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Measuring the cost-effectiveness of a home-visiting intervention to promote early child development among rural families linked to the Rwandan social protection system

Author

Listed:
  • Chris Desmond
  • Kathryn G Watt
  • Sarah K G Jensen
  • Erik Simmons
  • Shauna M Murray
  • Jordan Farrar
  • Matias Placencio-Castro
  • Vincent Sezibera
  • Laura B Rawlings
  • Briana Wilson
  • Theresa S Betancourt

Abstract

Early childhood development (ECD) programmes are heralded as a way to improve children’s health and educational outcomes. However, few studies in developing countries calculate the effectiveness of quality early childhood interventions. This study estimates the cost and cost-effectiveness of the Sugira Muryango (SM) trial, a home-visiting intervention to improve ECD outcomes through positive parent-child relationships. Cost-effectiveness analysis of ECD interventions is challenging given their potential to have multiple benefits. We propose a cost-effectiveness method using a single outcome, in this case the improvement in cognitive development per home-visit session, as an indication of efficiency comparable across similar interventions. The trial intervention cost US$456 per family. This cost will likely fall below US$200 if the intervention is scaled through government systems. The cost-effectiveness analysis suggests that while SM generated a relatively small impact on markers of early development, it did so efficiently. The observed improvements in cognitive development per home-visit are similar to other home-visiting interventions of longer duration. SM by focusing on the family had benefits beyond ECD, including reductions in violence against children and intermate partner violence, further analysis is needed to include these returns in the economic evaluation.

Suggested Citation

  • Chris Desmond & Kathryn G Watt & Sarah K G Jensen & Erik Simmons & Shauna M Murray & Jordan Farrar & Matias Placencio-Castro & Vincent Sezibera & Laura B Rawlings & Briana Wilson & Theresa S Betancour, 2023. "Measuring the cost-effectiveness of a home-visiting intervention to promote early child development among rural families linked to the Rwandan social protection system," PLOS Global Public Health, Public Library of Science, vol. 3(10), pages 1-15, October.
    • Handle: RePEc:plo:pgph00:0002473
    DOI: 10.1371/journal.pgph.0002473
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    2. Patricia Justino & Marinella Leone & Pierfrancesco Rolla & Monique Abimpaye & Caroline Dusabe & Marie D Uwamahoro & Richard Germond, 2023. "Improving Parenting Practices for Early Child Development: Experimental Evidence from Rwanda," Journal of the European Economic Association, European Economic Association, vol. 21(4), pages 1510-1550.
    3. James Heckman & Rodrigo Pinto & Peter Savelyev, 2013. "Understanding the Mechanisms through Which an Influential Early Childhood Program Boosted Adult Outcomes," American Economic Review, American Economic Association, vol. 103(6), pages 2052-2086, October.
    4. Chris Desmond & Ruth M Bland & Gerard Boyce & Hoosen M Coovadia & Anna Coutsoudis & Nigel Rollins & Marie-Louise Newell, 2008. "Scaling-Up Exclusive Breastfeeding Support Programmes: The Example of KwaZulu-Natal," PLOS ONE, Public Library of Science, vol. 3(6), pages 1-9, June.
    5. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
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