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Cost-effectiveness Analysis of Health Care Interventions in Meskanena Mareko Wereda, Ethiopia


Ababi Zergaw
Damen Haile Mariam
Ahmed Ali

Abstract

Background: Decisions concerning the implementation of health programs are usually made on the basis of descriptive assessment. There are only few attempts to review whether returns from investment on these programs worth the effort.

Objectives: To analyze and evaluate the cost-effectiveness of health care interventions in terms of lessening disease burden and improving health status in a rural community.

Methods: The evaluation was conducted in health institutions in Meskana Mareko Wereda and in Shashemene Hospital that were purposively selected. Study subjects were people utilizing these facilities. Data on inputs of interventions were analyzed using the Disease Burden Modeling System and Disability Adjusted Life Years (DALYs) gained was used as a measure of effectiveness of interventions.

Results: Interventions at health stations level were most cost-effective compared to those at health center and the hospital. Generally, community and preventive interventions were found to be more cost-effective in lessening existing burden of disease (BOD) in the local community and in improving the general health status of the populations with cost of less than 5 Birr per DALY gained.

Conclusions: Implementing 22 health care interventions with cost of less than 100 Birr per DALY gained at the health stations level will avert 52% of the BOD in the area. On the other hand implementing 17 interventions at the hospital and 18 interventions at the health center level will avert only about 22 to 34% of the BOD. Given the availability of information pertaining to the local BOD and cost-effective intervention options, there appears to be a dire need to review local health priorities and intervention strategies.

[Ethiop.J.Health Dev. 2002;16(3):267-276]