Choices, choices: Radio campaign to reduce rural child mortality or public transport infrastructure for Ouagadougou

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?


About mkevane

Economist at Santa Clara University and Director of Friends of African Village Libraries.
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