Assessing the cost-effectiveness of integrated case management of Neglected Tropical Diseases in Liberia

BMC Health Services Research

Research

Melissa Edmiston¹  Tiawanlyn G. Godwin-Akpan¹  Stefanie Weiland¹  Fred Sosu²  John Solunta Smith²  Karin Diaconu³  Karsor K. Kollie⁴ 

[1] American Leprosy Missions, Greenville, SC, USA;Capitol Bye-Pass, University of Liberia – Atlantic Centre for Research and Evaluation, University of Liberia, Monrovia, Liberia;Institute for Global Health and Development, Queen Margaret University, EH21 6UU, Edinburgh, Musselburgh, Scotland;Neglected Tropical Diseases Program, Ministry of Health, Oldest Congo Town, Monrovia, Liberia;

关键词: NTDs;    Integrated approach;    Case management;    Cost-savings;   

DOI  :  10.1186/s12913-023-09685-0

 received in 2022-12-20, accepted in 2023-06-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn 2017, Liberia became one of the first countries in the African region to develop and implement a national strategy for integrated case management of Neglected Tropical Diseases (CM-NTDs), specifically Buruli ulcer, leprosy, lymphatic filariasis morbidities, and yaws. Implementing this plan moves the NTD program from many countries' fragmented (vertical) disease management. This study explores to what extent an integrated approach offers a cost-effective investment for national health systems.MethodsThis study is a mixed-method economic evaluation that explores the cost-effectiveness of the integrated CM-NTDs approach compared to the fragmented (vertical) disease management. Primary data were collected from two integrated intervention counties and two non-intervention counties to determine the relative cost-effectiveness of the integrated program model vs. fragmented (vertical) care. Data was sourced from the NTDs program annual budgets and financial reports for integrated CM-NTDs and Mass Drug Administration (MDA) to determine cost drivers and effectiveness.ResultsThe total cost incurred by the integrated CM-NTD approach from 2017 to 2019 was US$ 789,856.30, with the highest percentage of costs for program staffing and motivation (41.8%), followed by operating costs (24.8%). In the two counties implementing fragmented (vertical) disease management, approximately US$ 325,000 was spent on the diagnosis of 84 persons and the treatment of twenty-four persons suffering from NTDs. While 2.5 times as much was spent in integrated counties, 9–10 times more patients were diagnosed and treated.ConclusionsThe cost of a patient being diagnosed under the fragmented (vertical) implementation is five times higher than integrated CM-NTDs, and providing treatment is ten times as costly. Findings indicate that the integrated CM-NTDs strategy has achieved its primary objective of improved access to NTD services. The success of implementing an integrated CM-NTDs approach in Liberia, presented in this paper, demonstrates that NTD integration is a cost-minimizing solution.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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