Breastfeeding promotion and priority setting in health
Breastfeeding promotion and priority setting in health
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DOI：
10.1093/heapol/11.2.156
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发表时间：
1996-06-01
影响因子：
3.2
通讯作者：
SegallCorrea, SM
中科院分区：
文献类型：
--
作者：
Horton, S;Sanghvi, T;SegallCorrea, SM
纯母乳喂养普及率的提高可大大降低婴儿的死亡率和发病率。在本文中，三个母乳喂养促进计划，通过在巴西，洪都拉斯和墨西哥的孕产妇服务实施的演员和影响的估计，用于开发成本效益的措施，这些与其他健康干预措施进行比较。结果表明，推广母乳喂养可以是最具成本效益的健康干预措施之一，以预防腹泻病例，预防腹泻死亡，并获得残疾调整生命年（DIFs）。在广泛的方案类型中，好处是巨大的。从在分娩过程中取消配方奶粉和药物开始的方案，每单位净增量成本可能产生很大的影响。如果医院已经有了母婴同室，没有奶瓶喂养，成本效益就比较低（但相对于其他干预措施来说仍然具有吸引力）;随着方案的完善，成本效益就会提高。从托儿所和产科病房的配方奶喂养开始的方案，每年每出生一个婴儿的费用约为30至40美分，每预防一例腹泻病例可减少约0.65至1.10美元，每避免一例腹泻死亡可减少100至200美元，每残疾调整生命年可减少疾病负担约2至4美元。已经取消配方奶粉的产科服务可以通过为每名新生儿投资2至3美元来预防腹泻病例和死亡，每例病例的费用分别为3.50至6.75美元，每例死亡的费用分别为550至800美元，每例DALY增加12至19美元。
An increase in exclusive breastfeeding prevalence can substantially reduce mortality and morbidity among infants. In this paper, estimates of the casts and impacts of three breastfeeding promotion programmes, implemented through maternity services in Brazil, Honduras and Mexico, are used to develop cost-effectiveness measures and these are compared with other health interventions. The results show that breastfeeding promotion can be one of the most: cost-effective health interventions for preventing cases of diarrhoea, preventing deaths from diarrhoea, and gaining disability-adjusted life years (DALYs). The benefits are substantial over a broad range of programme types. Programmes starting with the removal of Formula and medications during delivery are likely to derive a high level of impact per unit of net incremental cost. Cost-effectiveness is lower (but still attractive relative to other interventions) if hospitals already have rooming-in and no bottle-feeds; and the cost-effectiveness improves as programmes become well-established. At an annual cost of about 30 to 40 US cents per birth, programmes starting with formula feeding in nurseries and maternity wards can reduce diarrhoea cases for approximately $0.65 to $1.10 per case prevented, diarrhoea deaths for $100 to $200 per death averted, and reduce the burden of disease for approximately $2 to $4 per DALY. Maternity services that have already eliminated formula can, by investing from $2 to $3 per birth, prevent diarrhoea cases and deaths for $3.50 to $6.75 per case, and $550 to $800 per death respectively, with DALYs gained at $12 to $19 each.