Achieving the millennium development goals for health - Cost effectiveness analysis of strategies for child health in developing countries
Achieving the millennium development goals for health - Cost effectiveness analysis of strategies for child health in developing countries
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DOI：
10.1136/bmj.38652.550278.7c
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发表时间：
2005-11-19
影响因子：
105.7
通讯作者：
Evans, DB
中科院分区：
文献类型：
--
作者：
Edejer, TTT;Aikins, M;Evans, DB
目的 确定选定的儿童健康干预措施的成本和效果，即肺炎病例管理、口服补液疗法、补充和强化维生素 A 和锌、提供补充食品并提供营养咨询和麻疹免疫。设计成本效果分析。数据来源 效果数据来自已发表的系统评价以及项目前后的评估。对于资源投入，数量来自文献和专家意见，价格来自世界卫生组织选择具有成本效益的干预措施 (WHO-CHOICE) 数据库。结果成本效益比分为三组，其中锌和维生素 A 强化是最具成本效益的干预措施，提供补充食品和营养咨询是成本效益最低的干预措施。其中包括口服补液治疗肺炎病例管理、补充维生素A和锌以及麻疹免疫接种。 结论 出于成本效益的考虑，除了对患病儿童进行口服补液治疗和肺炎病例管理外，还应常规向所有儿童提供微量营养素中期麻疹免疫接种。现有的干预措施未能很好地解决营养不良的挑战。
Objective To determine the costs and effectiveness of selected child health interventions-namely, case management of pneumonia, oral rehydration therapy, Supplementation and fortification of staple foods with vitamin A and zinc, provision of supplementary food with counselling on nutrition, and immunisation against measles.Design Cost effectiveness analysis.Data sources Efficacy data came from Published systematic reviews and before and after evaluations of programmes. For resource inputs, quantities came from literature and expert opinion, and prices from the World Health Organization Choosing Interventions that are Cost Effective (WHO-CHOICE) database.Results Cost effectiveness ratios clustered in three groups with fortification with zinc and vitamin A as the most cost effective intervention, and provision of supplementary food and counselling on nutrition as the least cost effective. Between these were oral rehydration therapy case management of pneumonia, vitamin A and zinc supplementation, and measles immunisation.Conclusions On the grounds of cost effectiveness, micronutrients mid measles immunisation should be provided routinely to all children, in addition to oral rehydration therapy and case management of pneumonia for those who are sick. The challenge of malnutrition is not well addressed by existing interventions.