Costs of promoting exclusive breastfeeding at community level in three sites in South Africa

Community-based peer support has been shown to be effective in improving exclusive breastfeeding rates in a variety of settings. We conducted a cost analysis of a community cluster randomised-controlled trial (Promise-EBF), aimed at promoting exclusive infant feeding in three sites in South Africa....

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Bibliographic Details
Published in:PloS one 2014-01, Vol.9 (1), p.e79784-e79784
Main Authors: Nkonki, Lungiswa Leonora, Daviaud, Emmanuelle, Jackson, Debra, Chola, Lumbwe, Doherty, Tanya, Chopra, Mickey, Robberstad, Bjarne
Format: Article
Language:English
Subjects:
Adult
Breast feeding
Breast Feeding - statistics & numerical data
Breastfeeding & lactation
Childrens health
Communities
Cost analysis
Cost-Benefit Analysis
Costs
Councils
Feasibility studies
Feeding
Female
Health Promotion - economics
Health sciences
HIV
Human health and pathology
Human immunodeficiency virus
Humans
Infant
Infants
Intervention
Life Sciences
Medical personnel
Medical research
Medicine
Peer tutoring
Pneumonia
Postpartum
Pregnancy
Promotion
Public health
Skilled labor
Social and Behavioral Sciences
Social Environment
South Africa
Sustainability
Workers
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Summary:Community-based peer support has been shown to be effective in improving exclusive breastfeeding rates in a variety of settings. We conducted a cost analysis of a community cluster randomised-controlled trial (Promise-EBF), aimed at promoting exclusive infant feeding in three sites in South Africa. The costs were considered from the perspective of health service providers. Peer supporters in this trial visited women to support exclusive infant feeding, once antenatally and four times postpartum. The total economic cost of the Promise-EBF intervention was US$393 656, with average costs per woman and per visit of US$228 and US$52, respectively. The average costs per woman and visit in an operational 'non research' scenario were US$137 and US$32 per woman and visit, respectively. Investing in the promotion of exclusive infant feeding requires substantial financial commitment from policy makers. Extending the tasks of multi-skilled community health workers (CHWs) to include promoting exclusive infant feeding is a potential option for reducing these costs. In order to avoid efficiency losses, we recommend that the time requirements for delivering the promotion of exclusive infant feeding are considered when integrating it within the existing activities of CHWs. This paper focuses on interventions for exclusive infant feeding, but its findings more generally illustrate the importance of documenting and quantifying factors that affect the feasibility and sustainability of community-based interventions, which are receiving increased focus in low income settings.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0079784