Adane Francis, Aryeetey Richmond, Aryeetey Genevieve, Nonvignon Justice
Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana.
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.
Cost Eff Resour Alloc. 2024 Sep 17;22(1):69. doi: 10.1186/s12962-024-00559-8.
Anaemia among women of reproductive age (WRA) remains persistently high in Ghana, affecting 41% in 2022. Women in low-income communities in Ghana engaged in fish processing activities are at increased risk of anaemia due to inadequate diets, exposure to infectious pathogens, and pollutants. The Invisible Fishers (IFs) project was implemented among women fish processors in their reproductive age in Central and Volta regions of Ghana to mitigate anaemia. Despite the efficacy, feasibility and scalability of the intervention, the cost of implementing the intervention is unknown. The objective of this study was to estimate the costs of implementing the IFs project in Ghana.
We used micro-costing approach to analyse the costs of implementing the IFs project. Data were collected as part of a pilot randomized control trial with three interventions: Behaviour Change Communication (BCC), Strengthening Market Engagement of fish processors plus Behaviour Change Communication (SME + BCC), and Fish Smoking Technology and Practices plus Behaviour Change Communication (FST + BCC). The interventions were delivered to 60 women fish processors in the Central region and 60 in Volta region. The cost of the intervention was estimated from the societal perspective. Economic costs were categorized as direct costs (i.e. personnel, transportation, meetings, training, and monitoring) and indirect cost (i.e. value of productive time lost due to women and community volunteers' participation in the activities of the IFs project).
The FST + BCC had the highest average cost per beneficiary (US$11898.62), followed by the SME + BCC (US8962.93). The least expensive was the BCC (US$4651.93) over the intervention period of 18 months. Recurrent costs constituted the largest component of economic costs (98%). Key drivers of direct costs were personnel (58%), administrative expenses (14%), and transportation (7%).
There is a high cost for implementing interventions included in the IFs project. Planning and scaling -up of the interventions across larger populations could bring about economies of scale to reduce the average cost of the interventions.
加纳育龄妇女贫血率持续居高不下，2022年受影响率达41%。加纳低收入社区从事鱼类加工活动的妇女因饮食不足、接触传染性病原体和污染物，贫血风险增加。“隐形渔民”（IFs）项目在加纳中部和沃尔特地区的育龄女性鱼类加工者中实施，以缓解贫血问题。尽管该干预措施具有有效性、可行性和可扩展性，但其实施成本尚不清楚。本研究的目的是估计在加纳实施IFs项目的成本。
我们采用微观成本核算方法分析实施IFs项目的成本。数据收集作为一项试点随机对照试验的一部分，该试验有三种干预措施：行为改变沟通（BCC）、加强鱼类加工者市场参与度加行为改变沟通（SME + BCC）以及鱼类烟熏技术与实践加行为改变沟通（FST + BCC）。这些干预措施分别提供给中部地区的60名女性鱼类加工者和沃尔特地区的60名女性鱼类加工者。从社会角度估计干预成本。经济成本分为直接成本（即人员、交通、会议、培训和监测）和间接成本（即由于妇女和社区志愿者参与IFs项目活动而损失的生产时间价值）。
在18个月的干预期内，FST + BCC的每位受益人的平均成本最高（11898.62美元），其次是SME + BCC（8962.93美元）。最便宜的是BCC（4651.93美元）。经常性成本构成经济成本的最大组成部分（98%）。直接成本的主要驱动因素是人员（58%）、行政费用（14%）和交通（7%）。
实施IFs项目所包含的干预措施成本高昂。在更大规模人群中规划和扩大干预措施可能会带来规模经济，以降低干预措施的平均成本。
