RT Journal Article
T1 Integration of Acute Malnutrition Treatment Into Integrated Community Case Management in Three Districts in Southern Mali: An Economic Evaluation
A1 Cichon, Bernardette
A1 López Ejeda, Noemí
A1 Mampindu, Magloire Bunkembo
A1 Bagayoko, Aliou
A1 Samake, Mahamadou
A1 Cuellar, Pilar Charle
AB Background:Enabling community health workers (CHWs) to treat acute malnutrition improves treatment access and coverage. However, data on the cost and cost-effectiveness of this approach is limited. We aimed to cost the treatment at scale and determine the cost-effectiveness of different levels of supervision and technical support.Methods:This economic evaluation was part of a prospective nonrandomized community intervention study in 3 districts in Mali examining the impact of different levels of CHW and health center supervision and support on treatment outcomes for children with severe acute malnutrition. Treatment admission and outcome data were extracted from the records of 120 participating health centers and 169 CHW sites. Cost data were collected from accountancy records and through key informant interviews. Results were presented as cost per child treated and cured. Modeled scenario sensitivity analyses were conducted to determine how cost-efficiency and cost-effectiveness estimates change in an equal scale scenario and/or if the supervision had been done by government staff.Results:In the observed scenario, with an unequal number of children, the average cost per child treated was US$203.40 in Bafoulabé where a basic level of supervision and support was provided, US$279.90 in Kayes with a medium level of supervision, and US$253.9 in Kita with the highest level of supervision. Costs per child cured were US$303.90 in Bafoulabé, US$324.90 in Kayes, and US$311.80 in Kita, with overlapping uncertainty ranges.Conclusion:Additional supervision has the potential to be a cost-effective strategy if supervision costs are reduced without compromising the quality of supervision. Further research should aim to better adapt the supervision model and associated tools to the context and investigate where efficiencies can be made in its delivery.
PB U.S. Agency for International Development / Johns Hopkins Bloomberg School of Public Health Center for Communication Programs
SN 2169-575X
YR 2024
FD 2024
LK https://hdl.handle.net/20.500.14352/118743
UL https://hdl.handle.net/20.500.14352/118743
LA eng
NO Cichon B, López-Ejeda N, Mampindu MB, Bagayoko A, Samake M, Cuellar PC. Integration of acute malnutrition treatment into integrated community case management in three districts in southern Mali: an economic evaluation. Glob Health Sci Pract. 2024;12(3):e2300431. https://doi.org/10.9745/GHSP-D-23-00431
NO This work was funded by the Innocent Foundation, The European Civil Protection and Humanitarian Aid Operation (ECHO), the Post Code Lottery Foundation, and UNICEF.
NO The Innocent Foundation
NO European Commission
NO The Post Code Lottery Foundation
NO Fondo de las Naciones Unidas para la Infancia
DS Docta Complutense
RD 28 abr 2025