IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0009158.html
   My bibliography  Save this article

Cost and Cost-Effectiveness of Treating Smear-Positive Tuberculosis by Health Extension Workers in Ethiopia: An Ancillary Cost-Effectiveness Analysis of Community Randomized Trial

Author

Listed:
  • Daniel G Datiko
  • Bernt Lindtjørn

Abstract

Background: Evidence for policy- and decision-making related to the cost of delivering tuberculosis (TB) control is lacking in Ethiopia. We aimed to determine the cost and cost-effectiveness of involving health extension workers (HEWs) in TB treatment under a community-based initiative in Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a RCT, from which the main outcomes have already been published. Methodology/Principal Findings: Options of treating TB patients in the community by HEWs in the health posts and general health workers at health facility were compared in a community-randomized trial. Costs were analysed from a societal perspective in 2007 in US dollars using standard methods. We prospectively enrolled smear-positive patients, and calculated the cost-effectiveness in terms of the cost per patient successfully treated. The total cost for each successfully treated smear-positive patient was higher in health facilities (US$161.9) compared with the community-based approach (US$60.7). The total, patient and care giver costs of community-based treatment were lower than health facility DOT by 62.6%, 63.9% and 88.2%, respectively. Involving HEWs added a total cost of US$8.80 to the health service per patient treated in the health posts in the community. Conclusions/Significance: Community-based treatment by HEWs costs only 37% of what treatment by general health workers costs for similar outcomes. Involving HEWs in TB treatment is a cost-effective treatment alternative to the health service and to the patients and their caregivers. Therefore, there is both an economic and public health reason to consider involving HEWs in TB treatment in Ethiopia. However, community-based treatment would require initial investment for implementation, training and supervision. Trial Registration: ClinicalTrials.gov NCT00913172

Suggested Citation

  • Daniel G Datiko & Bernt Lindtjørn, 2010. "Cost and Cost-Effectiveness of Treating Smear-Positive Tuberculosis by Health Extension Workers in Ethiopia: An Ancillary Cost-Effectiveness Analysis of Community Randomized Trial," PLOS ONE, Public Library of Science, vol. 5(2), pages 1-7, February.
    • Handle: RePEc:plo:pone00:0009158
    DOI: 10.1371/journal.pone.0009158
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0009158
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0009158&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0009158?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lelisa Fekadu Assebe & Wondesen Nigatu Belete & Senait Alemayehu & Elias Asfaw & Kora Tushune Godana & Yibeltal Kiflie Alemayehu & Alula M Teklu & Amanuel Yigezu, 2021. "Economic evaluation of Health Extension Program packages in Ethiopia," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-16, February.
    2. Kingsley N Ukwaja & Isaac Alobu & Chika lgwenyi & Philip C Hopewell, 2013. "The High Cost of Free Tuberculosis Services: Patient and Household Costs Associated with Tuberculosis Care in Ebonyi State, Nigeria," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-10, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0009158. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.