Publication: Malaria community health workers in Myanmar: a cost analysis
Issued Date
2016
Resource Type
Language
eng
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Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Malaria Journal. Vol.15, (2016), 41
Suggested Citation
Shwe Sin Kyaw, Drake, Tom, Aung Thi, Myat Phone Kyaw, Thaung Hlaing, Smithuis, Frank M., White, Lisa J., Lubell, Yoel Malaria community health workers in Myanmar: a cost analysis. Malaria Journal. Vol.15, (2016), 41. doi:10.1186/s12936-016-1102-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3157
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Title
Malaria community health workers in Myanmar: a cost analysis
Abstract
Background: Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited
healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes
is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite
considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well
understood.
Methods: An ingredients based micro-costing approach was used to develop a model of the annual implementation
cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of
training, patient malaria services, monitoring and supervision, programme management, overheads and incentives.
The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial
reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria
control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty
and explore changes to programme cost for key assumptions.
Results: The range of total annual costs for the support of one CHW was US$ 966–2486. The largest driver of CHW
cost was monitoring and supervision (31–60 % of annual CHW cost). Other important determinants of cost included
programme management (15–28 % of annual CHW cost) and patient services (6–12 % of annual CHW cost). Within
patient services, malaria rapid diagnostic tests are the major contributor to cost (64 % of patient service costs).
Conclusion: The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the
design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates
provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic
evaluations of their cost-effectiveness.