“Economic evaluation of neonatal care packages in a cluster-randomized controlled trial in Sylhet, Bangladesh” – 11/11/13 – Neil Sarna

“Economic evaluation of neonatal care packages in a cluster-randomized controlled trial in Sylhet, Bangladesh”                                                                                                                   08/12/13

I was frankly astonished when I read that 7.6 million children, younger than 5 years old, died in 2010 alone. What was even more shocking was the fact that 99% of neonatal deaths occur in low and middle income countries, indicating a problem that is socioeconomically concentrated rather than a fundamental physiological in humans. The reasons for neonatal deaths are often consistent throughout low and middle income countries, such as poor nutrition, lack of sanitation, high communicable disease burden, and a less than efficient healthcare system. The Project for Advancing the Health of Newborns and Mothers was created in 2002 and was created in the hopes that the neonatal fatalities could be decreased significantly; especially in rural areas of the Bangladesh.

An interesting study conducted as part of the project was a cost-benefit analysis between individualized “home-care” for pregnant mothers and a “community-care” model to test and see which model provided the best improvements in neonatal fatalities while being able to remain as a sustainable system due to shortfalls in funding. For the “home-care” model, women with at least 10 years of education were trained to become community health workers (CHW) and trained in obstetric and neonatal care techniques. For the “community-care” model, community mobilizers were used to help promote neonatal care. The community care mobilizers held community meetings and encouraged expectant mothers to visit local health facilities without providing any sort of clinical care. At the end of the study period in 2005, it was determined through a rather complicated economic analysis that the “home-care” model was the more cost and clinically effective model to follow even though the home-care option was more expensive than the community model.

To read more on the effects each system had on improving DALY’s and infant mortality, find the full text below: http://www.who.int/bulletin/volumes/91/10/12-117127/en/index.html

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