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赞比亚农村地区利用移动健康技术强化儿童疟疾、腹泻和肺炎综合社区病例管理的成本分析

Cost analysis of integrated community case management of childhood malaria, diarrhea and pneumonia enhanced by mobile health technology in rural Zambia.

作者信息

Biemba Godfrey, Mulenga Arnold, Chiluba Boniface, Griffiths Ulla K, Yeboah-Antwi Kojo, MacLeod William, Lunze Karsten, Hamer Davidson H

机构信息

National Health Research Authority, Lusaka, Zambia.

Department of Global Health, Boston University School of Public Health, Boston, MA, USA.

出版信息

J Public Health Afr. 2020 Mar 19;10(2):1039. doi: 10.4081/jphia.2019.1039. eCollection 2019 Dec 31.

Abstract

Integrated community case management (iCCM) of malaria, diarrhea, and pneumonia is a comprehensive, equitybased strategy to improve treatment access for underserved children under five years old. This paper presents data on cost of iCCM and incremental costs of mHealth enhanced supervision and supply chain management in Zambia. We collected cost data using three questionnaires applied at national, district, health facility and community levels. We interviewed 40 health facility supervisors and 75 community health workers. A provider perspective and an ingredient costing method was used. We entered and analyzed data in a customized excel costing tool. The result shows that total iCCM cost per patient contact was USD 18.43. The incremental cost of using the mHealth intervention per child contact for all iCCM conditions was USD 11.35. The incremental cost per treatment of diarrhea, pneumonia, and malaria with mHealth intervention was USD 9.58, USD 10.37 and USD 12.82. Program costs accounted for 67% of the total, and the largest share was associated with supervision estimated at 36%, followed by supply chain management at 27%. This study has provided valuable information to policy makers on how much it costs to implement iCCM program using mHealth interventions.

摘要

疟疾、腹泻和肺炎的综合社区病例管理(iCCM)是一项基于公平的综合战略,旨在改善五岁以下服务不足儿童的治疗可及性。本文介绍了赞比亚iCCM的成本以及移动健康增强监督和供应链管理的增量成本数据。我们使用在国家、地区、卫生设施和社区层面应用的三份问卷收集成本数据。我们采访了40名卫生设施监督员和75名社区卫生工作者。采用了提供者视角和要素成本计算方法。我们在定制的Excel成本计算工具中录入和分析数据。结果显示,每次患者接触的iCCM总成本为18.43美元。在所有iCCM情况下,每次儿童接触使用移动健康干预的增量成本为11.35美元。使用移动健康干预治疗腹泻、肺炎和疟疾的每次治疗增量成本分别为9.58美元、10.37美元和12.82美元。项目成本占总成本的67%,其中最大份额与监督相关,估计为36%,其次是供应链管理,占27%。本研究为政策制定者提供了关于使用移动健康干预实施iCCM项目成本的宝贵信息。

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