| Titre : | Cost-effectiveness analysis and mortality impact estimation of scaling-up pregnancy test kits in Madagascar, Ethiopia and Malawi (2017) |
| Auteurs : | Robert John Kolesar, Auteur ; Martine Audibert, Auteur ; Comfort, Alison B., Auteur |
| Type de document : | Article : Revues - Articles |
| Dans : | Health policy and planning (Vol.32 N°6, July 2017) |
| Article en page(s) : | pp. 869 - 881 |
| Langues: | Anglais |
| Catégories : |
[Eurovoc] GÉOGRAPHIE > Afrique > Afrique subsaharienne > Afrique orientale > Corne de l'Afrique > Éthiopie [Eurovoc] GÉOGRAPHIE > géographie économique > pays ACP > Ethiopia [Eurovoc] GÉOGRAPHIE > géographie économique > pays ACP > Madagascar [Eurovoc] GÉOGRAPHIE > géographie économique > pays ACP > Malawi [Eurovoc] QUESTIONS SOCIALES > démographie et population > démographie > mortalité > mortalité infantile [Eurovoc] QUESTIONS SOCIALES > santé > politique de la santé |
| Tags : | community health ; contraception ; cost-effectiveness analysis ; developing countries ; disability-adjusted life years ; health economics ; infant mortality ; maternal mortality ; reproductive health ; safe motherhood |
| Résumé : | Cost-effective, innovative approaches are needed to accelerate progress towards ending preventableinfant, child and maternal mortality. To inform policy decisions, we conducted a costeffectivenessanalysis of adding urine pregnancy test kits to the maternal and reproductive servicespackage offered at the community level in Madagascar, Ethiopia and Malawi. We used a decisiontree model to compare the intervention with the status quo for each country. We also completedsingle factor sensitivity analyses and Monte Carlo simulations with 10 000 iterations to generatethe probability distribution of the estimates and uncertainty limits. Among a hypothetical cohort of100 000 women of reproductive age, we estimate that over a 1-year period, the intervention wouldsave 26, 35 and 48 lives in Madagascar, Ethiopia, and Malawi, respectively. The Incremental CostEffectiveness Ratio (ICER) for the cost per life saved varies by country: $2311 [95% UncertaintyInterval (UI): $3454] in Madagascar; $2969 [UI: $5041] in Ethiopia and $1228 [UI: $1777] in Malawi. This equates to an average cost per Disability Adjusted Life Year (DALY)averted of $36.28, $47.95 and $21.92, respectively. Based on WHO criteria and a comparison withother maternal, newborn, and child health interventions, we conclude that the addition of urinepregnancy tests to an existing community health worker maternal and reproductive services packageis highly cost-effective in all three countries. To optimize uptake of family planning and antenatalcare services and, in turn, accelerate the reduction of mortality and DALYs, decision makersand program planners should consider adding urine pregnancy tests to the community-level packageof services. |
| Doi : |
DOI : 10.1093/heapol/czx013 
|
| Axe de recherche : | Trajectoires de développement durable |
| En ligne : | https://hal-clermont-univ.archives-ouvertes.fr/hal-01682488 |
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