Health> Vol.6 No.10, April 2014

Economic Cost of Community-Based Management of Severe Acute Malnutrition in a Rural District in Ghana

DownloadDownload as PDF (Size:312KB)  HTML    PP. 886-889  

ABSTRACT

Background: The community based management of severe acute malnutrition (CMAM) was introduced in Ghana in 2008 to manage cases of severe acute malnutrition (SAM) recorded at the community level. This study estimated the economic cost of the CMAM programme for children under-five in the Agona west municipality of Ghana. Methods: A retrospective cross sectional study that used a cost analysis design was employed to estimate the economic cost of the programme from the societal perspective. Household cost data from caregivers were obtained using a semi-structured questionnaire. That of programme cost data was obtained from document reviews as well as the use of semi-structured questionnaires and subsequent discussions with key personnel of the Ghana Health Service, Food and Nutrition Technical Assistance and UNICEF. One and multi-way sensitivity analyses were conducted to test how sensitive the cost estimates are to certain variations in the cost profiles. Results: The economic household cost of CMAM was estimated as $1905.32 ($47.63 per household) of which 79% was attributed to direct cost while the remaining 21% made up indirect cost. Programme economic cost of CMAM was estimated as $27633.5 (96% recurrent and 4% capital), with refresher training constituting majority of the cost (34%). The constituents of the total economic cost of the programme, estimated as $32214.56 are programme cost (86%), household costs (6%) and community volunteer cost (8%). Therefore, the economic cost of treating one SAM case using the CMAM protocol was estimated as $805.36. Conclusion: Although CMAM has proven to be an effective tool for the management of SAM, its associated costs are quite enormous when coverage levels (geographic) are high yet small number of cases are detected and treated. Therefore, it is prudent to implement several cost saving strategies such as a reduction in the number of days spent on trainings in order to reduce these costs.

Cite this paper

Abdul-Latif, A. and Nonvignon, J. (2014) Economic Cost of Community-Based Management of Severe Acute Malnutrition in a Rural District in Ghana. Health, 6, 886-889. doi: 10.4236/health.2014.610112.

References

[1] World Health Organisation (2013) Global Nutrition Policy Review: What Does It Take to Scale up Nutrition Action? WHO Press, Geneva.
[2] Gibney, J.M., Margetts, B.M., Kearney, J.M., Arab, L., Guerrero, S., et al. (2004) Public Health Nutrition. Blackwell Science Ltd., Oxford.
[3] WHO Multicentre Growth Reference Study Group (2006) WHO Child Growth Standards: Methods and Development.
http://www.who.int/childgrowth/standards/technical_report/en
[4] WHO/WFP/UNICEF/UNSCN (2007) A Joint Statement on Community-Based Management of Severe Acute Malnutrition. Geneva and New York.
[5] WHO (2013) World Health Statistics. Geneva.
[6] Bhutta, Z.A., Ahmed, T., Black, R.E., Cousens, S., Dewey, K., et al. (2008) Maternal and Child under Nutrition: Global and Regional Exposures and Health Consequences. The Lancet, 371, 243-260.
http://dx.doi.org/10.1016/S0140-6736(07)61690-0
[7] Tekeste, A., Wondafrash, M., Azene, G. and Deribe, K. (2012) Cost Effectiveness of Community-Based and In-Patient Therapeutic Feeding Programs to Treat Severe Acute Malnutrition in Ethiopia. Cost Effectiveness and Resource Allocation, 10, 4.
http://dx.doi.org/10.1186/1478-7547-10-4
[8] USAID/FANTA (2011) Report on the Review of the Integration of Community Based Management of Acute Malnutrition into the Ghana Health System. Food and Nutrition Technical Assistance II Project (FANTA-2), Washington DC, 74S-91S.
[9] Wilford, R., Golden, K. and Walker, D.G. (2012) Cost-Effectiveness of Community-Based Management of Acute Malnutrition in Malawi. Health Policy and Planning, 27, 127-137.
http://dx.doi.org/10.1093/heapol/czr017
[10] Bachmann, M.O. (2009) Cost Effectiveness of Community-Based Therapeutic Care for Children with Severe Acute Malnutrition in Zambia: Decision Tree Model. Cost Effectiveness and Resource Allocation, 7, 2.
http://www.resource-allocation.com/content/7/1/2 http://dx.doi.org/10.1186/1478-7547-7-2
[11] Puett, C., Sadler, K., Alderman, H., Coates, J., Fiedler, J.L., et al. (2012) Cost-Effectiveness of the Community-Based Management of Severe Acute Malnutrition by Community Health Workers in Southern Bangladesh. Health Policy and Planning, Oxford University Press, 1-14.
[12] Purwestri, R.C., Scherbaum, V., Inayati, D.A., Wirawan, N.N., Suryantan, J., et al. (2012) Cost Analysis of Community-Based Daily and Weekly Programs for Treatment of Moderate and Mild Wasting among Children on Nias Island, Indonesia. Food and Nutrition Bulletin, 33, 207-216.
[13] Collins, S., Sadler, K., Dent, N., Khara, T., Guerrero, S., et al. (2006) Key Issues in the Success of Community-Based Management of Severe Malnutrition. Food and Nutrition Bulletin-United Nations University, 27, 49.
[14] Hanson, K., Goodman, C., Lines, J., Meek, S., Bradley, D., et al. (2004) The Economics of Malaria Control Interventions.
http://announcementsfiles.cohred.org/gfhr_pub/assoc/s14802e/s14802e.pdf
[15] Drummond, M.F., Sculpher, M.J., Torrance, G.W., O’Brien, B.J. and Stoddart, G.L. (2005) Methods for the Economic Evaluation of Health Care Programs. Oxford University Press.
[16] Ashworth, A. and Khanum, S. (1997) Cost-Effective Treatment for Severely Malnourished Children: What Is the Best Approach? Health Policy and Planning, 12, 115-121.
http://dx.doi.org/10.1093/heapol/12.2.115
[17] Gold, M., Siegel, J., Russell, L. and Weinstein, M. (1996) Cost-Effectiveness in Health and Medicine. Oxford University Press, New York.
[18] Nonvignon, J., Chinbuah, M.A., Gyapong, M., Abbey, M., Awuni, E., et al. (2012) Is Home Management of Fevers a Cost-Effective Way of Reducing Under-Five Mortality in Africa? The Case of a Rural Ghanaian District. Tropical Medicine and International Health. Blackwell Publishing Ltd.
[19] Binka, F.N., Mensah, O.A. and Mills, A. (1997) The Cost-Effectiveness of Permethrin Impregnated Bednets in Preventing Child Mortality in Kassena-Nankana District of Northern Ghana. Health Policy, 41, 229-239.
http://dx.doi.org/10.1016/S0168-8510(97)00035-3
[20] Bachmann, M.O. (2010) Cost-Effectiveness of Community-Based Treatment of Severe Acute Malnutrition in Children. Expert Review of Pharmacoeconomics & Outcomes Research, 10, 605-612.
http://dx.doi.org/10.1586/erp.10.54
[21] Horton, S., Shekar, M., McDonald, C., Mahal, A. and Brooks, J.K. (2010) Scaling up Nutrition: What Will It Cost? World Bank Publications.

  
comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.