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Costs of Promoting Exclusive Breastfeeding at Community Level in Three Sites in South Africa

Author

Listed:
  • Lungiswa Leonora Nkonki
  • Emmanuelle Daviaud
  • Debra Jackson
  • Lumbwe Chola
  • Tanya Doherty
  • Mickey Chopra
  • Bjarne Robberstad
  • for the Promise-EBF Study Group

Abstract

Background: Community-based peer support has been shown to be effective in improving exclusive breastfeeding rates in a variety of settings. Methods: We conducted a cost analysis of a community cluster randomised-controlled trial (Promise-EBF), aimed at promoting exclusive infant feeding in three sites in South Africa. The costs were considered from the perspective of health service providers. Peer supporters in this trial visited women to support exclusive infant feeding, once antenatally and four times postpartum. Results: The total economic cost of the Promise-EBF intervention was US$393 656, with average costs per woman and per visit of US$228 and US$52, respectively. The average costs per woman and visit in an operational ‘non research’ scenario were US$137 and US$32 per woman and visit, respectively. Investing in the promotion of exclusive infant feeding requires substantial financial commitment from policy makers. Extending the tasks of multi-skilled community health workers (CHWs) to include promoting exclusive infant feeding is a potential option for reducing these costs. In order to avoid efficiency losses, we recommend that the time requirements for delivering the promotion of exclusive infant feeding are considered when integrating it within the existing activities of CHWs. Discussion: This paper focuses on interventions for exclusive infant feeding, but its findings more generally illustrate the importance of documenting and quantifying factors that affect the feasibility and sustainability of community-based interventions, which are receiving increased focus in low income settings.

Suggested Citation

  • Lungiswa Leonora Nkonki & Emmanuelle Daviaud & Debra Jackson & Lumbwe Chola & Tanya Doherty & Mickey Chopra & Bjarne Robberstad & for the Promise-EBF Study Group, 2014. "Costs of Promoting Exclusive Breastfeeding at Community Level in Three Sites in South Africa," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-9, January.
    • Handle: RePEc:plo:pone00:0079784
    DOI: 10.1371/journal.pone.0079784
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    References listed on IDEAS

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    1. Jan, Stephen & Pronyk, Paul & Kim, Julia, 2008. "Accounting for institutional change in health economic evaluation: A program to tackle HIV/AIDS and gender violence in Southern Africa," Social Science & Medicine, Elsevier, vol. 66(4), pages 922-932, February.
    2. Chris Desmond & Ruth M Bland & Gerard Boyce & Hoosen M Coovadia & Anna Coutsoudis & Nigel Rollins & Marie-Louise Newell, 2008. "Scaling-Up Exclusive Breastfeeding Support Programmes: The Example of KwaZulu-Natal," PLOS ONE, Public Library of Science, vol. 3(6), pages 1-9, June.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    Cited by:

    1. Lumbwe Chola & Lars T Fadnes & Ingunn M S Engebretsen & Lungiswa Nkonki & Victoria Nankabirwa & Halvor Sommerfelt & James K Tumwine & Thorkild Tylleskar & Bjarne Robberstad & PROMISE-EBF Study Group, 2015. "Cost-Effectiveness of Peer Counselling for the Promotion of Exclusive Breastfeeding in Uganda," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-18, November.
    2. Perpetua Modjadji & Ethel Sekori Seabela & Busisiwe Ntuli & Sphiwe Madiba, 2023. "Beliefs and Norms Influencing Initiation and Sustenance of Exclusive Breastfeeding: Experiences of Mothers in Primary Health Care Facilities in Ermelo, South Africa," IJERPH, MDPI, vol. 20(2), pages 1-17, January.

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