Al-Attar Ghada S T, Bishai David, El-Gibaly Omaima
Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Population, Family & Reproductive Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
Afr J Reprod Health. 2017 Mar;21(1):30-38. doi: 10.29063/ajrh2017/v21i1.2.
Cost effectiveness studies of family planning (FP) services are very valuable in providing evidence-based data for decision makers in Egypt. Cost data came from record reviews for all 15 mobile clinics and a matched set of 15 static clinics and interviews with staff members of the selected clinics at Assiut Governorate. Effectiveness measures included couple years of protection (CYPs) and FP visits. Incremental cost-effectiveness ratios (ICER) and sensitivity analyses were calculated. Mobile clinics cost more per facility, produced more CYPs but had fewer FP visits. Sensitivity analysis was done using: total costs, CYP and FP visits of mobile and static clinics and showed that variations in CYP of mobile and static clinics altered the ICER for CYP from $2 -$6. Mobile clinics with their high emphasis on IUDs offer a reasonable cost effectiveness of $4.46 per additional CYP compared to static clinics. The ability of mobile clinics to reach more vulnerable women and to offer more long acting methods might affect a policy decision between these options. Static clinics should consider whether emphasizing IUDs may make their services more cost-effective.
计划生育(FP)服务的成本效益研究对于为埃及的决策者提供循证数据非常有价值。成本数据来自对所有15个流动诊所和一组与之匹配的15个固定诊所的记录审查,以及对阿斯尤特省选定诊所工作人员的访谈。效果指标包括夫妇保护年限(CYPs)和计划生育就诊次数。计算了增量成本效益比(ICER)并进行了敏感性分析。每个流动诊所的成本更高,产生的CYPs更多,但计划生育就诊次数更少。使用流动诊所和固定诊所的总成本、CYPs和计划生育就诊次数进行敏感性分析,结果表明,流动诊所和固定诊所CYPs的变化使CYPs的ICER从2美元变为6美元。与固定诊所相比,高度重视宫内节育器(IUDs)的流动诊所每增加一个CYPs的成本效益合理,为4.46美元。流动诊所能够接触到更多弱势妇女并提供更多长效方法,这可能会影响这些方案之间的政策决策。固定诊所应考虑强调宫内节育器是否会使其服务更具成本效益。