EVIHDAF (Evidence for Sustainable Human Development Systems in Africa), BP 35328, Yaoundé, Cameroon.
CPC Community Health, Denver, CO, USA.
Int J Public Health. 2020 Dec;65(9):1603-1612. doi: 10.1007/s00038-020-01487-z. Epub 2020 Oct 10.
This paper evaluates the cost-effectiveness of rebranding former traditional birth attendants (TBAs) to conduct health promotion activities and refer women to health facilities.
The project used 200 former TBAs, 100 of whom were also enrolled in a small income generating business. The evaluation had a three-arm, quasiexperimental design with baseline and endline household surveys. The three arms were: (a) Health promotion (HP) only; (b) Health promotion plus business (HP+); and (c) the comparison group. The Lives Saved Tool is used to estimate the number of lives saved.
The HP+ intervention had a statistically significant impact on health facility delivery and four or more antenatal care (ANC) visits during pregnancy. The cost-effectiveness ratio was estimated at US$4130 per life year saved in the HP only arm, and US$1539 in the HP+ arm. Therefore, only the HP+ intervention is considered to be cost-effective.
It is critical to prioritize cost-effective interventions such as, in the case of rural Sierra Leone, community-based strategies involving rebranding TBAs as health promoters and enrolling them in health-related income generating activities.
本文评估了将前传统接生员（TBA）重新定位为开展健康促进活动并将妇女转介到卫生机构的成本效益。
该项目使用了 200 名前 TBA，其中 100 名还参与了一项小型创收业务。评估采用了三臂准实验设计，包括基线和终线家庭调查。三个臂分别是：（a）仅健康促进（HP）；（b）健康促进加业务（HP+）；和（c）对照组。使用拯救生命工具来估计挽救的生命数量。
HP+干预措施对在卫生设施分娩和妊娠期间进行四次或更多次产前护理（ANC）访问有统计学意义的影响。仅在 HP 臂的成本效益比估计为每挽救一年生命 4130 美元，而在 HP+臂为 1539 美元。因此，仅 HP+干预措施被认为是具有成本效益的。
在农村塞拉利昂等情况下，优先考虑成本效益高的干预措施至关重要，例如将 TBA 重新定位为健康促进者并让他们参与与健康相关的创收活动的社区策略。
