Scale Matters: A Cost-Outcome Analysis of an m-Health Intervention in Malawi

Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association
Erin Larsen-CooperAnn Levin

Abstract

The primary objectives of this study are to determine cost per user and cost per contact with users of a mobile health (m-health) intervention. The secondary objectives are to map costs to changes in maternal, newborn, and child health (MNCH) and to estimate costs of alternate implementation and usage scenarios. A base cost model, constructed from recurrent costs and selected capital costs, was used to estimate average cost per user and per contact of an m-health intervention. This model was mapped to statistically significant changes in MNCH intermediate outcomes to determine the cost of improvements in MNCH indicators. Sensitivity analyses were conducted to estimate costs in alternate scenarios. The m-health intervention cost $29.33 per user and $4.33 per successful contact. The average cost for each user experiencing a change in an MNCH indicator ranged from $67 to $355. The sensitivity analyses showed that cost per user could be reduced by 48% if the service were to operate at full capacity. We believe that the intervention, operating at scale, has potential to be a cost-effective method for improving maternal and child health indicators.

References

Oct 1, 2008·BMJ : British Medical Journal·Michael DrummondBrian Ferguson
Nov 5, 2010·BMC Medical Informatics and Decision Making·Jaranit KaewkungwalApisit Wechsart
Jun 21, 2011·Maternal and Child Health Journal·Tigest Tamrat, Stan Kachnowski
Nov 7, 2012·BMC Medical Informatics and Decision Making·Natalie LeonEmmanuelle Daviaud
Nov 28, 2012·BMC Public Health·William Douglas EvansJeremy Snider

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Citations

Feb 19, 2019·BMJ Global Health·Aduragbemi Banke-ThomasNynke van den Broek
May 28, 2019·Healthcare Informatics Research·Jisan LeeHyeong Suk Lee

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