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Large-scale delivery of seasonal malaria chemoprevention to children under 10 in Senegal: an economic analysis
- Source :
- Health Policy and Planning
- Publication Year :
- 2017
-
Abstract
- Seasonal Malaria Chemoprevention (SMC) is recommended for children under 5 in the Sahel and sub-Sahel. The burden in older children may justify extending the age range, as has been done effectively in Senegal. We examine costs of door-to-door SMC delivery to children up to 10 years by community health workers (CHWs). We analysed incremental financial and economic costs at district level and below from a health service perspective. We examined project accounts and prospectively collected data from 405 CHWs, 46 health posts, and 4 district headquarters by introducing questionnaires in advance and completing them after each monthly implementation round. Affordability was explored by comparing financial costs of SMC to relevant existing health expenditure levels. Costs were disaggregated by administration month and by health service level. We used linear regression models to identify factors associated with cost variation between health posts. The financial cost to administer SMC to 180 000 children over one malaria season, reaching ∼93% of children with all three intended courses of SMC was $234 549 (constant 2010 USD) or $0.50 per monthly course administered. Excluding research–participation incentives, the financial cost was $0.32 per resident (all ages) in the catchment area, which is 1.2% of Senegal’s general government expenditure on health per capita. Economic costs were 18.7% higher than financial costs at $278 922 or $0.59 per course administered and varied widely between health posts, from $0.38 to $2.74 per course administered. Substantial economies of scale across health posts were found, with the smallest health posts incurring highest average costs per monthly course administered. SMC for children up to 10 is likely to be affordable, particularly where it averts substantial curative care costs. Estimates of likely costs and cost-effectiveness of SMC in other contexts must account for variation in average costs across delivery months and health posts.
- Subjects :
- Male
Cost-Benefit Analysis
030231 tropical medicine
malaria
intermittent preventive treatment
Chemoprevention
campaigns
1605 Policy And Administration
Antimalarials
03 medical and health sciences
community health workers
0302 clinical medicine
Economic cost
Environmental health
Sulfadoxine
Health care
Per capita
Humans
030212 general & internal medicine
Child
Curative care
health care economics and organizations
mass drug administration
Sub-Saharan Africa
Cost–benefit analysis
business.industry
Health Policy
Infant, Newborn
Amodiaquine
Infant
cost variation
Original Articles
Cost-effectiveness analysis
Senegal
Economies of scale
primary health care
Drug Combinations
Pyrimethamine
1117 Public Health And Health Services
cost function
Child, Preschool
Community health
Health Policy & Services
RA Public aspects of medicine
Female
Seasons
Business
Seasonal malaria chemoprevention (SMC)
Subjects
Details
- Language :
- English
- ISSN :
- 02681080
- Database :
- OpenAIRE
- Journal :
- Health Policy and Planning
- Accession number :
- edsair.doi.dedup.....b584ce2c8d7b1156e35c2470c9217315