ArticleBMJ global health2021
Economic and cost-effectiveness analysis of the Community-Level Interventions for Pre-eclampsia (CLIP) trials in India, Pakistan and Mozambique.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01911494 (The CLIP), which is not on this map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
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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.
The CLIP (Community Level Interventions for Pre-eclampsia) Cluster Randomized Controlled Trial
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Decision-analytic models in the economic evaluation of community health worker programmes globally: a systematic review.BMJ global health · 2026Pooled it
- Prescribing patterns for hypertensive disorders of pregnancy in low- and middle-income countries: a systematic review.BMC pregnancy and childbirth · 2026Pooled it
- Pooled it
- Terminal Digit Preference and Threshold Avoidance in Digital Blood Pressure Measurements During Pregnancy: Secondary Analysis of Data From the CLIP and PRECISE Cohorts.JMIR mHealth and uHealth · 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
- Are Economic Evaluations of Task Shifting Too Narrow in Focus? A Rapid Review.PharmacoEconomics · 2025Review
- Low-dose calcium supplementation during pregnancy in low and middle-income countries: A cost-effectiveness analysis.PLOS global public health · 2025Article
- What's in a name? Unpacking 'CommunityBMJ global health · 2023Article
- A global view of hypertensive disorders and diabetes mellitus during pregnancy.Nature reviews. Endocrinology · 2022Review
- 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
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Community-Level Interventions for Pre-eclampsia (CLIP) trials (NCT01911494) in India, Pakistan and Mozambique (February 2014-2017) involved community engagement and task sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the incremental costs and cost-effectiveness of the CLIP intervention overall in comparison to standard of care, and by PIERS (Pre-eclampsia Integrated Estimate of RiSk) On the Move (POM) mobile health application visit frequency.
methodsIncluded were all women enrolled in the three CLIP trials who had delivered with known outcomes by trial end. According to the number of POM-guided home contacts received (0, 1-3, 4-7, ≥8), costs were collected from annual budgets and spending receipts, with inclusion of family opportunity costs in Pakistan. A decision tree model was built to determine the cost-effectiveness of the intervention (vs usual care), based on the primary clinical endpoint of years of life lost (YLL) for mothers and infants. A probabilistic sensitivity analysis was used to assess uncertainty in the cost and clinical outcomes.
resultsThe incremental per pregnancy cost of the intervention was US$12.66 (India), US$11.51 (Pakistan) and US$13.26 (Mozambique). As implemented, the intervention was not cost-effective due largely to minimal differences in YLL between arms. However, among women who received ≥8 CLIP contacts (four in Pakistan), the probability of health system and family (Pakistan) cost-effectiveness was ≥80% (all countries).
conclusionThe intervention was likely to be cost-effective for women receiving ≥8 contacts in Mozambique and India, and ≥4 in Pakistan, supporting WHO guidance on antenatal contact frequency. TRIAL REGISTRATION NUMBER: NCT01911494.
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