Journal Article

Cost-effectiveness of community health workers in tuberculosis control in Bangladesh

Nobukatsu Ishikawa, Akramul Islam, J. Patrick Vaughan, Susumu Wakai, Akhteruzzaman Chowdhury

2002

Overview

To compare the cost-effectiveness of the tuberculosis (TB) programme run by the Bangladesh Rural Advancement Committee (BRAC), which uses community health workers (CHWs), with that of the government TB programme which does not use CHWs. TB control statistics and cost data for July 1996 - June 1997 were collected from both government and BRAC thanas (subdistricts) in rural Bangladesh. To measure the cost per patient cured, total costs were divided by the total number of patients cured. In the BRAC and government areas, respectively, a total of 186 and 185 TB patients were identified over one year, with cure rates among sputum-positive patients of 84% and 82%. However, the cost per patient cured was US$ 64 in the BRAC area compared to US$ 96 in the government area. The government programme was 50% more expensive for similar outcomes. Although both the BRAC and government TB control programmes appeared to achieve satisfactory cure rates using DOTS (a five-point strategy), the involvement of CHWs was found to be more cost-effective in rural Bangladesh. With the same budget, the BRAC programme could cure three TB patients for every two in the government programme.

• Publisher: World Health Organization (WHO),Organisation mondiale de la santé,World Health Organization,The World Health Organization
• Subject: Bacterial diseases / Bangladesh / Bangladesh - epidemiology / Biological and medical sciences / Capital costs / Citizen participation / Communicable Disease Control - economics / Communicable diseases / Community health aides / Community health aides/economics / Community health aides/utilization / Community health care / Community health services / Community health workers / Community Health Workers - economics / Comparative study / Cost analysis / Cost-Benefit Analysis / Costs / Cure / Data Collection / Directly observed therapy / Drugs / Female / Finance / General aspects / Government / Health care expenditures / Health facilities / Health personnel/utilization / Health policy / Health Policy & Services / Health services / Health Services Research / Human bacterial diseases / Humans / Infectious diseases / Laboratories / Male / Management / Medical sciences / National Health Programs - economics / National health programs/organization and administration / Paramedics / Patients / Planification. Prevention (methods). Intervention. Evaluation / Population / Prevention / Public aspects of medicine / Public health / Public health. Hygiene / Public health. Hygiene-occupational medicine / Quality control / RA1-1270 / Research Article / Rural areas / Rural communities / Rural Health Services - economics / Rural Health Services - manpower / Statistics / Tropical medicine / Tuberculosis / Tuberculosis and atypical mycobacterial infections / Tuberculosis, Pulmonary - economics / Tuberculosis, Pulmonary - epidemiology / Tuberculosis, Pulmonary - prevention & control / Tuberculosis, Pulmonary/prevention and control / Workers