Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
Addis Ababa University School of Public Health, Addis Ababa, Ethiopia.
BMJ Open. 2021 Mar 29;11(3):e042365. doi: 10.1136/bmjopen-2020-042365.
Experience of intimate partner violence (IPV) is associated with adverse health and psychosocial outcomes for women. However, rigorous economic evaluations of interventions targeting IPV prevention are rare. This paper analyses the cost-effectiveness of Unite for a Better Life (UBL), a gender-transformative intervention designed to prevent IPV and HIV risk behaviours among men, women and couples.
We use an economic evaluation nested within a large-scale cluster randomised controlled trial, analysing financial and economic costs tracked contemporaneously.
UBL was implemented in rural southern Ethiopia between 2013 and 2015.
The randomised controlled trial included 6770 households in 64 villages.
UBL is an intervention delivered within the context of the Ethiopian coffee ceremony, a culturally established forum for community discussion, and designed to assist participants to build skills for healthy, non-violent, equitable relationships.
This paper reports on the unit cost and cost-effectiveness of the interventions implemented. Cost-effectiveness is measured as the cost per case of past-year physical and/or sexual IPV averted.
The estimated annualised cost of developing and implementing UBL was 2015 US$296 772, or approximately 2015 US$74 per individual directly participating in the intervention and 2015 US$5 per person annually for each community-level beneficiary (woman of reproductive age in intervention communities). The estimated cost per case of past-year physical and/or sexual IPV averted was 2015 US$2726 for the sample of direct beneficiaries, and 2015 US$194 for the sample of all community-level beneficiaries.
UBL is an effective and cost-effective intervention for the prevention of IPV in a low and middle-income country setting. Further research should explore strategies to quantify the positive effects of the intervention across other domains.
NCT02311699 (ClinicalTrials.gov); AEARCTR-0000211 (AEA Registry).
亲密伴侣暴力（IPV）的经历会对女性的健康和心理社会结果产生不利影响。然而，针对 IPV 预防的干预措施的严格经济评估却很少。本文分析了“联合创造更美好生活”（UBL）的成本效益，这是一种旨在预防男性、女性和夫妇之间的 IPV 和艾滋病毒风险行为的性别转换干预措施。
我们使用嵌套在大规模群组随机对照试验中的经济评估，同时分析跟踪到的财务和经济成本。
UBL 于 2013 年至 2015 年在埃塞俄比亚南部农村实施。
随机对照试验包括 64 个村庄的 6770 户家庭。
UBL 是在埃塞俄比亚咖啡仪式的背景下提供的一种干预措施，咖啡仪式是一个文化上建立的社区讨论论坛，旨在帮助参与者建立健康、非暴力、平等关系的技能。
本文报告了实施干预措施的单位成本和成本效益。成本效益以每例过去一年身体和/或性暴力侵害事件避免的成本来衡量。
UBL 的开发和实施的年化成本估计为 2015 年 296772 美元，或直接参与干预的个人约为 2015 年 74 美元，每个社区一级受益人（干预社区的育龄妇女）每年为 2015 年 5 美元。过去一年身体和/或性暴力侵害事件避免的每例成本估计为直接受益人的 2015 年 2726 美元，以及所有社区一级受益人的 2015 年 194 美元。
UBL 是在中低收入国家环境中预防 IPV 的有效且具有成本效益的干预措施。进一步的研究应该探索量化干预措施在其他领域的积极影响的策略。
NCT02311699（ClinicalTrials.gov）；AEARCTR-0000211（AEA 注册表）。
