The cost-effectiveness analysis of iron- folic acid supplementation and the combination of kitchen gardening with iron-folic acid supplementation in the prevention and control of gestational anaemia in Kiboga district.

Abstract

Background: Gestational anaemia is one of the leading causes of maternal morbidity and mortality in developing countries. This study analyzed the cost-effectiveness of Iron-Folic Acid supplementation and the combination of Kitchen Gardening and Iron-Folic Acid supplementation in the prevention and control of gestational anaemia amongst pregnant women in Kiboga District. Methods: This was a cost effectiveness analysis from a providers’ perspective using a pregnant woman in Kiboga as the reference case over a seven months’ time horizon. With the aid of Treeage pro 2017 version software, a decision tree analytic model was used for analyzing cost-effectiveness. Cost data was collection from primary sources while effectiveness data was obtained from secondary source. Final effects were QALYs gained and cases of gestation anaemia prevented. The measure of cost effectiveness was the ICER. Sensitivity analysis for assessment of uncertainty was done using Multiple Univariate Sensitivity Analysis. Results: The mean cost of IFA-supplementation was USD 8.96 per pregnant woman, while the cost of the combination of Kitchen gardening with IFA-supplementation was USD 8.10 per pregnant woman. The combined intervention also gained more QALYs and prevented more cases of gestational anaemia (0.80 and 0.53 respectively) compared to IFA-alone (0.70 and 0.35 respectively). The standard intervention “IFA-supplementation alone” was absolutely dominated indicating that the combination of Kitchen with IFA-supplementation was cost saving and more effective in the prevention and control of gestational anaemia. Sensitivity analysis with Tornado diagrams revealed that the model ICERs for the two outcomes were more sensitive to the cost of sensitization on Kitchen gardening and the treatment of severe gestational anaemia. Conclusion: The combination of Kitchen gardening with Iron Folic Acid-supplementation showed potential to be a highly cost-effective intervention in the prevention and control of gestational anaemia and should be adopted for incorporation into policies for control of gestation anemia in Kiboga district.