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- Title
Economic evaluation of a community health worker model for tuberculosis care in Ho Chi Minh City, Viet Nam: a mixed-methods Social Return on Investment Analysis.
- Authors
Quang Vo, Luan Nguyen; Forse, Rachel Jeanette; Tran, Jacqueline; Dam, Thu; Driscoll, Jenny; Codlin, Andrew James; Creswell, Jacob; Sidney-Annerstedt, Kristi; Van Truong, Vinh; Thi Minh, Ha Dang; Huu, Lan Nguyen; Nguyen, Hoa Binh; Nguyen, Nhung Viet
- Abstract
Background: There is extensive evidence for the cost-effectiveness of programmatic and additional tuberculosis (TB) interventions, but no studies have employed the social return on investment (SROI) methodology. We conducted a SROI analysis to measure the benefits of a community health worker (CHW) model for active TB case finding and patient-centered care. Methods: This mixed-method study took place alongside a TB intervention implemented in Ho Chi Minh City, Viet Nam, between October-2017 – September-2019. The valuation encompassed beneficiary, health system and societal perspectives over a 5-year time-horizon. We conducted a rapid literature review, two focus group discussions and 14 in-depth interviews to identify and validate pertinent stakeholders and material value drivers. We compiled quantitative data from the TB program's and the intervention's surveillance systems, ecological databases, scientific publications, project accounts and 11 beneficiary surveys. We mapped, quantified and monetized value drivers to derive a crude financial benefit, which was adjusted for four counterfactuals. We calculated a SROI based on the net present value (NPV) of benefits and investments using a discounted cash flow model with a discount rate of 3.5%. A scenario analysis assessed SROI at varying discount rates of 0-10%. Results: The mathematical model yielded NPVs of US$235,511 in investments and US$8,497,183 in benefits. This suggested a return of US$36.08 for each dollar invested, ranging from US$31.66-US39.00 for varying discount rate scenarios. Conclusions: The evaluated CHW-based TB intervention generated substantial individual and societal benefits. The SROI methodology may be an alternative for the economic evaluation of healthcare interventions.
- Subjects
HO Chi Minh City (Vietnam); VIETNAM; ETHICAL investments; COMMUNITY health workers; INVESTMENT analysis; DISCOUNTED cash flow; NET present value
- Publication
BMC Public Health, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2458
- Publication type
Article
- DOI
10.1186/s12889-023-15841-2