Cost-effectiveness of a complex continuum of care intervention targeting women and children: protocol for an economic evaluation of the Bukhali trial in South Africa

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dc.contributor.authorNorris, Shane A.
dc.contributor.authorPalmer, Tom
dc.contributor.authorGranados, Rolando Leiva
dc.contributor.authorDraper, Catherine
dc.contributor.authorBatura, Neha
dc.date.accessioned2024-08-07T06:46:42Z
dc.date.available2024-08-07T06:46:42Z
dc.date.issued2024
dc.description.abstractIntroduction: As nearly two-thirds of women presenting at their first antenatal visit are either overweight or obese in urban South Africa, the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and non-communicable diseases. This protocol describes the planned economic evaluation of an individually randomised controlled trial of a complex continuum of care intervention targeting women and children in Soweto, South Africa (Bukhali trial). Methods and analysis: The economic evaluation of the Bukhali trial will be conducted as a within-trial analysis from both provider and societal perspectives. Incremental costs and health outcomes of the continuum of care intervention will be compared with standard care. The economic impact on implementing agencies (programme costs), healthcare providers, participants and their households will be estimated. Incremental cost-effectiveness ratios (ICERs) will be calculated in terms of cost per case of child adiposity at age years averted. Additionally, ICERs will also be reported in terms of cost per quality-adjusted life year gained. If Bukhali demonstrates effectiveness, we will employ a decision analytical model to examine the cost-effectiveness of the intervention over a child’s lifetime. A Markov model will be used to estimate long-term health benefits, healthcare costs and cost-effectiveness. Probabilistic sensitivity analyses will be conducted to explore uncertainty and ensure robust results. An analysis will be conducted to assess the equity impact of the intervention, by comparing intervention impact within quintiles of socioeconomic status. Ethics and dissemination: The Bukhali trial economic evaluation has ethical approval from the Human Ethics Research Committee of the University of the Witwatersrand, Johannesburg, South Africa (M240162). The results of the economic evaluation will be disseminated in a peer-reviewed journal and presented at a relevant international conference.
dc.description.sponsorshipSouth African Medical Research Council (Strategic Health Innovation Partnerships grant)
dc.description.sponsorshipCanadian Institute of Health Research for funding (grant number: HLS 151553)
dc.description.submitterPM2024
dc.facultyFaculty of Health Sciences
dc.identifier0000-0001-7124-3788
dc.identifier.citationPalmer T, Leiva Granados R, Draper C, et al. Cost-effectiveness of a complex continuum of care intervention targeting women and children: protocol for an economic evaluation of the Bukhali trial in South Africa. BMJ Open 2024;14:e080166. doi:10.1136/ bmjopen-2023-080166
dc.identifier.issn2044-6055 (online)
dc.identifier.other10.1136/bmjopen-2023-080166
dc.identifier.urihttps://hdl.handle.net/10539/40007
dc.journal.titleBMJ Open
dc.language.isoen
dc.publisherBMJ Publishing Group
dc.rights© 2024 The Author(s). This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license.
dc.schoolSchool of Clinical Medicine
dc.subjectOverweight
dc.subjectObese
dc.subjectHealth providers
dc.subjectHealth care cost
dc.subjectSouth Africa
dc.subject.otherSDG-3: Good health and well-being
dc.titleCost-effectiveness of a complex continuum of care intervention targeting women and children: protocol for an economic evaluation of the Bukhali trial in South Africa
dc.typeArticle
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