Table 4 Economic evaluation results - CHEERS model
Country | Study parameters | Costing | Outcome measurements | Heterogeneity characterization | Estimating tools | Key findings |
|---|---|---|---|---|---|---|
Zambia Friedman et al., 2016 [30] | Evaluation period-2.25 years Sample size n = 338,248 children aged between 0 and 59 months, and 372,073 women of childbearing age. Comparators- C1(input financing) C2 (no treatment group) | Reported based on programmatic costs (designing, planning implementation and consumables and supplies) Total program costs- US $13.26 million | Quality and coverage of key MNCH indicators-vaccination coverages, family planning, and institutional deliveries | Results not reported for subgroups | Difference in difference approach Lives Saved Tool, QALY | -ICERs were $1642 per QALY gained and $999 per QALY gained, when compared with C1 and C2, respectively, without adjustment for the quality of care -These ratios improve to $1324 per QALY gained and $809 per QALY gained, when compared with C1 and C2, respectively -Program established to be cost effective in terms of lives saved or QALYS gained relative to Zambia’s GDP/ capita in 2013 ($1759) -However, this effectiveness came at a high unit cost |
Argentina Gertler et al., 2014 [20] | Evaluation period- 4 years Sample size n = 28,042 Unit of analysis -pregnant women and births, Comparators – No treatment group | Reported based on fixed and variable costs (medical equipment, office equipment, vehicles, and administration costs Total program costs-US $106 million | Birth weight and neonatal mortality | Results not reported for subgroups | Difference in difference approach Intention to Treat (ITT) Treatment on Treatment (TOT) | -A DALY saved through PBF in maternal health services were $814 -Program established to be effective in terms of DALYS averted relative to 2005–2008 Argentina GDP/capita of $6075. |
Nigeria Kandpal et al., 2019 [26] | Evaluation period- 4 years Unit of analysis -pregnant women and children under 5, Comparators – DFF and C1 (no treatment group) | Reported based on PBF implementation costs and costs for designing, implementing, and monitoring Costs were rescaled by population size and calculated as costs per capita. Total program costs-USD $ 132.9 million | Antenatal care, iron supplementation, postnatal care, skill birth attendance, immunization, modern conceptive use, and children slept under insecticide-treated bed nets | Results not reported for subgroups | Difference in difference approach Lives Saved Tool, QALYS | -ICERs of PBF compared to DFF and control were $698 and $796/QALY gained, respectively, without quality of care adjustment -Ratios fell to $458 and $300/QALY gained after adjusting for quality -PBF is cost-effective as compared to the control group regardless of whether life years are adjusted for quality. -Effectiveness of both PBF and DFF is driven by the improvements in the quality of care |