IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0265033.html
   My bibliography  Save this article

A cost analysis of implementing mobile health facilitated tuberculosis contact investigation in a low-income setting

Author

Listed:
  • Patricia Turimumahoro
  • Austin Tucker
  • Amanda J Gupta
  • Radhika P Tampi
  • Diana Babirye
  • Emmanuel Ochom
  • Joseph M Ggita
  • Irene Ayakaka
  • Hojoon Sohn
  • Achilles Katamba
  • David Dowdy
  • J Lucian Davis

Abstract

Introduction: Mobile health (mHealth) applications may improve timely access to health services and improve patient-provider communication, but the upfront costs of implementation may be prohibitive, especially in resource-limited settings. Methods: We measured the costs of developing and implementing an mHealth-facilitated, home-based strategy for tuberculosis (TB) contact investigation in Kampala, Uganda, between February 2014 and July 2017. We compared routine implementation involving community health workers (CHWs) screening and referring household contacts to clinics for TB evaluation to home-based HIV testing and sputum collection and transport with test results delivered by automated short messaging services (SMS). We carried out key informant interviews with CHWs and asked them to complete time-and-motion surveys. We estimated program costs from the perspective of the Ugandan health system, using top-down and bottom-up (components-based) approaches. We estimated total costs per contact investigated and per TB-positive contact identified in 2018 US dollars, one and five years after program implementation. Results: The total top-down cost was $472,327, including $358,504 (76%) for program development and $108,584 (24%) for program implementation. This corresponded to $320-$348 per household contact investigated and $8,873-$9,652 per contact diagnosed with active TB over a 5-year period. CHW time was spent primarily evaluating household contacts who returned to the clinic for evaluation (median 30 minutes per contact investigated, interquartile range [IQR]: 30–70), collecting sputum samples (median 29 minutes, IQR: 25–30) and offering HIV testing services (median 28 minutes, IQR: 17–43). Cost estimates were sensitive to infrastructural capacity needs, program reach, and the epidemiological yield of contact investigation. Conclusion: Over 75% of all costs of the mHealth-facilitated TB contact investigation strategy were dedicated to establishing mHealth infrastructure and capacity. Implementing the mHealth strategy at scale and maintaining it over a longer time horizon could help decrease development costs as a proportion of total costs.

Suggested Citation

  • Patricia Turimumahoro & Austin Tucker & Amanda J Gupta & Radhika P Tampi & Diana Babirye & Emmanuel Ochom & Joseph M Ggita & Irene Ayakaka & Hojoon Sohn & Achilles Katamba & David Dowdy & J Lucian Dav, 2022. "A cost analysis of implementing mobile health facilitated tuberculosis contact investigation in a low-income setting," PLOS ONE, Public Library of Science, vol. 17(4), pages 1-13, April.
    • Handle: RePEc:plo:pone00:0265033
    DOI: 10.1371/journal.pone.0265033
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265033
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0265033&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0265033?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. Michael K. Chapko & Chuan‐Fen Liu & Mark Perkins & Yu‐Fang Li & John C. Fortney & Matthew L. Maciejewski, 2009. "Equivalence of two healthcare costing methods: bottom‐up and top‐down," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1188-1201, October.
    2. World Bank, 2015. "World Development Indicators 2015," World Bank Publications - Books, The World Bank Group, number 21634.
    3. Sarah J Iribarren & Kenrick Cato & Louise Falzon & Patricia W Stone, 2017. "What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-20, February.
    4. Youngji Jo & Farangiz Mirzoeva & Monyrath Chry & Zhi Zhen Qin & Andrew Codlin & Oktam Bobokhojaev & Jacob Creswell & Hojoon Sohn, 2020. "Standardized framework for evaluating costs of active case-finding programs: An analysis of two programs in Cambodia and Tajikistan," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-12, January.
    5. World Bank, 2014. "World Development Indicators 2014," World Bank Publications - Books, The World Bank Group, number 18237.
    Full references (including those not matched with items on IDEAS)

    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. 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.
    2. Naoyuki Yoshino & Victoriia Alekhina, 2016. "Impact of oil price fluctuations on an energy-exporting economy: Evidence from Russia," Journal of Administrative and Business Studies, Professor Dr. Usman Raja, vol. 2(4), pages 156-166.
    3. Channing Arndt & Felix Asante & James Thurlow, 2015. "Implications of Climate Change for Ghana’s Economy," Sustainability, MDPI, vol. 7(6), pages 1-18, June.
    4. Ashok Gulati & Shweta Saini, 2015. "India's political economy responses to the global food price shock of 2007-08: Learning some lessons," WIDER Working Paper Series wp-2015-120, World Institute for Development Economic Research (UNU-WIDER).
    5. José Aguilar Retureta, 2016. "Explaining regional inequality from the periphery: The mexican case, 1900-2000," Documentos de Trabajo (DT-AEHE) 1608, Asociación Española de Historia Económica.
    6. Miomir Jovanović & Ljiljana Kašćelan & Aleksandra Despotović & Vladimir Kašćelan, 2015. "The Impact of Agro-Economic Factors on GHG Emissions: Evidence from European Developing and Advanced Economies," Sustainability, MDPI, vol. 7(12), pages 1-21, December.
    7. Adrino Mazenda, 2016. "The Effect of BRICS Trade Relations on South Africa’s Growth," EERI Research Paper Series EERI RP 2016/11, Economics and Econometrics Research Institute (EERI), Brussels.
    8. Giorgio Calcagnini & Germana Giombini & Giuseppe Travaglini, 2015. "The productivity gap among European countries," Working Papers 1510, University of Urbino Carlo Bo, Department of Economics, Society & Politics - Scientific Committee - L. Stefanini & G. Travaglini, revised 2015.
    9. Kaan Kutlay & Okan Veli Safakli, 2018. "The Relationship between Bank Profitability and Micro Variables with Particular Emphasis on Bank Type: The Case of Northern Cyprus," International Journal of Academic Research in Accounting, Finance and Management Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Accounting, Finance and Management Sciences, vol. 8(1), pages 26-40, January.
    10. Liyan Feng & Jun Zhai & Lei Chen & Wuqiang Long & Jiangping Tian & Bin Tang, 2017. "Increasing the application of gas engines to decrease China’s GHG emissions," Mitigation and Adaptation Strategies for Global Change, Springer, vol. 22(6), pages 839-861, August.
    11. Irwan Shah Zainal Abidin & Muhammad Haseeb & Muhammad Azam & Rabiul Islam, 2015. "Foreign Direct Investment, Financial Development, International Trade and Energy Consumption: Panel Data Evidence from Selected ASEAN Countries," International Journal of Energy Economics and Policy, Econjournals, vol. 5(3), pages 841-850.
    12. Alireza Nasiri & Antonio R. Alleyne & Lyu Yihui, 2016. "Analysis of innovation management in German enterprises," Cogent Business & Management, Taylor & Francis Journals, vol. 3(1), pages 1216727-121, December.
    13. Stahler Kevin & Subramanian Arvind, 2014. "Versailles Redux? Eurozone Competitiveness in a Dynamic Balassa-Samuelson-Penn Framework," Journal of Globalization and Development, De Gruyter, vol. 5(2), pages 129-176, December.
    14. repec:mth:ijafr8:v:8:y:2018:i:4:p:22-59 is not listed on IDEAS
    15. Wameq A. Raza & Ellen van de Poel & Arjun Bedi & Frans Rutten, 2016. "Impact of Community‐based Health Insurance on Access and Financial Protection: Evidence from Three Randomized Control Trials in Rural India," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 675-687, June.
    16. Ashok Gulati & Shweta Saini, 2015. "India's political economy responses to the global food price shock of 2007-08: Learning some lessons," WIDER Working Paper Series 120, World Institute for Development Economic Research (UNU-WIDER).
    17. Sayeeda Bano & Nawal K. Paswan, 2016. "New Zealand–India Trade Relations and Growth Potential: An Empirical Analysis," India Quarterly: A Journal of International Affairs, , vol. 72(1), pages 50-74, March.
    18. Maxim Pinkovskiy & Xavier Sala-i-Martin, 2018. "Shining a Light on Purchasing Power Parities," NBER Working Papers 24419, National Bureau of Economic Research, Inc.
    19. Wu, Po-Chin & Liu, Shiao-Yen & Hsiao, Juei-Ming & Huang, Tsai-Yuan, 2016. "Nonlinear and time-varying growth-tourism causality," Annals of Tourism Research, Elsevier, vol. 59(C), pages 45-59.
    20. Olanubi, Sijuola Orioye & Osode, Oluwanbepelumi Esther, 2017. "The efficiency of government spending on health: A comparison of different administrations in Nigeria," Journal of Policy Modeling, Elsevier, vol. 39(1), pages 79-98.
    21. Md. Muddassir Quamar, 2015. "Tunisia: Presidential and Parliamentary Elections, 2014," Contemporary Review of the Middle East, , vol. 2(3), pages 269-288, September.

    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:pone00:0265033. 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.