breastfeeding prevalence and disability adjusted life years. Costs were estimated from a provider perspective. Uncertainty around the results was characterized using one-way sensitivity analyses and a probabilistic sensitivity analysis.
findingsPeer counselling more than doubled the breastfeeding prevalence as reported by mothers, but there was no observable impact on diarrhoea prevalence. Estimated incremental cost-effectiveness ratios were US$68 per month of exclusive or predominant breastfeeding and U$11,353 per disability adjusted life year (DALY) averted. The findings were robust to parameter variations in the sensitivity analyses.
conclusionsOur strategy to promote community based peer counselling is unlikely to be cost-effective in reducing diarrhoea prevalence and mortality in Uganda, because its cost per DALY averted far exceeds the commonly assumed willingness-to-pay threshold of three times Uganda's GDP per capita (US$1653). However, since the intervention significantly increases prevalence of exclusive or predominant breastfeeding, it could be adopted in Uganda if benefits other than reducing the occurrence of diarrhoea are believed to be important.
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