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Cost effectiveness analysis of mHealth based breastfeeding promotion on infant diarrheal mortality and morbidity in Addis Ababa, Ethiopia
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2018 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Exclusive breastfeeding for the first six month of life has been a global recommendation since 2001. The recommendation emanates from various studies which have established that breastmilk is the best nutrition for infants,with benefits including reduction of diarrheal morbidity and mortality. Despitethe benefits and recommendations, rate of exclusive breastfeeding remains low globally. On top of that interventions to promote exclusive breastfeeding are limited and lack a component of continued support and counselling. Mobilephone-based promotion of exclusive breastfeeding has been proved effective in increasing the rate of mothers practicing exclusive breast feeding. However, research is lacking on cost effectiveness of such interventions.

Objective: The study aims to assess the cost effectiveness of mobile phone based exclusive breastfeeding promotion on diarrhea mortality and morbidity in infants aged 0 to 6 months in Addis Ababa, Ethiopia.

Methods: We used a combination of decision tree and a Markov model to capture all the components of exclusive breastfeeding on diarrheal morbidity and mortality. Our Markov model was constructed with four possible states of well, moderate diarrhea, severe diarrhea and diarrhea death. We took a time horizon of 6 months with weekly cycles. Input parameters for the model were extrapolated from the literature and health outcomes were calculated as DALYs averted. We quantified all the possible costs that might be incurred for a hypothetical mHealth intervention in our setting Addis Ababa.

Results: outcome of this analysis is an Incremental Cost Effectiveness Ratio of US$21 per DALY averted, which is highly cost effective. The ICER varies between 7 –64 USD/DALY averted in our one-way sensitivity analysis, which remains to be cost effective. The intervention will avert a total of 19,049 DALYs and 0.5 DALYs per child.

Conclusion: Our study establishes the cost effectiveness of mHealth breastfeeding promotion on reducing diarrheal mortality and morbidity. Taking this finding as a baseline, further cost effectiveness analysis studies could establish the full range of advantage accrued from mobile phone based breastfeeding promotion for both infant and mother.

Place, publisher, year, edition, pages
2018. , p. 33
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2018:28
Keywords [en]
mHealth, exclusive breastfeeding, breastfeeding promotion, infant diarrhea, cost-effectiveness, Markov model, ICER
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-152712OAI: oai:DiVA.org:umu-152712DiVA, id: diva2:1257332
External cooperation
Ethiopia Demographic Health Survey
Educational program
Master's Programme in Public Health
Presentation
2018-05-22, Caring Science building, Room A309, Umeå Unviversity, Umeå, 13:00 (English)
Supervisors
Examiners
Available from: 2018-10-22 Created: 2018-10-19 Last updated: 2018-10-22Bibliographically approved

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
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More styles
Language
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More languages
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