Evidence map›Paper›PMID 37386431›Full record

ArticleBMC health services research2023

Assessing the cost-effectiveness of integrated case management of Neglected Tropical Diseases in Liberia.

Tiawanlyn G Godwin-Akpan, Karin Diaconu, Melissa Edmiston, John Solunta Smith, Fred Sosu, Stefanie Weiland, Karsor K Kollie

Abstract readComparative Study
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

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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

3 citing papers in PubMed.

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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

7 authors.

Tiawanlyn G Godwin-AkpanAmerican Leprosy Missions, Greenville, SC, USA. tiagongloe@gmail.com.
Karin DiaconuInstitute for Global Health and Development, Queen Margaret University, Edinburgh, Musselburgh, EH21 6UU, Scotland.
Melissa EdmistonAmerican Leprosy Missions, Greenville, SC, USA.
John Solunta SmithCapitol Bye-Pass, University of Liberia - Atlantic Centre for Research and Evaluation, University of Liberia, Monrovia, Liberia.
Fred SosuCapitol Bye-Pass, University of Liberia - Atlantic Centre for Research and Evaluation, University of Liberia, Monrovia, Liberia.
Stefanie Weiland
Karsor K KollieNeglected Tropical Diseases Program, Ministry of Health, Oldest Congo Town, Monrovia, Liberia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2017, Liberia became one of the first countries in the African region to develop and implement a national strategy for integrated case management of Neglected Tropical Diseases (CM-NTDs), specifically Buruli ulcer, leprosy, lymphatic filariasis morbidities, and yaws. Implementing this plan moves the NTD program from many countries' fragmented (vertical) disease management. This study explores to what extent an integrated approach offers a cost-effective investment for national health systems.

methodsThis study is a mixed-method economic evaluation that explores the cost-effectiveness of the integrated CM-NTDs approach compared to the fragmented (vertical) disease management. Primary data were collected from two integrated intervention counties and two non-intervention counties to determine the relative cost-effectiveness of the integrated program model vs. fragmented (vertical) care. Data was sourced from the NTDs program annual budgets and financial reports for integrated CM-NTDs and Mass Drug Administration (MDA) to determine cost drivers and effectiveness.

resultsThe total cost incurred by the integrated CM-NTD approach from 2017 to 2019 was US$ 789,856.30, with the highest percentage of costs for program staffing and motivation (41.8%), followed by operating costs (24.8%). In the two counties implementing fragmented (vertical) disease management, approximately US$ 325,000 was spent on the diagnosis of 84 persons and the treatment of twenty-four persons suffering from NTDs. While 2.5 times as much was spent in integrated counties, 9-10 times more patients were diagnosed and treated.

conclusionsThe cost of a patient being diagnosed under the fragmented (vertical) implementation is five times higher than integrated CM-NTDs, and providing treatment is ten times as costly. Findings indicate that the integrated CM-NTDs strategy has achieved its primary objective of improved access to NTD services. The success of implementing an integrated CM-NTDs approach in Liberia, presented in this paper, demonstrates that NTD integration is a cost-minimizing solution.

Indexed as

Case ManagementDelivery of Health CareInfectionsNeglected DiseasesWest African PeopleBlack PeopleBudgetsCost-Benefit AnalysisCost-Effectiveness AnalysisDelivery of Health Care, IntegratedHealth Services AccessibilityHumansLiberiaTropical MedicineCase managementCost-savingsIntegrated approachNTDs

Identifiers

PMID37386431
PMCPMC10308665

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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.