Cost-effectiveness of essential newborn care training in urban first-level facilities.

Academic Article

Abstract

  • OBJECTIVE: To determine the cost-effectiveness of the World Health Organization (WHO) Essential Newborn Care (ENC) training of health care providers in first-level facilities in the 2 largest cities in Zambia. METHODS: Data were extracted from a study in which the effectiveness of the ENC training was evaluated (including universal precautions and cleanliness, routine neonatal care, resuscitation, thermoregulation, breastfeeding, skin-to-skin care, care of the small infant, danger signs, and common illnesses). The costs to train an ENC instructor for each first-level delivery facility and the costs of salary/benefits for 2 coordinators responsible for maintenance of the program were recorded in 2005 US dollars. The incremental costs per life gained and per disability-adjusted life-year averted were calculated. SETTING: A 5-day ENC training-of-trainers was conducted in Lusaka, Zambia, to certify 18 college-trained midwives as ENC instructors. The instructors trained all clinic midwives working in their first-level facilities as part of a before-and-after study of the effect of ENC training on early neonatal mortality conducted from Oct 2004 to Nov 2006. RESULTS: All-cause 7-day (early) neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 live births after ENC training of the clinic midwives (relative risk: 0.59; 95% confidence interval: 0.48-0.77; P < .001; 40 615 births). The intervention costs were $208 per life saved and $5.24 per disability-adjusted life-year averted. CONCLUSIONS: ENC training of clinic midwives who provide care in low-risk facilities is a low-cost intervention that can reduce early neonatal mortality in these settings.
  • Published In

  • Pediatrics  Journal
  • Keywords

  • Ambulatory Care, Cost-Benefit Analysis, Developing Countries, Female, Health Care Costs, Health Personnel, Humans, Infant Care, Infant Mortality, Infant, Newborn, Male, Nurse Midwives, Pediatric Nursing, Program Evaluation, Risk Assessment, World Health Organization, Zambia
  • Digital Object Identifier (doi)

    Author List

  • Manasyan A; Chomba E; McClure EM; Wright LL; Krzywanski S; Carlo WA; Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women's and Children's Health Research
  • Start Page

  • e1176
  • End Page

  • e1181
  • Volume

  • 127
  • Issue

  • 5