Evidence map›Paper›PMID 38553707›Full record

ArticleHuman resources for health2024

Cost-effectiveness of severe acute malnutrition treatment delivered by community health workers in the district of Mayahi, Niger.

Elisa M Molanes-López, José M Ferrer, Abdias Ogobara Dougnon, Abdoul Aziz Gado, Atté Sanoussi, Nassirou Ousmane, Ramatoulaye Hamidou Lazoumar, Pilar Charle-Cuéllar

Open access · goldAbstract readControlled Clinical TrialMulticenter Study
In one paragraph

Article in Human resources for health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 20% of its field
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

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
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

8 authors at 4 institutions in 3 countries.

Elisa M Molanes-LópezDepartment of Statistics and Operational Research, Faculty of Medicine, Universidad Complutense de Madrid (UCM), 28040, Madrid, Spain.ORCID 0000-0003-3217-8551
José M FerrerDepartment of Statistics and Operational Research, Faculty of Medicine, Interdisciplinary Mathematics Institute, Universidad Complutense de Madrid (UCM), HUMLOG Research Group, 28040, Madrid, Spain.ORCID 0000-0002-1021-1157
Abdias Ogobara DougnonAction Against Hunger. West and Central Africa Regional, 29621, Dakar, Senegal.
Abdoul Aziz GadoAction Against Hunger, BP 11491, Niamey, Niger.
Atté SanoussiNutrition Direction, Ministry of Health, 623, Niamey, Niger.
Nassirou OusmaneNutrition Direction, Ministry of Health, 623, Niamey, Niger.
Ramatoulaye Hamidou LazoumarCentre de Recherche Médicale et Sanitaire (CERMES), 10887, Niamey, Niger.
Pilar Charle-CuéllarAction Against Hunger, C/Duque de Sevilla No. 3., 28002, Madrid, Spain. pcharle@accioncontraelhambre.org.ORCID 0000-0003-4784-5003
Universidad Complutense de Madrid · ESAction Contre la Faim · FRCentre de Recherche Médicale et Sanitaire · NEUnited Nations Children's Fund Niger · NE

Funding

Gobierno de España PID2019-108679RBI00/AEI/10.13039/501100011033MTM2015- 65803-R.Office of U.S. Foreign Disaster Assistance AID-OFDA-G-17-00277
6 · The paper itself

Abstract

backgroundA non-randomized controlled trial, conducted from June 2018 to March 2019 in two rural communes in the health district of Mayahi in Niger, showed that including community health workers (CHWs) in the treatment of severe acute malnutrition (SAM) resulted in a better recovery rate (77.2% vs. 72.1%) compared with the standard treatment provided solely at the health centers. The present study aims to assess the cost and cost-effectiveness of the CHWs led treatment of uncomplicated SAM in children 6-59 months compared to the standard national protocol.

methodsTo account for all relevant costs, the cost analysis included activity-based costing and bottom-up approaches from a societal perspective and on a within-trial time horizon. The cost-effectiveness analysis was conducted through a decision analysis network built with OpenMarkov and evaluated under two approaches: (1) with recovery rate and cost per child admitted for treatment as measures of effectiveness and cost, respectively; and (2) assessing the total number of children recovered and the total cost incurred. In addition, a multivariate probabilistic sensitivity analysis was carried out to evaluate the effect of uncertainty around the base case input data.

resultsFor the base case data, the average cost per child recovered was 116.52 USD in the standard treatment and 107.22 USD in the CHWs-led treatment. Based on the first approach, the CHWs-led treatment was more cost-effective than the standard treatment with an average cost per child admitted for treatment of 82.81 USD vs. 84.01 USD. Based on the second approach, the incremental cost-effectiveness ratio of the transition from the standard to the CHWs-led treatment amounted to 98.01 USD per additional SAM case recovered.

conclusionsIn the district of Mayahi in Niger, the CHWs-led SAM treatment was found to be cost-effective when compared to the standard protocol and provided additional advantages such as the reduction of costs for households.

trial registrationISRCTN with ID 31143316. https://doi.org/10.1186/ISRCTN31143316.

Indexed as

Community Health WorkersSevere Acute MalnutritionChild, PreschoolCost-Benefit AnalysisCost-Effectiveness AnalysisHumansInfantNigerCommunity-based Management of Acute Malnutrition (CMAM)Community health workers (CHWs)Cost-effectivenessDecision analysis network (DAN)NigerOpenMarkovSevere acute malnutrition (SAM)

Identifiers

PMID38553707
PMCPMC10979590
OpenAlexW4393313026

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.