ArticleHuman resources for health2018
Cost-effectiveness of the treatment of uncomplicated severe acute malnutrition by community health workers compared to treatment provided at an outpatient facility in rural Mali.
Article in Human resources for health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 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
28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Lay health workers in primary and community health care for maternal and child health: identification and treatment of wasting in children.The Cochrane database of systematic reviews · 2023Pooled 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
- Cost and cost-effectiveness analysis of treatment for child undernutrition in low- and middle-income countries: A systematic review.Wellcome open research · 2020Pooled it
- Ready-to-use therapeutic food (RUTF) for home-based nutritional rehabilitation of severe acute malnutrition in children from six months to five years of age.The Cochrane database of systematic reviews · 2019Pooled it
- Cost-effectiveness of decentralising acute malnutrition treatment with a standard or simplified treatment protocol: an economic evaluation in the region of Gao, Mali.BMC public health · 2025Trial
- The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: a cluster-randomized controlled trial.Health policy and planning · 2024Trial
- Effectiveness of decentralizing outpatient acute malnutrition treatment with community health workers and a simplified combined protocol: a cluster randomized controlled trial in emergency settings of Mali.Frontiers in public health · 2024Trial
- Integrated community case management plus compared with outpatient therapeutic programs: a quasi-experimental study among children with severe acute malnutrition in Jowhar, Somalia.The American journal of clinical nutrition · 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
- The Economic Implications of Relapse Among Children Recovered from Severe Acute Malnutrition: Results from a Multicountry Prospective Study in Mali, Somalia, and South Sudan.Current developments in nutrition · 2026Article
- Treatment of moderate acute malnutrition through community health volunteers is a cost-effective intervention: Evidence from a resource-limited setting.Maternal & child nutrition · 2024Article
- Article
- Integration of Acute Malnutrition Treatment Into Integrated Community Case Management in Three Districts in Southern Mali: An Economic Evaluation.Global health, science and practice · 2024Article
- Cost-effectiveness of severe acute malnutrition treatment delivered by community health workers in the district of Mayahi, Niger.Human resources for health · 2024Article
- Evidence on the impact of community health workers in the prevention, identification, and management of undernutrition amongst children under the age of five in conflict-affected or fragile settings: a systematic literature review.Conflict and health · 2024Review
- Healthcare-seeking behaviours among mother's having under-five children with severe wasting in Dodoma and Mbeya regions of Tanzania-A qualitative study.PLOS global public health · 2024Article
- Cost of Acute Malnutrition Treatment Using a Simplified or Standard Protocol in Diffa, Niger.Nutrients · 2023Article
- Costs and cost-effectiveness of treatment setting for children with wasting, oedema and growth failure/faltering: A systematic review.PLOS global public health · 2023Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Malian Nutrition Division of the Ministry of Health and Action Against Hunger tested the feasibility of integrating treatment of severe acute malnutrition (SAM) into the existing Integrated Community Case Management package delivered by community health workers (CHWs). This study assessed costs and cost-effectiveness of CHW-delivered care compared to outpatient facility-based care.
methodsActivity-based costing methods were used, and a societal perspective employed to include all relevant costs incurred by institutions, beneficiaries and communities. The intervention and control arm enrolled different numbers of children so a modelled scenario sensitivity analysis was conducted to assess the cost-effectiveness of the two arms, assuming equal numbers of children enrolled.
resultsIn the base case, with unequal numbers of children in each arm, for CHW-delivered care, the cost per child treated was 244 USD and cost per child recovered was 259 USD. Outpatient facility-based care was less cost-effective at 442 USD per child and 501 USD per child recovered. The conclusions of the analysis changed in the modelled scenario sensitivity analysis, with outpatient facility-based care being marginally more cost-effective (cost per child treated is 188 USD, cost per child recovered is 214 USD), compared to CHW-delivered care. This suggests that achieving good coverage is a key factor influencing cost-effectiveness of CHWs delivering treatment for SAM in this setting. Per week of treatment, households receiving CHW-delivered care spent half of the time receiving treatment and three times less money compared with those receiving treatment from the outpatient facility.
conclusionsThis study supports existing evidence that the delivery of treatment by CHWs is a cost-effective intervention, provided that good coverage is achieved. A major benefit of this strategy was the lower cost incurred by the beneficiary household when treatment is available in the community. Further research is needed on the implementation costs that would be incurred by the government to increase the operability of these results.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.