TY - JOUR
T1 - Promoting early childhood development in Viet Nam
T2 - cost-effectiveness analysis alongside a cluster-randomised trial
AU - Baek, Yeji
AU - Ademi, Zanfina
AU - Tran, Thach
AU - Owen, Alice
AU - Nguyen, Trang
AU - Luchters, Stanley
AU - Hipgrave, David B.
AU - Hanieh, Sarah
AU - Tran, Tuan
AU - Tran, Ha
AU - Biggs, Beverley Ann
AU - Fisher, Jane
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2023/8
Y1 - 2023/8
N2 - Background: Economic evaluations are critical to ensure effective resource use to implement and scale up child development interventions. This study aimed to estimate the cost-effectiveness of a multicomponent early childhood development intervention in rural Viet Nam. Methods: We did a cost-effectiveness study alongside a cluster-randomised trial with a 30-month time horizon. The study included 669 mothers from 42 communes in the intervention group, and 576 mothers from 42 communes in the control group. Mothers in the intervention group attended Learning Clubs sessions from mid-pregnancy to 12 months after delivery. The primary outcomes were child cognitive, language, motor, and social–emotional development at age 2 years. In this analysis, we estimated the incremental cost-effectiveness ratios (ICERs) of the intervention compared with the usual standard of care from the service provider and household perspectives. We used non-parametric bootstrapping to examine uncertainty, and applied a 3% discount rate. Findings: The total intervention cost was US$169 898 (start-up cost $133 692 and recurrent cost $36 206). The recurrent cost per child was $58 (1 341 741 Vietnamese dong). Considering the recurrent cost alone, the base-case ICER was $14 and mean ICER of 1000 bootstrap samples was $14 (95% CI –0·48 to 30) per cognitive development score gained with a 3% discount rate to costs. The ICER per language and motor development score gained was $22 and $20, respectively, with a 3% discount rate to costs. Interpretation: The intervention was cost-effective: the ICER per child cognitive development score gained was 0·5% of Viet Nam's gross domestic product per capita, alongside other benefits in language and motor development. This finding supports the scaling up of this intervention in similar socioeconomic settings. Funding: Australian National Health and Medical Research Council and Grand Challenges Canada. Translation: For the Vietnamese translation of the abstract see Supplementary Materials section.
AB - Background: Economic evaluations are critical to ensure effective resource use to implement and scale up child development interventions. This study aimed to estimate the cost-effectiveness of a multicomponent early childhood development intervention in rural Viet Nam. Methods: We did a cost-effectiveness study alongside a cluster-randomised trial with a 30-month time horizon. The study included 669 mothers from 42 communes in the intervention group, and 576 mothers from 42 communes in the control group. Mothers in the intervention group attended Learning Clubs sessions from mid-pregnancy to 12 months after delivery. The primary outcomes were child cognitive, language, motor, and social–emotional development at age 2 years. In this analysis, we estimated the incremental cost-effectiveness ratios (ICERs) of the intervention compared with the usual standard of care from the service provider and household perspectives. We used non-parametric bootstrapping to examine uncertainty, and applied a 3% discount rate. Findings: The total intervention cost was US$169 898 (start-up cost $133 692 and recurrent cost $36 206). The recurrent cost per child was $58 (1 341 741 Vietnamese dong). Considering the recurrent cost alone, the base-case ICER was $14 and mean ICER of 1000 bootstrap samples was $14 (95% CI –0·48 to 30) per cognitive development score gained with a 3% discount rate to costs. The ICER per language and motor development score gained was $22 and $20, respectively, with a 3% discount rate to costs. Interpretation: The intervention was cost-effective: the ICER per child cognitive development score gained was 0·5% of Viet Nam's gross domestic product per capita, alongside other benefits in language and motor development. This finding supports the scaling up of this intervention in similar socioeconomic settings. Funding: Australian National Health and Medical Research Council and Grand Challenges Canada. Translation: For the Vietnamese translation of the abstract see Supplementary Materials section.
UR - http://www.scopus.com/inward/record.url?scp=85165029160&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(23)00271-1
DO - 10.1016/S2214-109X(23)00271-1
M3 - Article
C2 - 37474233
AN - SCOPUS:85165029160
SN - 2214-109X
VL - 11
SP - e1269-e1276
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 8
ER -