Measuring the cost-effectiveness of a home-visiting intervention to promote early child development among rural families linked to the Rwandan social protection system.

Journal: PLOS global public health

Volume: 3

Issue: 10

Year of Publication: 

Affiliated Institutions:  Faculty of Health Sciences, SAMRC/Wits Centre for Health Economics and Decision Science, PRICELESS, University of Witwatersrand School of Public Health, Johannesburg, South Africa. Centre for Rural Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa. Boston College, School of Social Work, Chestnut Hill, Massachusetts, United States of America. University of Massachusetts Boston, Boston, Massachusetts, United States of America. Boston College, Lynch School of Education and Human Development, Chestnut Hill, Massachusetts, United States of America. Centre for Mental Health, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda. The World Bank, Washington, DC, United States of America.

Abstract summary 

Early childhood development (ECD) programmes are heralded as a way to improve children's health and educational outcomes. However, few studies in developing countries calculate the effectiveness of quality early childhood interventions. This study estimates the cost and cost-effectiveness of the Sugira Muryango (SM) trial, a home-visiting intervention to improve ECD outcomes through positive parent-child relationships. Cost-effectiveness analysis of ECD interventions is challenging given their potential to have multiple benefits. We propose a cost-effectiveness method using a single outcome, in this case the improvement in cognitive development per home-visit session, as an indication of efficiency comparable across similar interventions. The trial intervention cost US$456 per family. This cost will likely fall below US$200 if the intervention is scaled through government systems. The cost-effectiveness analysis suggests that while SM generated a relatively small impact on markers of early development, it did so efficiently. The observed improvements in cognitive development per home-visit are similar to other home-visiting interventions of longer duration. SM by focusing on the family had benefits beyond ECD, including reductions in violence against children and intermate partner violence, further analysis is needed to include these returns in the economic evaluation.

Authors & Co-authors:  Desmond Chris C Watt Kathryn G KG Jensen Sarah K G SKG Simmons Erik E Murray Shauna M SM Farrar Jordan J Placencio-Castro Matias M Sezibera Vincent V Rawlings Laura B LB Wilson Briana B Betancourt Theresa S TS

Study Outcome 

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Statistics
Citations :  Shonkoff JP, Richter LM, van der Gaag J, Bhutta ZA. An Integrated Scientific Framework for Child Survival and Early Childhood Development. Pediatrics. 2012;129: e460. doi: 10.1542/peds.2011-0366
Authors :  11
Identifiers
Doi : e0002473
SSN : 2767-3375
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Study Approach
Country of Study
Rwanda
Publication Country
United States