We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS , and additional evidence exists for the potential to achieve cost savings from activities related to malaria , NCDs , NTDs , childhood illness , and other disease areas , especially at the primary health care and community levels .
Conclusions Task shifting presents a viable option for health system cost savings in LMICs .
Background Task shifting has become an increasingly popular way to increase access to health services , especially in low-re source setting s. Research has demonstrated that task shifting , including the use of community health workers ( CHWs ) to deliver care , can improve population health .
This systematic review investigates whether task shifting in low-income and middle-income countries ( LMICs ) results in efficiency improvements by achieving cost savings .
Costs and Cost-Effectiveness of Training Traditional Birth Attendants to Reduce Neonatal Mortality in the Lufwanyama Neonatal Survival Study (LUNESP)
Background The Lufwanyama Neonatal Survival Project ( “ LUNESP ” ) was a cluster r and omized , controlled trial that showed that training traditional birth attendants ( TBAs ) to perform interventions targeting birth asphyxia , hypothermia , and neonatal sepsis reduced all-cause neonatal mortality by 45 % . This companion analysis was undertaken to analyze intervention costs and cost-effectiveness , and factors that might improve cost-effectiveness . Methods and Findings We calculated LUNESP 's financial and economic costs and the economic cost of implementation for a forecasted ten-year program ( 2011–2020 ) . In each case , we calculated the incremental cost per death avoided and disability-adjusted life years ( DALYs ) averted in real 2011 US dollars . The forecasted 10-year program analysis included a base case as well as ‘ conservative ’ and ‘ optimistic ’ scenarios . Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis . The estimated financial and economic costs of LUNESP were $ 118,574 and $ 127,756 , respectively , or $ 49,469 and $ 53,550 per year . Fixed costs accounted for nearly 90 % of total costs . For the 10-year program , discounted total and annual program costs were $ 256,455 and $ 26,834 respectively ; for the base case , optimistic , and conservative scenarios , the estimated cost per death avoided was $ 1,866 , $ 591 , and $ 3,024 , and cost per DALY averted was $ 74 , $ 24 , and $ 120 , respectively . Outcomes were robust to variations in local costs , but sensitive to variations in intervention effect size , number of births attended by TBAs , and the extent of foreign consultants ' participation . Conclusions Based on established guidelines , the strategy of using trained TBAs to reduce neonatal mortality was ‘ highly cost effective ’ . We strongly recommend consideration of this approach for other remote rural population s with limited access to health care
We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS , and additional evidence exists for the potential to achieve cost savings from activities related to malaria , NCDs , NTDs , childhood illness , and other disease areas , especially at the primary health care and community levels .
Conclusions Task shifting presents a viable option for health system cost savings in LMICs .
Background Task shifting has become an increasingly popular way to increase access to health services , especially in low-re source setting s. Research has demonstrated that task shifting , including the use of community health workers ( CHWs ) to deliver care , can improve population health .
This systematic review investigates whether task shifting in low-income and middle-income countries ( LMICs ) results in efficiency improvements by achieving cost savings .