IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0223004.html
   My bibliography  Save this article

Costs and cost-effectiveness analyses of mCARE strategies for promoting care seeking of maternal and newborn health services in rural Bangladesh

Author

Listed:
  • Youngji Jo
  • Amnesty E LeFevre
  • Katherine Healy
  • Neelu Singh
  • Kelsey Alland
  • Sucheta Mehra
  • Hasmot Ali
  • Saijuddin Shaikh
  • Rezawanul Haque
  • Parul Christian
  • Alain B Labrique

Abstract

Objective: We examined the incremental cost-effectiveness between two mHealth programs, implemented from 2011 to 2015 in rural Bangladesh: (1) Comprehensive mCARE package as an intervention group and (2) Basic mCARE package as a control group. Methods: Both programs included a core package of census enumeration and pregnancy surveillance provided by an established cadre of digitally enabled community health workers (CHWs). In the comprehensive mCARE package, short message service (SMS) and home visit reminders were additionally sent to pregnant women (n = 610) and CHWs (n = 70) to promote the pregnant women’s care-seeking of essential maternal and newborn care services. Economic costs were assessed from a program perspective inclusive of development, start-up, and implementation phases. Effects were calculated as disability adjusted life years (DALYs) and the number of newborn deaths averted. For comparative purposes, we normalized our evaluation to estimate total costs and total newborn deaths averted per 1 million people in a community for both groups. Uncertainty was assessed using probabilistic sensitivity analyses with Monte Carlo simulation. Results: The addition of SMS and home visit reminders based on a mobile phone-facilitated pregnancy surveillance system was highly cost effective at a cost per DALY averted of $31 (95% uncertainty range: $19–81). The comprehensive mCARE program had at least 88% probability of being highly cost-effective as compared to the basic mCARE program based on the threshold of Bangladesh’s GDP per capita. Conclusion: mHealth strategies such as SMS and home visit reminders on a well-established pregnancy surveillance system may improve service utilization and program cost-effectiveness in low-resource settings.

Suggested Citation

  • Youngji Jo & Amnesty E LeFevre & Katherine Healy & Neelu Singh & Kelsey Alland & Sucheta Mehra & Hasmot Ali & Saijuddin Shaikh & Rezawanul Haque & Parul Christian & Alain B Labrique, 2019. "Costs and cost-effectiveness analyses of mCARE strategies for promoting care seeking of maternal and newborn health services in rural Bangladesh," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-13, October.
    • Handle: RePEc:plo:pone00:0223004
    DOI: 10.1371/journal.pone.0223004
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223004
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0223004&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0223004?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. Carla Guerriero & John Cairns & Ian Roberts & Anthony Rodgers & Robyn Whittaker & Caroline Free, 2013. "The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 789-797, October.
    2. Sarah J Iribarren & Kenrick Cato & Louise Falzon & Patricia W Stone, 2017. "What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-20, February.
    3. Dejan Zurovac & Bruce A Larson & Raymond K Sudoi & Robert W Snow, 2012. "Costs and Cost-Effectiveness of a Mobile Phone Text-Message Reminder Programmes to Improve Health Workers' Adherence to Malaria Guidelines in Kenya," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-6, December.
    Full references (including those not matched with items on IDEAS)

    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. Yeonsoo Jang & Sang Hoon Ahn & Kyunghwa Lee & Oh Young Kwon & Jeong Hyun Kim, 2021. "Development and Pilot Testing of a Smartphone-Based Self-Care Program for Patients with Chronic Hepatitis B," IJERPH, MDPI, vol. 18(21), pages 1-13, October.
    2. Diego Chambergo-Michilot & Walter Andree Tellez & Naysha Becerra-Chauca & Jessica Hanae Zafra-Tanaka & Alvaro Taype-Rondan, 2020. "Text message reminders for improving sun protection habits: A systematic review," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-15, May.
    3. Khushbu Singh & Matthew R Walters, 2024. "Use of mHealth in promoting maternal and child health in “BIMARU” states of India “A health system strengthening strategy”: Systematic literature review," PLOS Digital Health, Public Library of Science, vol. 3(2), pages 1-26, February.
    4. Pal, Sumantra, 2022. "Mobile health interventions: A policymakers’ note on the World’s largest Nutrition Surveillance in India," EconStor Preprints 264272, ZBW - Leibniz Information Centre for Economics.
    5. Secinaro, Silvana & Lanzalonga, Federico & Oppioli, Michele & de Nuccio, Elbano, 2025. "The effects of disruptive technologies on accountability in fintech industry: Using bibliometric analysis to develop a research agenda," Research in International Business and Finance, Elsevier, vol. 76(C).
    6. Secinaro, Silvana & Brescia, Valerio & Lanzalonga, Federico & Santoro, Gabriele, 2022. "Smart city reporting: A bibliometric and structured literature review analysis to identify technological opportunities and challenges for sustainable development," Journal of Business Research, Elsevier, vol. 149(C), pages 296-313.
    7. Helena Biancuzzi & Francesca Dal Mas & Chiara Bidoli & Veronica Pegoraro & Maristella Zantedeschi & Pietro Antonio Negro & Stefano Campostrini & Lorenzo Cobianchi, 2023. "Economic and Performance Evaluation of E-Health before and after the Pandemic Era: A Literature Review and Future Perspectives," IJERPH, MDPI, vol. 20(5), pages 1-18, February.
    8. Sarah J Iribarren & Kenrick Cato & Louise Falzon & Patricia W Stone, 2017. "What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-20, February.
    9. Elyssa Wiecek & Fernanda S Tonin & Andrea Torres-Robles & Shalom I Benrimoj & Fernando Fernandez-Llimos & Victoria Garcia-Cardenas, 2019. "Temporal effectiveness of interventions to improve medication adherence: A network meta-analysis," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    10. Alex Armand & Mattia Fracchia & Pedro C. Vicente, 2024. "Let's call! Using the phone to increase vaccine acceptance," Health Economics, John Wiley & Sons, Ltd., vol. 33(1), pages 82-106, January.
    11. Emily R Mangone & Smisha Agarwal & Kelly L’Engle & Christine Lasway & Trinity Zan & Hajo van Beijma & Jennifer Orkis & Robert Karam, 2016. "Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-12, January.
    12. Nkiruka D Eze & Céu Mateus & Tiago Cravo Oliveira Hashiguchi, 2020. "Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-24, August.
    13. Patricia Turimumahoro & Austin Tucker & Amanda J Gupta & Radhika P Tampi & Diana Babirye & Emmanuel Ochom & Joseph M Ggita & Irene Ayakaka & Hojoon Sohn & Achilles Katamba & David Dowdy & J Lucian Dav, 2022. "A cost analysis of implementing mobile health facilitated tuberculosis contact investigation in a low-income setting," PLOS ONE, Public Library of Science, vol. 17(4), pages 1-13, April.
    14. María Barroso-Hurtado & Daniel Suárez-Castro & Carmela Martínez-Vispo & Elisardo Becoña & Ana López-Durán, 2021. "Smoking Cessation Apps: A Systematic Review of Format, Outcomes, and Features," IJERPH, MDPI, vol. 18(21), pages 1-18, November.
    15. Mary D Adu & Usman H Malabu & Aduli E O Malau-Aduli & Bunmi S Malau-Aduli, 2019. "Enablers and barriers to effective diabetes self-management: A multi-national investigation," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-22, June.
    16. Nina van der Vliet & Anita W.M. Suijkerbuijk & Adriana T. de Blaeij & G. Ardine de Wit & Paul F. van Gils & Brigit A.M. Staatsen & Rob Maas & Johan J. Polder, 2020. "Ranking Preventive Interventions from Different Policy Domains: What Are the Most Cost-Effective Ways to Improve Public Health?," IJERPH, MDPI, vol. 17(6), pages 1-24, March.
    17. Mohammed Gali Salam, 2024. "Diffusion of Innovation in Ghana: The Adoption of M health Among Pregnant Women in Ayensu Ade Rural Community in The Gomoa West District," International Journal of Research and Innovation in Social Science, International Journal of Research and Innovation in Social Science (IJRISS), vol. 8(5), pages 1091-1104, May.
    18. Nystrand, Camilla & Gebreslassie, Mihretab & Ssegonja, Richard & Feldman, Inna & Sampaio, Filipa, 2021. "A systematic review of economic evaluations of public health interventions targeting alcohol, tobacco, illicit drug use and problematic gambling: Using a case study to assess transferability," Health Policy, Elsevier, vol. 125(1), pages 54-74.
    19. Taehwan Park & Hyemin Kim & Seunghyun Song & Scott K. Griggs, 2022. "Economic Evaluation of Pharmacist-Led Digital Health Interventions: A Systematic Review," IJERPH, MDPI, vol. 19(19), pages 1-16, September.
    20. Antonio Lopez-Villegas & César Leal-Costa & Mercedes Perez-Heredia & Irene Villegas-Tripiana & Daniel Catalán-Matamoros, 2021. "Knowledge Update on the Economic Evaluation of Pacemaker Telemonitoring Systems," IJERPH, MDPI, vol. 18(22), pages 1-22, November.

    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:pone00:0223004. 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.