Saha Somen, Pandya Apurvakumar, Raval Devang, Saxena Deepak
Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India.
Director, Parul Institute of Public Health, Parul University, Gandhinagar, Gujarat, India.
Indian J Community Med. 2022 Oct-Dec;47(4):549-554. doi: 10.4103/ijcm.ijcm_192_22. Epub 2022 Dec 14.
Gujarat has implemented an mHealth program, technology for community health operations-plus (TeCHO+) in 2019. TeCHO+ is a mobile and web-based application that essentially enables data entry by the frontline workers providing service at the time and place of service delivery to improve the coverage and data quality. It also facilitates early identification of morbid condition and timely treatment. This study assessed the cost-effectiveness of TeCHO+ program in Gujarat.
The study compared key program outcome indicators before and after the launch of TeCHO+ program. As the program was launched across the State, eMamta, the previous version of mother and child tracking system was used for comparison. A decision tree was parameterized to estimate change in disability-adjusted life year (DALY) and cost as a result of implementing TeCHO+ from a health system perspective.
TeCHO+ incurred a cost of Rs. 2,624 per beneficiary against Rs. 1,075 per beneficiary under the previous eMamta program. TeCHO+ has resulted in significant DALY averted through early identification of high-risk cases both among pregnant women and children. Overall, cost-effectiveness analysis indicated that TeCHO+ incurred an incremental cost of Rs. 1802.84 per DALY averted, which is 1.19% of the GDP per capita of India (year 2020).
This study concludes that TeCHO+ is cost-effective for mother and child care and can be considered for replicating.
古吉拉特邦于2019年实施了一项移动健康计划，即社区健康行动技术升级版（TeCHO+）。TeCHO+是一款基于移动设备和网络的应用程序，它能让一线工作人员在服务提供的时间和地点进行数据录入，从而提高覆盖率和数据质量。它还有助于早期识别疾病状况并及时进行治疗。本研究评估了古吉拉特邦TeCHO+计划的成本效益。
该研究比较了TeCHO+计划启动前后的关键计划成果指标。由于该计划是在全州范围内推出的，因此使用了母婴追踪系统的旧版本eMamta进行比较。从卫生系统的角度对决策树进行参数化，以估计实施TeCHO+后残疾调整生命年（DALY）和成本的变化。
TeCHO+计划每位受益人的成本为2624卢比，而之前的eMamta计划每位受益人的成本为1075卢比。TeCHO+通过早期识别孕妇和儿童中的高危病例，显著避免了DALY。总体而言，成本效益分析表明，TeCHO+每避免一个DALY的增量成本为1802.84卢比，这是印度2020年人均GDP的1.19%。
本研究得出结论，TeCHO+在母婴护理方面具有成本效益，可考虑推广。
