Scenario
In a rural area of Guatemala, three groups of villages received different public health interventions. The Minister of Health wants to know which of these interventions was the most cost-effective for averting death among children who are 3 years of age and younger. Persons in the first group of villages were provided with both nutrition and healthcare services (NUTHC). Those in the second group of villages received nutrition services only (NUT) and those in the third group received healthcare only (HC). Analyze the table below and answer the following questions:
Intervention
Cost per death averted
Up to 3 years
Perinatal
(< 28 days of age)
Infants
(< 1 years of age)
1-3 years old
NUTHC
$160.30
$9.85
$40.35
$110.10
NUT
$131.20
$7.75
$38.40
$85.05
HC
$76.36
$14.15
$25.56
$35.65
Which intervention is the most cost-effective for averting infant death in these villages?
Do interventions have the same effect on all age groups according to the table data? Explain.
Why do you think one intervention is more cost effective in one age group than in another age group? Are there biological, social, and environmental risk factors that are different among these age groups that may explain these differences? Explain your answer.
If you were short on resources, what intervention would you chose?
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To determine which intervention is the most cost-effective for averting infant death in these villages, we need to compare the "Cost per death averted" data provided in the table.
Looking at the data, we see that the cost per death averted for the NUTHC intervention is $40.35 for infants (<1 year old). On the other hand, for the NUT intervention, the cost per death averted is $38.40, and for the HC intervention, it is $25.56.
From this data, we can conclude that the HC intervention is the most cost-effective for averting infant death in these villages, as it has the lowest cost per death averted.
However, it's important to note that the interventions might not have the same effect on all age groups, according to the table data. The cost per death averted varies for different age groups within each intervention.
For example, the cost per death averted for the HC intervention is the lowest in the 1-3 years old age group ($35.65), while it is the highest in the perinatal (<28 days of age) age group ($14.15). Similarly, the NUT intervention has the lowest cost per death averted in the 1-3 years old age group ($85.05) and the highest in the perinatal age group ($7.75). These variations suggest that the interventions have varying effectiveness in different age groups.
There may be several factors that contribute to why one intervention is more cost-effective in one age group compared to another. Biological, social, and environmental risk factors can differ among age groups and impact their vulnerability to specific health interventions. For example, infants may have different nutritional needs and require specialized healthcare, while older children may require different healthcare services. Additionally, social and environmental factors, such as access to healthcare facilities, availability of nutritious food, and exposure to infectious diseases, can also vary across age groups and affect the effectiveness of interventions.
If resources were limited, the choice of intervention would depend on the specific goals and priorities of the Minister of Health. If the primary concern is averting infant deaths, then the HC intervention appears to be the most cost-effective option for that age group. However, if the focus is on the entire age range of 1-3 years old, then the NUT intervention might be more appropriate, considering its lower cost per death averted in that age group. Ultimately, the decision would depend on the specific circumstances, available resources, and objectives of the public health program.