Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali
Abstract Background The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, th...
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doaj-54bb5a48addb429b9126085ec29cd1f92020-11-25T00:27:51ZengBMCBMC Public Health1471-24582017-06-0117111110.1186/s12889-017-4490-6Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, MaliRoberta Maccario0Saba Rouhani1Tom Drake2Annie Nagy3Modibo Bamadio4Seybou Diarra5Souleymane Djanken6Natalie Roschnik7Siân E. Clarke8Moussa Sacko9Simon Brooker10Josselin Thuilliez11Department of Social Policy, London School of EconomicsLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineSave the ChildrenSave the ChildrenSave the ChildrenSave the ChildrenSave the ChildrenLondon School of Hygiene and Tropical MedicineInstitut National de Recherche en Santé PubliqueLondon School of Hygiene and Tropical MedicineCES-CNRS, Université Paris 1, Panthéon-Sorbonne, Centre d’économie de la Sorbonne, Maison des Sciences Economiques, 106-112 Boulevard de l’HôpitalAbstract Background The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali. Methods Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. Results The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. Conclusions A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.http://link.springer.com/article/10.1186/s12889-017-4490-6MalariaCost analysisMalaria controlSchoolsSchool healthLLINs |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Roberta Maccario Saba Rouhani Tom Drake Annie Nagy Modibo Bamadio Seybou Diarra Souleymane Djanken Natalie Roschnik Siân E. Clarke Moussa Sacko Simon Brooker Josselin Thuilliez |
spellingShingle |
Roberta Maccario Saba Rouhani Tom Drake Annie Nagy Modibo Bamadio Seybou Diarra Souleymane Djanken Natalie Roschnik Siân E. Clarke Moussa Sacko Simon Brooker Josselin Thuilliez Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali BMC Public Health Malaria Cost analysis Malaria control Schools School health LLINs |
author_facet |
Roberta Maccario Saba Rouhani Tom Drake Annie Nagy Modibo Bamadio Seybou Diarra Souleymane Djanken Natalie Roschnik Siân E. Clarke Moussa Sacko Simon Brooker Josselin Thuilliez |
author_sort |
Roberta Maccario |
title |
Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali |
title_short |
Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali |
title_full |
Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali |
title_fullStr |
Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali |
title_full_unstemmed |
Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali |
title_sort |
cost analysis of a school-based comprehensive malaria program in primary schools in sikasso region, mali |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2017-06-01 |
description |
Abstract Background The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali. Methods Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. Results The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. Conclusions A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel. |
topic |
Malaria Cost analysis Malaria control Schools School health LLINs |
url |
http://link.springer.com/article/10.1186/s12889-017-4490-6 |
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