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Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India

Author

Listed:
  • Hassan Haghparast-Bidgoli
  • Amit Ojha
  • Rajkumar Gope
  • Shibanand Rath
  • Hemanta Pradhan
  • Suchitra Rath
  • Amit Kumar
  • Vikash Nath
  • Parabita Basu
  • Andrew Copas
  • Tanja A J Houweling
  • Akay Minz
  • Pradeep Baskey
  • Manir Ahmed
  • Vasudha Chakravarthy
  • Riza Mahanta
  • Tom Palmer
  • Jolene Skordis
  • Nirmala Nair
  • Prasanta Tripathy
  • Audrey Prost

Abstract

An estimated 2.4 million newborn infants died in 2020, 80% of them in sub-Saharan Africa and South Asia. To achieve the Sustainable Development Target for neonatal mortality reduction, countries with high mortality need to implement evidence-based, cost-effective interventions at scale. Our study aimed to estimate the cost, cost-effectiveness, and benefit-cost ratio of a participatory women’s groups intervention scaled up by the public health system in Jharkhand, eastern India. The intervention was evaluated through a pragmatic cluster non-randomised controlled trial in six districts. We estimated the cost of the intervention at scale from a provider perspective, with a 42-month time horizon for 20 districts. We estimated costs using a combination of top-down and bottom-up approaches. All costs were adjusted for inflation, discounted at 3% per year, and converted to 2020 International Dollars (INT$). Incremental cost-effectiveness ratios (ICERs) were estimated using extrapolated effect sizes for the impact of the intervention in 20 districts, in terms of cost per neonatal deaths averted and cost per life year saved. We assessed the impact of uncertainty on results through one-way and probabilistic sensitivity analyses. We also estimated benefit-cost ratio using a benefit transfer approach. Total intervention costs for 20 districts were INT$ 15,017,396. The intervention covered an estimated 1.6 million livebirths across 20 districts, translating to INT$ 9.4 per livebirth covered. ICERs were estimated at INT$ 1,272 per neonatal death averted or INT$ 41 per life year saved. Net benefit estimates ranged from INT$ 1,046 million to INT$ 3,254 million, and benefit-cost ratios from 71 to 218. Our study suggests that participatory women’s groups scaled up by the Indian public health system were highly cost-effective in improving neonatal survival and had a very favourable return on investment. The intervention can be scaled up in similar settings within India and other countries.

Suggested Citation

  • Hassan Haghparast-Bidgoli & Amit Ojha & Rajkumar Gope & Shibanand Rath & Hemanta Pradhan & Suchitra Rath & Amit Kumar & Vikash Nath & Parabita Basu & Andrew Copas & Tanja A J Houweling & Akay Minz & P, 2023. "Economic evaluation of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India," PLOS Global Public Health, Public Library of Science, vol. 3(6), pages 1-16, June.
  • Handle: RePEc:plo:pgph00:0001128
    DOI: 10.1371/journal.pgph.0001128
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    References listed on IDEAS

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    1. Shanmugam, K R, 2001. "Self Selection Bias in the Estimates of Compensating Differentials for Job Risks in India," Journal of Risk and Uncertainty, Springer, vol. 22(3), pages 263-275, May.
    2. Soma Bhattacharya & Anna Alberini & Maureen Cropper, 2007. "The value of mortality risk reductions in Delhi, India," Journal of Risk and Uncertainty, Springer, vol. 34(1), pages 21-47, February.
    3. S. Madheswaran, 2007. "Measuring the value of statistical life: estimating compensating wage differentials among workers in India," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 84(1), pages 83-96, October.
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