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Multi-country analysis of the cost of community health workers kits and commodities for community-based maternal and newborn care.
Barger, Diana; Owen, Helen; Pitt, Catherine; Kerber, Kate; Sitrin, Deborah; Mayora, Chrispus; Guenther, Tanya; Daviaud, Emmanuelle; Lawn, Joy E.
Afiliação
  • Barger D; Save the Children, Washington, DC, USA.
  • Owen H; London School of Hygiene and Tropical Medicine, MARCH Centre, London, UK.
  • Pitt C; Department of Health Policy Planning and Management, London School of Hygiene and Tropical Medicine, London, UK.
  • Kerber K; Save the Children, Washington, DC, USA.
  • Sitrin D; Save the Children, Washington, DC, USA.
  • Mayora C; Makerere University School of Public Health, Kampala, Uganda.
  • Guenther T; Save the Children, Washington, DC, USA.
  • Daviaud E; Medical Research Council, Cape Town, South Africa.
  • Lawn JE; London School of Hygiene and Tropical Medicine, MARCH Centre, London, UK.
Health Policy Plan ; 32(suppl_1): i84-i92, 2017 Oct 01.
Article em En | MEDLINE | ID: mdl-28981765
Community-based maternal and newborn care with home visits by community health workers (CHWs) are recommended by WHO to complement facility-based care. As part of multi-country economic and systems analyses, we aimed to compare the content and financial costs associated with equipping CHWs or 'home visit kits' from seven studies in Bolivia, Ethiopia, Ghana, Malawi, South Africa, Tanzania and Uganda. We estimated the equivalent annual costs (EACs) of home visit kits per CHW in constant 2015 USD. We estimated EAC at scale in a population of 100 000 assuming four home visits per mother during the pregnancy and postnatal period. All seven packages were designed for health promotion; six included clinical assessments and one included curative care. The items used by CHWs differed between countries, even for the same task. The EAC per home visit kit ranged from $15 in Tanzania to $116 in South Africa. For health promotion and preventive care, between 82 and 100% of the cost of CHW commodities did not vary with the number of home visits conducted; however, in Ethiopia, the majority of EAC associated with curative care varied with the number of visits conducted. The EAC of equipping CHWs to meet the needs of 95% of expectant mothers in a catchment area of 100 000 people was highest in Bolivia, $40 260 for 633 CHWs, due to mothers being in hard-to-reach areas with CHW conducting few visits per year per, and lowest in Tanzania ($2693 for 172 CHWs), due to the greater number of CHW visits per week and lower EAC of items. To inform and ensure sustainable implementation at scale, national discussions regarding the cadre of CHWs and their workload should also consider carefully the composition and cost of equipping CHWs to carry out their work effectively and efficiently.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Serviços de Saúde da Criança / Agentes Comunitários de Saúde / Equipamentos e Provisões / Serviços de Saúde Materna Tipo de estudo: Diagnostic_studies / Health_economic_evaluation Limite: Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa / America do sul / Bolivia Idioma: En Revista: Health Policy Plan Assunto da revista: PESQUISA EM SERVICOS DE SAUDE / SAUDE PUBLICA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Serviços de Saúde da Criança / Agentes Comunitários de Saúde / Equipamentos e Provisões / Serviços de Saúde Materna Tipo de estudo: Diagnostic_studies / Health_economic_evaluation Limite: Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa / America do sul / Bolivia Idioma: En Revista: Health Policy Plan Assunto da revista: PESQUISA EM SERVICOS DE SAUDE / SAUDE PUBLICA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido