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Cost-Effectiveness Analysis of Two Integrated Early Childhood Development Programs into Bangladeshi Primary Health-Care Services

19 Pages Posted: 9 May 2024

See all articles by Sheikh Jamal Hossain

Sheikh Jamal Hossain

International Centre for Diarrheal Disease Research (ICDDR’B)

Tom Palmer

University College London - Institute for Global Health

S.M. Mulk Uddin Tipu

International Centre for Diarrheal Disease Research (ICDDR’B)

Syeda Fardina Mehrin

International Centre for Diarrheal Disease Research (ICDDR’B)

Shamima Shiraji

International Centre for Diarrheal Disease Research (ICDDR’B)

Mohammed Imrul Hasan

International Centre for Diarrheal Disease Research (ICDDR’B)

Saiful Alam Bhuiyan

International Centre for Diarrheal Disease Research (ICDDR’B)

Nur-E- Salveen

International Centre for Diarrheal Disease Research (ICDDR’B)

Fahmida Tofail

International Centre for Diarrheal Disease Research (ICDDR’B)

Helen Baker-Henningham

Bangor University

Hassan Haghparast-Bidgoli

University College London - Institute for Global Health

Jena Hamadani

International Center for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) - Centre for Child and Adolescent Health

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Abstract

Objectives: This study presents results of cost and cost-effectiveness analysis of two parenting interventions (group-based and pairs) integrated into primary health care centers in rural Bangladesh. 

Methods: A within-trial cost-effectiveness analysis was conducted from the provider perspective. Incremental cost effectiveness ratios were estimated for all primary child development outcomes and presented in terms of cost per standard deviation improvements in the outcomes. A series of cost scenario analyses were conducted to assess the effect of changing cost assumptions on the cost and cost-effectiveness results. All results are presented in 2022 USD.

Results: Total provider costs in the within-trial analysis were US$ 67,668 for the group-based intervention and US$ 117,028 for the pair intervention. Estimated cost per child covered by the interventions was US$156 for the group intervention and US$136 for the pair intervention, reflecting likely economies of scale in delivery of the pair intervntion. An additional US$100 expenditure on the group intervention is estimated to lead to a 0.55 SD improvement in cognition, 0.44 SD in language development and 0.33 SD in motor development. For the pair intervention, the corresponding estimates are improvements of 0.95 SD, 0.81 SD, and 0.88 SD, respectively. Under potential scale up scenarios, intervention cost can reduce substantially resulting in cost per child of US$44 and US$47 for group and pair interventions, respectively.

Conclusion: The findings indicates that cost-efficiency and cost-effectiveness results for both interventions are comparable with the results from limited similar interventions in LMICs. However, implementation costs of the interventions will be substantially lower at scale due to lower monitoring costs, economies of scale, and full integration into the public health system.

Funding: his work was supported by Grand Challenges Canada. icddr,b is also grateful to the Governments of Bangladesh and the Government of Canada for providing core/unrestricted support.

Declaration of Interest: The authors declare no competing interests.

Ethical Approval: Written informed consent was obtained from mothers at enrollment. Ethical approval was granted by the institutional review board of the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b).

Keywords: Early childhood development, cost-effectiveness analysis, parenting, Bangladesh

Suggested Citation

Hossain, Sheikh Jamal and Palmer, Tom and Tipu, S.M. Mulk Uddin and Mehrin, Syeda Fardina and Shiraji, Shamima and Hasan, Mohammed Imrul and Bhuiyan, Saiful Alam and Salveen, Nur-E- and Tofail, Fahmida and Baker-Henningham, Helen and Haghparast-Bidgoli, Hassan and Hamadani, Jena, Cost-Effectiveness Analysis of Two Integrated Early Childhood Development Programs into Bangladeshi Primary Health-Care Services. Available at SSRN: https://ssrn.com/abstract=4819279 or http://dx.doi.org/10.2139/ssrn.4819279

Sheikh Jamal Hossain

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

68 Shaheed Tajuddin Ahmed Sarani
Dhaka, 1212
Bangladesh

Tom Palmer (Contact Author)

University College London - Institute for Global Health ( email )

United Kingdom

S.M. Mulk Uddin Tipu

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

68 Shaheed Tajuddin Ahmed Sarani
Dhaka, 1212
Bangladesh

Syeda Fardina Mehrin

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

68 Shaheed Tajuddin Ahmed Sarani
Dhaka, 1212
Bangladesh

Shamima Shiraji

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

Mohammed Imrul Hasan

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

Saiful Alam Bhuiyan

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

Nur-E- Salveen

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

68 Shaheed Tajuddin Ahmed Sarani
Dhaka, 1212
Bangladesh

Fahmida Tofail

International Centre for Diarrheal Disease Research (ICDDR’B) ( email )

Helen Baker-Henningham

Bangor University ( email )

King Edward VII Avenue Cardiff
WALES, CF10 3NS
United Kingdom

Hassan Haghparast-Bidgoli

University College London - Institute for Global Health ( email )

United Kingdom

Jena Hamadani

International Center for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) - Centre for Child and Adolescent Health ( email )

68 Shahid Tajuddin Ahmed Sharani
Mohakhali (GPO Box 128, Dhaka 1000)
Dhaka, DC Dhaka 1212 Dhaka
Bangladesh