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. 2014 Jul 9;9(7):e102080.
doi: 10.1371/journal.pone.0102080. eCollection 2014.

Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania

Corinna Vossius  1 , Editha Lotto  2 , Sara Lyanga  2 , Estomih Mduma  2 , Georgina Msemo  3 , Jeffrey Perlman  4 , Hege L Ersdal  5
Affiliations

Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania

Corinna Vossius et al. PLoS One. .

Abstract

Objective: The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania.

Methods: Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health.

Findings: Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated.

Conclusion: The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.

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Conflict of interest statement

Competing Interests: Corinna Vossius has received project support from the Lærdal Foundation for Acute Medicine. Hege L. Ersdal has received project support and research grants from the Lærdal Foundation for Acute Medicine. Jeffrey Perlman has received travel support from the Lærdal Foundation for Acute Medicine to facilitate implementation of the HBB program in Tanzania. The other authors have indicated they have no financial relationships relevant to this article to disclose. Lærdal Global Health A/S, a nonprofit sister company of Lærdal Medical A/S, designs, develops and manufactures low cost training equipment and therapeutic devices, including those used in the HBB program. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

References

    1. Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, et al. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet 378 (9797) 1139–1165. - PubMed
    1. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, et al. (2010) Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375 (9730) 1969–1978. - PubMed
    1. Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Levin-Rector A, et al. (2010) Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet 375 (9730) 1988–2008 Epub 2010/06/16. - PubMed
    1. Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, et al. (2011) Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. PLoS medicine 8 (8) e1001080 Epub 2011/09/16. - PMC - PubMed
    1. UNICEF(2011) UNICEF report 2011: Levels and Trend in Child Mortality. New York: UNICEF, 2011.

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