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Summary of cost per child treated and cost per child recovered

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 8 replies.

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Lani Trenouth

Independent consultant

Normal user

21 Aug 2019, 00:54

Does anybody have at their fingertips a summary table or list of results from published studies that provide results on the cost per child treated and cost per child recovered from SAM?

I started to collate this information but it occurred to me that perhaps somebody has already done this and is willing to share, even if it might be a little outdated by now. I'd be happy to update and re-share.

One challenge I have noted, however, is that some of the studies I've read are not specific regarding what criteria was used as the discharge as recovered, other studies discharge as recovered at MUAC ≥ 115mm, while others discharge at MUAC ≥ 125mm (but still use RUTF, with some following a reduced protocol, and others seemingly not). 

Any support would be greatly appreciated!

Ciara Hogan

UNICEF

Normal user

21 Aug 2019, 09:17

Dear Lani,

I also started this work although it is not comprehensive. It seems country-specific for the costs that are included and the approach taken. I have a short word document I put together summarising two reports, one from the World Bank, another from SUN, you can see them here and here. If you drop me an email I can share the word document with you. Are you looking at a specific region or country?  
 

Best, Ciara 

Amy Mayberry

Frequent user

21 Aug 2019, 10:28

Hi Lani,

The most recent summary that I've seen is the R4D Nigeria report, which includes a summary table of the published cost-effectiveness studies for CMAM prior to 2015. Available here:  https://www.r4d.org/resources/community-based-management-acute-malnutrition-northern-nigeria/ 

You are right - many studies are not specific about discharge criteria and even 'cost per child treated' has different definitions across studies so limits comparability - ie. cost per child admitted for treatment and cured vs cost per child admitted for treatment (regardless of outcome).

We have been working on an updated summary and analysis of the latest availble evidence and hope to make it available in the next couple of months. If this aligns with your work and you're interested to discuss further feel free to contact me directly.

Best,

Amy

Desalegn

Normal user

27 Aug 2019, 16:31

Dear Ciara ,

Thanks for sharing the document. Please share me if you have any detail specifices for Ethioipa.

Desalegn, dyazew@unicef.org

Best,

Lani Trenouth

Independent consultant

Normal user

27 Aug 2019, 19:28

Thanks for the replies so far.

Ciara, it would be great if you could share your summary when you have a chance. My contact is lani.trenouth@gmail.com

Desalegn, you could have a look at Tekeste et al. Cost effectiveness of community-based and inpatient therapeutic feeding programs to treat severe acute malnutrition in Ethiopia. Cost Effectiveness and Resource Allocation 2012, 10:4 

They estimate a societal cost per child treated of $135, an institutional cost per child treated of $130, and a cost of $146 per child recovered (not stated if societal or institutional). Recovery is stated as "weight for height ≥85% for two consecutive weighing and no edema for 10 days". Meanwhile, the Ethiopia Humanitarian Response plan for 2019 estimates a cost per child treated of $120, which seems quite low compared to other results I’ve seen elsewhere so I’d be curious to see what is and is not included in that cost.

https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/2019/03/2019_HRP_030719.pdf

Desalegn

Normal user

29 Aug 2019, 14:15

Thank you Lani, very helpful

Emna

UNICEF

Normal user

19 Feb 2020, 17:11

Hello lani, were you able to collect this information? I would be very interested. thank you !

Mark Myatt

Consultant Epidemiologist

Frequent user

20 Feb 2020, 12:30

Dear Desalegn,

Concern recently did a CEA of standard CMAM and CMAM/Surge in Ethiopia and Niger. You should get these on request from:

    amanda.yourchuck@concern.net

Or from the Concern offices in Addis.

BTW ... methodological differences extend to the costs-base used. This can greatly affect results. Many studies consider only institutional costs (i.e to the health systems, NGOs, UNOs) and ignore societal costs (e.g. CBV time, costs to beneficiary households) which can be quite large. In a recent CEA that I completed, societal costs were a little over 13 % of total costs. Always check the costs-base used. The R4D Northern Nigeria CEA (report line above) used a comprehensive costs-base (see page 11).
 

Lani Trenouth

Independent consultant

Normal user

21 Feb 2020, 18:53

In addition to the cost-side methodology differences among studies mentioned by Mark, another thing to consider is adjusting cost to a common year when comparing a cost per child treated from a 2004 study to the cost from a 2019 study, for instance.

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