IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0142718.html
   My bibliography  Save this article

Cost-Effectiveness of Peer Counselling for the Promotion of Exclusive Breastfeeding in Uganda

Author

Listed:
  • 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

Abstract

Background: Community based breastfeeding promotion programmes have been shown to be effective in increasing breastfeeding prevalence. However, there is limited data on the cost-effectiveness of these programmes in sub-Saharan Africa. This paper evaluates the cost-effectiveness of a breastfeeding promotion intervention targeting mothers and their 0 to 6 month old children. Methods: Data were obtained from a community randomized trial conducted in Uganda between 2006–2008, and supplemented with evidence from several studies in sub-Saharan Africa. In the trial, peer counselling was offered to women in intervention clusters. In the control and intervention clusters, women could access standard health facility breastfeeding promotion services (HFP). Thus, two methods of breastfeeding promotion were compared: community based peer counselling (in addition to HFP) and standard HFP alone. A Markov model was used to calculate incremental cost-effectiveness ratios between the two strategies. The model estimated changes in breastfeeding prevalence and disability adjusted life years. Costs were estimated from a provider perspective. Uncertainty around the results was characterized using one-way sensitivity analyses and a probabilistic sensitivity analysis. Findings: Peer counselling more than doubled the breastfeeding prevalence as reported by mothers, but there was no observable impact on diarrhoea prevalence. Estimated incremental cost-effectiveness ratios were US$68 per month of exclusive or predominant breastfeeding and U$11,353 per disability adjusted life year (DALY) averted. The findings were robust to parameter variations in the sensitivity analyses Conclusions: Our strategy to promote community based peer counselling is unlikely to be cost-effective in reducing diarrhoea prevalence and mortality in Uganda, because its cost per DALY averted far exceeds the commonly assumed willingness-to-pay threshold of three times Uganda’s GDP per capita (US$1653). However, since the intervention significantly increases prevalence of exclusive or predominant breastfeeding, it could be adopted in Uganda if benefits other than reducing the occurrence of diarrhoea are believed to be important.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0142718
    DOI: 10.1371/journal.pone.0142718
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142718
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0142718&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0142718?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
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. World Bank, 2014. "World Development Indicators 2014," World Bank Publications - Books, The World Bank Group, number 18237.
    3. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

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


    Cited by:

    1. Keith James Topping, 2022. "Peer Education and Peer Counselling for Health and Well-Being: A Review of Reviews," IJERPH, MDPI, vol. 19(10), pages 1-19, May.
    2. Carolina Lechosa-Muñiz & María Paz-Zulueta & María Sáez de Adana Herrero & Elsa Cornejo del Rio & Sonia Mateo Sota & Javier Llorca & María J. Cabero-Perez, 2020. "Health Care Costs Associated to Type of Feeding in the First Year of Life," IJERPH, MDPI, vol. 17(13), pages 1-9, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vasilev, Aleksandar, 2015. "Welfare gains from the adoption of proportional taxation in a general-equilibrium model with a grey economy: the case of Bulgaria's 2008 flat tax reform," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 48(2), pages 169-185.
    2. Muhammad Akhtaruzzaman & Shaohua Yang & Azizah Omar, 2018. "Are Resource-Rich Countries More Attractive than Countries with Good Institutions to Foreign Direct Investors in Sub-Saharan Africa?," International Journal of Economics and Finance, Canadian Center of Science and Education, vol. 10(6), pages 65-74, June.
    3. Khan, Syed Abdul Rehman & Zaman, Khalid & Zhang, Yu, 2016. "The relationship between energy-resource depletion, climate change, health resources and the environmental Kuznets curve: Evidence from the panel of selected developed countries," Renewable and Sustainable Energy Reviews, Elsevier, vol. 62(C), pages 468-477.
    4. Charléty, Patricia & Romelli, Davide & Santacreu-Vasut, Estefania, 2017. "Appointments to central bank boards: Does gender matter?," Economics Letters, Elsevier, vol. 155(C), pages 59-61.
    5. Jan Fagerberg & Martin Srholec, 2017. "Global Dynamics, Capabilities and the Crisis," Economic Complexity and Evolution, in: Andreas Pyka & Uwe Cantner (ed.), Foundations of Economic Change, pages 83-106, Springer.
    6. Simplice A. Asongu, 2014. "Knowledge Economy and Financial Sector Competition in African Countries," African Development Review, African Development Bank, vol. 26(2), pages 333-346, June.
    7. Stephanie E. Austin & Robbert Biesbroek & Lea Berrang-Ford & James D. Ford & Stephen Parker & Manon D. Fleury, 2016. "Public Health Adaptation to Climate Change in OECD Countries," IJERPH, MDPI, vol. 13(9), pages 1-20, September.
    8. Al Zayed, Islam Sabry & Elagib, Nadir Ahmed & Ribbe, Lars & Heinrich, Jürgen, 2016. "Satellite-based evapotranspiration over Gezira Irrigation Scheme, Sudan: A comparative study," Agricultural Water Management, Elsevier, vol. 177(C), pages 66-76.
    9. David Roodman, 2020. "The impact of life-saving interventions on fertility," Papers 2007.11388, arXiv.org.
    10. Dreher, Axel & Fuchs, Andreas & Langlotz, Sarah, 2019. "The effects of foreign aid on refugee flows," European Economic Review, Elsevier, vol. 112(C), pages 127-147.
    11. Day, Creina & Guest, Ross, 2016. "Fertility and female wages: A new link via house prices," Economic Modelling, Elsevier, vol. 53(C), pages 121-132.
    12. Sims, Katharine R.E. & Alix-Garcia, Jennifer M., 2017. "Parks versus PES: Evaluating direct and incentive-based land conservation in Mexico," Journal of Environmental Economics and Management, Elsevier, vol. 86(C), pages 8-28.
    13. Reinsberg,Bernhard Wilfried & Michaelowa,Katharina & Knack,Stephen, 2015. "Which donors, which funds ? the choice of multilateral funds by bilateral donors at the World Bank," Policy Research Working Paper Series 7441, The World Bank.
    14. Chen, Han & Huang, Ye & Shen, Huizhong & Chen, Yilin & Ru, Muye & Chen, Yuanchen & Lin, Nan & Su, Shu & Zhuo, Shaojie & Zhong, Qirui & Wang, Xilong & Liu, Junfeng & Li, Bengang & Tao, Shu, 2016. "Modeling temporal variations in global residential energy consumption and pollutant emissions," Applied Energy, Elsevier, vol. 184(C), pages 820-829.
    15. GHITA-MITRESCU Silvia & DUHNEA Cristina, 2015. "An Overview On The Romanian Banking System Stability," Revista Economica, Lucian Blaga University of Sibiu, Faculty of Economic Sciences, vol. 67(1), pages 55-67, February.
    16. BADALYAN, Gohar & HERZFELD, Thomas & RAJCANIOVA, Miroslava, 2014. "Transport Infrastructure And Economic Growth: Panel Data Approach For Armenia, Georgia And Turkey," Review of Agricultural and Applied Economics (RAAE), Faculty of Economics and Management, Slovak Agricultural University in Nitra, vol. 17(2), pages 1-10, October.
    17. Nora Libertun de Duren & Roberto Guerrero Compeán, 2016. "Growing resources for growing cities: Density and the cost of municipal public services in Latin America," Urban Studies, Urban Studies Journal Limited, vol. 53(14), pages 3082-3107, November.
    18. Marlous Milliano & Ilze Plavgo, 2018. "Analysing Multidimensional Child Poverty in Sub-Saharan Africa: Findings Using an International Comparative Approach," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 11(3), pages 805-833, June.
    19. James Raymo & Marcia Carlson & Alicia VanOrman & Sojung Lim & Brienna Perelli-Harris & Miho Iwasawa, 2015. "Educational differences in early childbearing," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 33(3), pages 65-92.
    20. Guillermo Cruces & Gary S. Fields & David Jaume & Mariana Viollaz, 2015. "The growth-employment-poverty nexus in Latin America in the 2000s: Costa Rica country study," WIDER Working Paper Series wp-2015-074, World Institute for Development Economic Research (UNU-WIDER).

    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:pone00:0142718. 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.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with 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.