PMID- 18671874
OWN - NLM
STAT- MEDLINE
DCOM- 20080911
LR  - 20211020
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 8
DP  - 2008 Jul 31
TI  - From strategy development to routine implementation: the cost of Intermittent 
      Preventive Treatment in Infants for malaria control.
PG  - 165
LID - 10.1186/1472-6963-8-165 [doi]
AB  - BACKGROUND: Achieving the Millennium Development Goals for health requires a 
      massive scaling-up of interventions in Sub Saharan Africa. Intermittent 
      Preventive Treatment in infants (IPTi) is a promising new tool for malaria 
      control. Although efficacy information is available for many interventions, there 
      is a dearth of data on the resources required for scaling up of health 
      interventions. METHOD: We worked in partnership with the Ministry of Health and 
      Social Welfare (MoHSW) to develop an IPTi strategy that could be implemented and 
      managed by routine health services. We tracked health system and other costs of 
      (1) developing the strategy and (2) maintaining routine implementation of the 
      strategy in five districts in southern Tanzania. Financial costs were extracted 
      and summarized from a costing template and semi-structured interviews were 
      conducted with key informants to record time and resources spent on IPTi 
      activities. RESULTS: The estimated financial cost to start-up and run IPTi in the 
      whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were 
      incurred at the national level, mainly on the development of Behaviour Change 
      Communication (BCC) materials, stakeholders' meetings and other consultations. 
      The annual running cost at national level for intervention management and 
      monitoring and drug purchase was estimated at US$459,096. Start-up costs at the 
      district level were US$7,885 per district, mainly expenditure on training. Annual 
      running costs were US$170 per district, mainly for printing of BCC materials. 
      There was no incremental financial expenditure needed to deliver the intervention 
      in health facilities as supplies were delivered alongside routine vaccinations 
      and available health workers performed the activities without working overtime. 
      The economic cost was estimated at 23 US cents per IPTi dose delivered. 
      CONCLUSION: The costs presented here show the order of magnitude of expenditures 
      needed to initiate and to implement IPTi at national scale in settings with high 
      Expanded Programme on Immunization (EPI) coverage. The IPTi intervention appears 
      to be affordable even within the budget constraints of Ministries of Health of 
      most sub-Saharan African countries.
FAU - Manzi, Fatuma
AU  - Manzi F
AD  - Ifakara Health Research and Development Centre, Ifakara, Tanzania. 
      manzif@yahoo.com
FAU - Hutton, Guy
AU  - Hutton G
FAU - Schellenberg, Joanna
AU  - Schellenberg J
FAU - Tanner, Marcel
AU  - Tanner M
FAU - Alonso, Pedro
AU  - Alonso P
FAU - Mshinda, Hassan
AU  - Mshinda H
FAU - Schellenberg, David
AU  - Schellenberg D
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080731
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
RN  - 0 (Antimalarials)
RN  - 0 (Drug Combinations)
RN  - 37338-39-9 (fanasil, pyrimethamine drug combination)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
MH  - Antimalarials/*economics/therapeutic use
MH  - Community Health Services/economics
MH  - Drug Combinations
MH  - Health Care Costs
MH  - Health Plan Implementation/*economics
MH  - Health Resources/economics/statistics & numerical data/trends
MH  - Humans
MH  - Infant
MH  - Interviews as Topic
MH  - Malaria/*prevention & control
MH  - Planning Techniques
MH  - Preventive Health Services/*economics
MH  - Pyrimethamine/*economics/therapeutic use
MH  - Residence Characteristics
MH  - Sulfadoxine/*economics/therapeutic use
MH  - Tanzania
PMC - PMC2527562
EDAT- 2008/08/02 09:00
MHDA- 2008/09/13 09:00
PMCR- 2008/07/31
CRDT- 2008/08/02 09:00
PHST- 2007/12/23 00:00 [received]
PHST- 2008/07/31 00:00 [accepted]
PHST- 2008/08/02 09:00 [pubmed]
PHST- 2008/09/13 09:00 [medline]
PHST- 2008/08/02 09:00 [entrez]
PHST- 2008/07/31 00:00 [pmc-release]
AID - 1472-6963-8-165 [pii]
AID - 10.1186/1472-6963-8-165 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2008 Jul 31;8:165. doi: 10.1186/1472-6963-8-165.