Integrated Management of Neonatal and Childhood Illnesses Programme: Implementation and Cost-Effectiveness
A study published in the journal PLoS One evaluated the cost-effectiveness of implementing integrated management of neonatal and childhood illnesses programme (IMNCI) in India from a health system and societal perspective.
A decision analytic model was parameterised to determine incremental cost-effectiveness of implementing IMNCI programme versus routine child health services for infant population at district level in India. A time horizon of 15 years (2007–2022) was considered suitable to cover all costs and effects systematically. Cost-effectiveness of implementing IMNCI programme was measured in terms of child deaths prevented, illness episodes averted, life years gained and disability-adjusted life years (DALY) averted. The findings were reported as incremental cost of implementing IMNCI programme for infants per DALY prevented, per infant death prevented, and per illness episode prevented versus routine care services. Costs and effects were discounted at the rate of 3% to account for time preference of cost and utility.
During the period of 15 years, implementation of IMNCI programme at district level prevented 1967 deaths, 57,861 episodes of illness, and 63,249 million DALYs in the infant population. From a health system perspective, the IMNCI programme gained an incremental cost of INR 1554 per DALY prevented, INR 49,963 per infant death prevented, INR 1554 per life year gained, and INR 1699 per illness prevented during infancy. Correspondingly, from a societal perspective, implementing IMNCI programme gained an additional cost of INR 34,799 per infant death prevented, INR 1082 per DALY prevented, and INR 1183 per illness prevented during infancy. Ultimately, implementing IMNCI programme resulted in more than 90% probability of being cost-effective from a willingness to pay threshold translating to INR 2300 per DALY prevented, which is 5.5% of India’s gross domestic product per capita.
The study demonstrated that compared to routine health care programme, implementing IMNCI programme is cost-effective for child survival in India. Such programmes should be scaled-up as a major child survival strategy.
News source - Prinja S, Bahuguna P, Mohan P, et al. Cost Effectiveness of Implementing Integrated Management of Neonatal and Childhood Illnesses Program in District Faridabad, India. PLoS One. 2016;11(1):e0145043.