Journal Article

Modelling the cost of community interventions to reduce child mortality in South Africa using the Lives Saved Tool (LiST)

Nkonki, Lungiswa, LL, Tugendhaft, Aviva, A, Hofman, Karen, K, Chola, Lumbwe, L

2017

Overview

ObjectiveTo estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider’s perspective.SettingIn this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality.ParticipantsDemProj Based on National South African Data.InterventionsA total of nine interventions namely, breastfeeding promotion, complementary feeding, vitamin supplementation, hand washing with soap, hygienic disposal of children’s stools, oral rehydration solution, oral antibiotics for the treatment of pneumonia, therapeutic feeding for wasting and treatment for moderate malnutrition.Primary and secondary outcome measuresReducing child mortality.ResultsA total of 9 interventions can prevent 8891 deaths by 2030. Hand washing with soap (21%) accounts for the highest number of deaths prevented, followed by therapeutic feeding (19%) and oral rehydration therapy (16%). The top 5 interventions account for 77% of all deaths prevented. At scale, an estimated cost of US$169.5 million (US$3 per capita) per year will be required in community health worker costs.ConclusionThe use of community health workers offers enormous opportunities for saving lives. These programmes require appropriate financial investments. Findings from this study show what can be achieved if concerted effort is channelled towards the identified set of life-saving interventions.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Acquired immune deficiency syndrome / AIDS / Anti-Bacterial Agents - therapeutic use / Antibiotics / Breast Feeding / Breastfeeding & lactation / Caregivers / Child / Child Health / Child Mortality / Children & youth / Childrens health / Community Health Workers / Cost analysis / Delivery of Health Care - economics / Diarrhea / Families & family life / Family planning / Fluid Therapy / Health Care Costs / Health Economics / Health risk assessment / HIV / Human immunodeficiency virus / Humans / Hygiene / Infant / Infant Health / Infant Mortality / Intervention / Malaria / Maternal & child health / Nutrition Therapy / Pneumonia / Pneumonia - drug therapy / Pneumonia - mortality / Prevention / Public health / Risk factors / South Africa / Stillbirth / Tuberculosis / Workers