Two items of note popped up this week. First, an economic analysis of the cost-effectiveness of a mass radio campaign to encourage women’s use of health centers. Very cost effective, apparently. The direct program cost was $7,749,128 and it apparently (lots of assumptions) may have resulted in 3,000 fewer deaths.

The [paper] uses the mortality predictions for Burkina Faso and other countries to calculate the cost-effectiveness of these interventions. Using Disability-Adjusted Life Years (DALYs) as the metric (equivalent to the cost of one year of healthy life added), the results show that mass media campaigns based on Saturation+ principles are among the most cost-effective methods available for saving children’s lives. The authors calculated that scaling-up campaigns in Burkina Faso, Burundi, Niger, Malawi and Mozambique would cost between $7 to $27 per DALY in 2018-20.  (For reference, $7-$27 per DALY equates to approximately $196-$756 per life saved.) According to the recently published Disease Control Priorities Project, Third Edition (the authoritative source for cost-effectiveness comparisons)¹, the costs per DALY for reproductive, mother and child health interventions ranges from $2900 down to $5. The costs per DALY of $7-$27 predicted for this intervention are therefore comparable to the most cost-effective interventions available. Only one intervention (treatment with severe malaria with artesunate) is less expensive than the $7-$27 predicted here. Roy Head of DMI who designed and led the study in partnership with LSHTM says: “What this study shows is that using mass media to drive people to health centres is actually more cost-effective than almost anything on earth in terms of saving children’s lives. And that makes sense – it reaches millions of people at a time – but this is the first time it has been shown in a scientific trial.”

Second, an announcement by the government of purchase of 550 modern buses and infrastructure work to create 4 rapid bus lines. The cost will be about $240 million.

So a decision-maker had a choice: fund a radio campaign over the entire country (scale it up by a factor of 30 or so) or buy the buses.  Wonder if they were looked at together?