IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0145043.html
   My bibliography  Save this article

Cost Effectiveness of Implementing Integrated Management of Neonatal and Childhood Illnesses Program in District Faridabad, India

Author

Listed:
  • Shankar Prinja
  • Pankaj Bahuguna
  • Pavitra Mohan
  • Sarmila Mazumder
  • Sunita Taneja
  • Nita Bhandari
  • Henri van den Hombergh
  • Rajesh Kumar

Abstract

Introduction: Despite the evidence for preventing childhood morbidity and mortality, financial resources are cited as a constraint for Governments to scale up the key health interventions in some countries. We evaluate the cost effectiveness of implementing IMNCI program in India from a health system and societal perspective. Methods: We parameterized a decision analytic model to assess incremental cost effectiveness of IMNCI program as against routine child health services for infant population at district level in India. Using a 15-years time horizon from 2007 to 2022, we populated the model using data on costs and effects as found from a cluster-randomized trial to assess effectiveness of IMNCI program in Haryana state. Effectiveness was estimated as reduction in infant illness episodes, deaths and disability adjusted life years (DALY). Incremental cost per DALY averted was used to estimate cost effectiveness of IMNCI. Future costs and effects were discounted at a rate of 3%. Probabilistic sensitivity analysis was undertaken to estimate the probability of IMNCI to be cost effective at varying willingness to pay thresholds. Results: Implementation of IMNCI results in a cumulative reduction of 57384 illness episodes, 2369 deaths and 76158 DALYs among infants at district level from 2007 to 2022. Overall, from a health system perspective, IMNCI program incurs an incremental cost of USD 34.5 (INR 1554) per DALY averted, USD 34.5 (INR 1554) per life year gained, USD 1110 (INR 49963) per infant death averted. There is 90% probability for ICER to be cost effective at INR 2300 willingness to pay, which is 5.5% of India’s GDP per capita. From a societal perspective, IMNCI program incurs an additional cost of USD 24.1 (INR 1082) per DALY averted, USD 773 (INR 34799) per infant death averted and USD 26.3 (INR 1183) per illness averted in during infancy. Conclusion: IMNCI program in Indian context is very cost effective and should be scaled-up as a major child survival strategy.

Suggested Citation

  • Shankar Prinja & Pankaj Bahuguna & Pavitra Mohan & Sarmila Mazumder & Sunita Taneja & Nita Bhandari & Henri van den Hombergh & Rajesh Kumar, 2016. "Cost Effectiveness of Implementing Integrated Management of Neonatal and Childhood Illnesses Program in District Faridabad, India," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-19, January.
    • Handle: RePEc:plo:pone00:0145043
    DOI: 10.1371/journal.pone.0145043
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145043
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0145043&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0145043?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Michael K. Chapko & Chuan‐Fen Liu & Mark Perkins & Yu‐Fang Li & John C. Fortney & Matthew L. Maciejewski, 2009. "Equivalence of two healthcare costing methods: bottom‐up and top‐down," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1188-1201, October.
    2. Adam, Taghreed & Edwards, Sally J. & Amorim, Débora G. & Amaral, João & Victora, Cesar G. & Evans, David B., 2009. "Cost implications of improving the quality of child care using integrated clinical algorithms: Evidence from Northeast Brazil," Health Policy, Elsevier, vol. 89(1), pages 97-106, January.
    3. Shankar Prinja & Akashdeep Chauhan & Blake Angell & Indrani Gupta & Stephen Jan, 2015. "A Systematic Review of the State of Economic Evaluation for Health Care in India," Applied Health Economics and Health Policy, Springer, vol. 13(6), pages 595-613, December.
    4. Ahmed, Haitham M. & Mitchell, Marc & Hedt, Bethany, 2010. "National implementation of Integrated Management of Childhood Illness (IMCI): Policy constraints and strategies," Health Policy, Elsevier, vol. 96(2), pages 128-133, July.
    5. Shankar Prinja & Gursimer Jeet & Ramesh Verma & Dinesh Kumar & Pankaj Bahuguna & Manmeet Kaur & Rajesh Kumar, 2014. "Economic Analysis of Delivering Primary Health Care Services through Community Health Workers in 3 North Indian States," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-9, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Stephanie Bogdewic & Rohit Ramaswamy & David M Goodman & Emmanuel K Srofenyoh & Sebnem Ucer & Medge D Owen, 2020. "The cost-effectiveness of a program to reduce intrapartum and neonatal mortality in a referral hospital in Ghana," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-18, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Shankar Prinja & Akashdeep Singh Chauhan & Pankaj Bahuguna & Sakhtivel Selvaraj & V. R. Muraleedharan & Thiagarajan Sundararaman, 2020. "Cost of Delivering Secondary Healthcare Through the Public Sector in India," PharmacoEconomics - Open, Springer, vol. 4(2), pages 249-261, June.
    2. Shankar Prinja & Sehr Brar & Maninder Pal Singh & Kavitha Rajsekhar & Oshima Sachin & Jyotsna Naik & Malkeet Singh & Himanshi Tomar & CHSI Study Collaborating Investigators & Pankaj Bahuguna & Lorna G, 2020. "Process evaluation of health system costing – Experience from CHSI study in India," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-22, May.
    3. Lê, Gillian & Morgan, Rosemary & Bestall, Janine & Featherstone, Imogen & Veale, Thomas & Ensor, Tim, 2016. "Can service integration work for universal health coverage? Evidence from around the globe," Health Policy, Elsevier, vol. 120(4), pages 406-419.
    4. Yashika Chugh & Pankaj Bahuguna & Aamir Sohail & Kavitha Rajsekar & V. R. Muraleedharan & Shankar Prinja, 2023. "Development of a Health Technology Assessment Quality Appraisal Checklist (HTA-QAC) for India," Applied Health Economics and Health Policy, Springer, vol. 21(1), pages 11-22, January.
    5. Bugge, Christoffer & Sæther, Erik Magnus & Brustugun, Odd Terje & Kristiansen, Ivar Sønbø, 2021. "Societal cost of cancer in Norway –Results of taking a broader cost perspective," Health Policy, Elsevier, vol. 125(8), pages 1100-1107.
    6. Susanne Mayer & Noemi Kiss & Agata Łaszewska & Judit Simon, 2017. "Costing evidence for health care decision-making in Austria: A systematic review," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-18, August.
    7. Lucy Cunnama & Edina Sinanovic & Lebogang Ramma & Nicola Foster & Leigh Berrie & Wendy Stevens & Sebaka Molapo & Puleng Marokane & Kerrigan McCarthy & Gavin Churchyard & Anna Vassall, 2016. "Using Top‐down and Bottom‐up Costing Approaches in LMICs: The Case for Using Both to Assess the Incremental Costs of New Technologies at Scale," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 53-66, February.
    8. Jessica Ochalek & Miqdad Asaria & Pei Fen Chuar & James Lomas & Sumit Mazumdar & Karl Claxton, 2019. "Assessing health opportunity costs for the Indian health care systems," Working Papers 161cherp, Centre for Health Economics, University of York.
    9. Shankar Prinja & Laura E. Downey & Vijay K. Gauba & Soumya Swaminathan, 2018. "Health Technology Assessment for Policy Making in India: Current Scenario and Way Forward," PharmacoEconomics - Open, Springer, vol. 2(1), pages 1-3, March.
    10. Shankar Prinja & Akashdeep Singh Chauhan & Anup Karan & Gunjeet Kaur & Rajesh Kumar, 2017. "Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-19, February.
    11. Vogl, Matthias, 2013. "Improving patient-level costing in the English and the German ‘DRG’ system," Health Policy, Elsevier, vol. 109(3), pages 290-300.
    12. Mayanka Ambade & Nidhiya Menon & S. V. Subramanian, 2024. "The impact of early-life access to oral polio vaccines on disability: evidence from India," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(1), pages 1-25, March.
    13. Akashdeep Singh Chauhan & Shankar Prinja & Sushmita Ghoshal & Roshan Verma & Arun S Oinam, 2018. "Cost of treatment for head and neck cancer in India," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    14. Maninder Pal Singh & Riya Popli & Sehr Brar & Kavitha Rajsekar & Oshima Sachin & Jyotsna Naik & Sanjay Kumar & Setu Sinha & Varsha Singh & Prakash Patel & Ramesh Verma & Avijit Hazra & Raghunath Misra, 2022. "CHSI costing study–Challenges and solutions for cost data collection in private hospitals in India," PLOS ONE, Public Library of Science, vol. 17(12), pages 1-16, December.
    15. Yashika Chugh & Radha Krishan Dhiman & Madhumita Premkumar & Shankar Prinja & Gagandeep Singh Grover & Pankaj Bahuguna, 2019. "Real-world cost-effectiveness of pan-genotypic Sofosbuvir-Velpatasvir combination versus genotype dependent directly acting anti-viral drugs for treatment of hepatitis C patients in the universal cove," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-24, August.
    16. Shankar Prinja & Maninder Pal Singh & Kavitha Rajsekar & Oshima Sachin & Praveen Gedam & Anu Nagar & Balram Bhargava, 2021. "Translating Research to Policy: Setting Provider Payment Rates for Strategic Purchasing under India's National Publicly Financed Health Insurance Scheme," Applied Health Economics and Health Policy, Springer, vol. 19(3), pages 353-370, May.
    17. Cohen, Deborah & Manuel, Douglas G. & Tugwell, Peter & Sanmartin, Claudia & Ramsay, Tim, 2014. "Direct healthcare costs of acute myocardial infarction in Canada’s elderly across the continuum of care," The Journal of the Economics of Ageing, Elsevier, vol. 3(C), pages 44-49.
    18. Kathleen Carey & Theodore Stefos, 2011. "Measuring the cost of hospital adverse patient safety events," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1417-1430, December.
    19. Indrani Gupta & Mayur Trivedi & Vishal Jani & Kanksha Barman & Avantika Ranjan & Manas Sharma, 2021. "Costing Of Health And Wellness Centre A Case Study Of Gujarat," IEG Working Papers 415, Institute of Economic Growth.
    20. Ahmed, Haitham M. & Mitchell, Marc & Hedt, Bethany, 2010. "National implementation of Integrated Management of Childhood Illness (IMCI): Policy constraints and strategies," Health Policy, Elsevier, vol. 96(2), pages 128-133, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0145043. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.