Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar
Objective To review and compare the cost-effectiveness of the integrated model (IM) and vertical model (VM) of school eye health programme in Zanzibar.Methods and analysis This 6-month implementation research was conducted in four districts in Zanzibar. Nine and ten schools were recruited into the I...
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doaj-460a8e5168d04b0aa83fa4ecf0e8f65d2021-07-28T12:30:11ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692021-07-016110.1136/bmjophth-2020-000561Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in ZanzibarHasan Minto0Ving Fai Chan1Fatma Omar2Elodie Yard3Eden Mashayo4Damaris Mulewa5Mary Wepo68 Brien Holden Vision Institute, Sydney, Australia Centre for Public Health, Queen's University Belfast, Faculty of Medicine Health and Life Sciences, Belfast, UKZanzibar Ministry of Health, Zanzibar, United Republic of TanzaniaPartnership for Child Development, Imperial College London, London, UKBrien Holden Vision Institute Foundation Africa Trust, Durban, South AfricaPartnership for Child Development, Imperial College London, London, UKBrien Holden Vision Institute Foundation Africa Trust, Durban, South AfricaObjective To review and compare the cost-effectiveness of the integrated model (IM) and vertical model (VM) of school eye health programme in Zanzibar.Methods and analysis This 6-month implementation research was conducted in four districts in Zanzibar. Nine and ten schools were recruited into the IM and VM, respectively. In the VM, teachers conducted eye health screening and education only while these eye health components were added to the existing school feeding programme (IM). The number of children aged 6–13 years old screened and identified was collected monthly. A review of project account records was conducted with 19 key informants. The actual costs were calculated for each cost categories, and costs per child screened and cost per child identified were compared between the two models.Results Screening coverage was 96% and 90% in the IM and VM with 297 children (69.5%) from the IM and 130 children (30.5%) from VM failed eye health screening. The 6-month eye health screening cost for VM and IM was US$6 728 and US$7 355. The cost per child screened for IM and VM was US$1.23 and US$1.31, and the cost per child identified was US$24.76 and US$51.75, respectively.Conclusion Both models achieved high coverage of eye health screening with the IM being a more cost-effective school eye health delivery screening compared with VM with great opportunities for cost savings.https://bmjophth.bmj.com/content/6/1/e000561.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hasan Minto Ving Fai Chan Fatma Omar Elodie Yard Eden Mashayo Damaris Mulewa Mary Wepo |
spellingShingle |
Hasan Minto Ving Fai Chan Fatma Omar Elodie Yard Eden Mashayo Damaris Mulewa Mary Wepo Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar BMJ Open Ophthalmology |
author_facet |
Hasan Minto Ving Fai Chan Fatma Omar Elodie Yard Eden Mashayo Damaris Mulewa Mary Wepo |
author_sort |
Hasan Minto |
title |
Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar |
title_short |
Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar |
title_full |
Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar |
title_fullStr |
Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar |
title_full_unstemmed |
Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar |
title_sort |
is an integrated model of school eye health delivery more cost-effective than a vertical model? an implementation research in zanzibar |
publisher |
BMJ Publishing Group |
series |
BMJ Open Ophthalmology |
issn |
2397-3269 |
publishDate |
2021-07-01 |
description |
Objective To review and compare the cost-effectiveness of the integrated model (IM) and vertical model (VM) of school eye health programme in Zanzibar.Methods and analysis This 6-month implementation research was conducted in four districts in Zanzibar. Nine and ten schools were recruited into the IM and VM, respectively. In the VM, teachers conducted eye health screening and education only while these eye health components were added to the existing school feeding programme (IM). The number of children aged 6–13 years old screened and identified was collected monthly. A review of project account records was conducted with 19 key informants. The actual costs were calculated for each cost categories, and costs per child screened and cost per child identified were compared between the two models.Results Screening coverage was 96% and 90% in the IM and VM with 297 children (69.5%) from the IM and 130 children (30.5%) from VM failed eye health screening. The 6-month eye health screening cost for VM and IM was US$6 728 and US$7 355. The cost per child screened for IM and VM was US$1.23 and US$1.31, and the cost per child identified was US$24.76 and US$51.75, respectively.Conclusion Both models achieved high coverage of eye health screening with the IM being a more cost-effective school eye health delivery screening compared with VM with great opportunities for cost savings. |
url |
https://bmjophth.bmj.com/content/6/1/e000561.full |
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