Cost-effectiveness Analysis of a Large-scale Crèche Intervention to Prevent Child Drowning in Rural Bangladesh

Overview

Journal Inj Epidemiol

Publisher Biomed Central

Date 2021 Oct 30

PMID 34715946

Citations 1

Authors

Y Natalia Alfonso

Adnan A Hyder

Olakunle Alonge

Shumona Sharmin Salam

Kamran Baset

Aminur Rahman

Dewan Md Emdadul Hoque

Md Irteja Islam

Fazlur Rahman

Shams El-Arifeen

David Bishai

Affiliations

Soon will be listed here.

Abstract

Background: Drowning is the leading cause of death among children 12-59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche (daycare) intervention in preventing child drowning.

Methods: The cost of the crèches intervention was evaluated using an ingredients-based approach and monthly expenditure data collected prospectively throughout the study period from two agencies implementing the intervention in different study areas. The estimate of the effectiveness of the crèches intervention was based on a previous study. The study evaluated the cost-effectiveness from both a program and societal perspective.

Results: From the program perspective the annual operating cost of a crèche was $416.35 (95% CI: $221 to $576), the annual cost per child was $16 (95% CI: $8 to $23), and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,008 (95% CI: $8817 to $24,619). From the societal perspective (including parents time valued) the ICER per life saved was - $166,833 (95% CI: - $197,421 to - $141,341)-meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $1978, the crèche intervention was cost-effective even when the societal economic benefits were ignored.

Conclusions: Based on the evidence, the crèche intervention has great potential for generating net societal economic gains by reducing child drowning at a program cost that is reasonable.

Citing Articles

Fatal drowning in Indonesia: understanding knowledge gaps through a scoping review.

Cenderadewi M, Devine S, Sari D, Franklin R Health Promot Int. 2023; 38(5).

PMID: 37851464 PMC: 10583758. DOI: 10.1093/heapro/daad130.

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