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Verfasst von:Zeng, Wu [VerfasserIn]   i
 Chansa, Collins [VerfasserIn]   i
Titel:Cost-effectiveness of results-based financing, Zambia
Titelzusatz:a cluster randomized trial
Verf.angabe:Wu Zeng, Donald S Shepard, Ha Nguyen, Collins Chansa, Ashis Kumar Das, Jumana Qamruddin & Jed Friedman
E-Jahr:2018
Jahr:29 August 2018
Umfang:12 S.
Fussnoten:Gesehen am 30.03.2020
Titel Quelle:Enthalten in: WeltgesundheitsorganisationBulletin of the World Health Organization
Ort Quelle:Geneva : WHO, 1947
Jahr Quelle:2018
Band/Heft Quelle:96(2018), 11, Seite 760-771
ISSN Quelle:1564-0604
Abstract:Objective - To evaluate the cost-effectiveness of results-based financing and input-based financing to increase use and quality of maternal and child health services in rural areas of Zambia. - - Methods - In a cluster-randomized trial from April 2012 to June 2014, 30 districts were allocated to three groups: results-based financing (increased funding tied to performance on pre-agreed indicators), input-based financing (increased funding not tied to performance) or control (no additional funding), serving populations of 1.33, 1.26 and 1.40 million people, respectively. We assessed incremental financial costs for programme implementation and verification, consumables and supervision. We evaluated coverage and quality effectiveness of maternal and child health services before and after the trial, using data from household and facility surveys, and converted these to quality-adjusted life years (QALYs) gained. - - Findings - Coverage and quality of care increased significantly more in results-based financing than control districts: difference in differences for coverage were 12.8% for institutional deliveries, 8.2% postnatal care, 19.5% injectable contraceptives, 3.0% intermittent preventive treatment in pregnancy and 6.1% to 29.4% vaccinations. In input-based financing districts, coverage increased significantly more versus the control for institutional deliveries (17.5%) and postnatal care (13.2%). Compared with control districts, 641 more lives were saved (lower-upper bounds: 580-700) in results-based financing districts and 362 lives (lower-upper bounds: 293-430) in input-based financing districts. The corresponding incremental cost-effectiveness ratios were 809 United States dollars (US$) and US$ 413 per QALY gained, respectively. - - Conclusion - Compared with the control, both results-based financing and input-based financing were cost-effective in Zambia.
DOI:doi:10.2471/BLT.17.207100
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.2471/BLT.17.207100
 Volltext: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239017/
 DOI: https://doi.org/10.2471/BLT.17.207100
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1693506025
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