Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh

Article


Alfonso, Y. Natalia, Hyder, Adnan A., Alonge, Olakunle, Salam, Shumona Sharmin, Baset, Kamran, Rahman, Aminur, Hoque, Dewan Md Emdadul, Islam, Irteja, Rahman, Fazlur, El-Arifeen, Shams and Bishai, David. 2021. "Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh ." Injury Epidemiology. 8 (1). https://doi.org/10.1186/s40621-021-00351-9
Article Title

Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh

ERA Journal ID210594
Article CategoryArticle
AuthorsAlfonso, Y. Natalia, Hyder, Adnan A., Alonge, Olakunle, Salam, Shumona Sharmin, Baset, Kamran, Rahman, Aminur, Hoque, Dewan Md Emdadul, Islam, Irteja, Rahman, Fazlur, El-Arifeen, Shams and Bishai, David
Journal TitleInjury Epidemiology
Journal Citation8 (1)
Article Number61
Number of Pages14
Year2021
PublisherBioMed Central Ltd.
Place of PublicationUnited Kingdom
ISSN2197-1714
Digital Object Identifier (DOI)https://doi.org/10.1186/s40621-021-00351-9
Web Address (URL)https://injepijournal.biomedcentral.com/articles/10.1186/s40621-021-00351-9
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.

KeywordsBangladesh; Child health; Children; Cost-effectiveness; Crèche; Drowning; Injury; Mortality; Prevention
ANZSRC Field of Research 20204202. Epidemiology
FunderInternational Centre for Diarrhoeal Disease Research, Bangladesh
Byline AffiliationsJohns Hopkins Bloomberg School of Public Health, United States
George Washington University, United States
University of Sheffield, United Kingdom
Center for Injury Prevention and Research (CIPRB), Bangladesh
International Center for Diarrhoeal Diseases Research, Bangladesh
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