Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania

The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hos...

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Bibliographic Details
Published inPloS one Vol. 9; no. 7; p. e102080
Main Authors Vossius, Corinna, Lotto, Editha, Lyanga, Sara, Mduma, Estomih, Msemo, Georgina, Perlman, Jeffrey, Ersdal, Hege L
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 09.07.2014
Public Library of Science (PLoS)
Subjects
Babies
Cost analysis
Cost-Benefit Analysis - economics
Costs
Curricula
Curriculum
Developing Countries
Education
Evidence-based medicine
Evidence-Based Practice - economics
Evidence-Based Practice - education
Global health
Government procurement
Health aspects
Hospitals
Hospitals, Rural
Humans
Infant
Infant mortality
Infant Mortality - trends
Infant, Newborn
Infants
Medical Staff, Hospital - economics
Medical Staff, Hospital - education
Medicine and Health Sciences
Midwifery
Missionaries
Mortality
Neonates
Newborn babies
Pediatrics
Purchasing power parity
Quality-Adjusted Life Years
Research and Analysis Methods
Resuscitation
Resuscitation - economics
Resuscitation - education
Simulation
Stillbirth - epidemiology
Tanzania
Training
Ventilators
Tanzania
New York
United States > US
Norway
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Summary:The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania. Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health. Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated. The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.
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Conceived and designed the experiments: CV EL SL EM GM JP HLE. Analyzed the data: CV EL EM HLE. Contributed with cost data or provided information about the organization of the clinical work at the delivery room: CV EL SL EM GM JP HLE. Contributed to the writing of the manuscript: CV EL SL EM GM JP HLE.
Competing Interests: Corinna Vossius has received project support from the Lærdal Foundation for Acute Medicine. Hege L. Ersdal has received project support and research grants from the Lærdal Foundation for Acute Medicine. Jeffrey Perlman has received travel support from the Lærdal Foundation for Acute Medicine to facilitate implementation of the HBB program in Tanzania. The other authors have indicated they have no financial relationships relevant to this article to disclose. Lærdal Global Health A/S, a nonprofit sister company of Lærdal Medical A/S, designs, develops and manufactures low cost training equipment and therapeutic devices, including those used in the HBB program. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0102080