优化维生素A补充:对象牙海岸北部常规分销策略的成本效益比较分析
Melissa M Baker1, Lyonel Nerolin Doffou Assalé2, David Doledec1
1Helen Keller Intl, Nairobi, Kenya.
PloS one
|December 15, 2025
概括
科特迪瓦的常规维生素A补充剂 (VAS) 配送在三个战略中被证明是具有成本效益的. 基于社区的先进方法为儿童健康计划提供了最佳的覆盖范围和效率平衡.
科学领域:
- 公共卫生 公共卫生
- 营养干预 营养干预
- 卫生经济学 卫生经济学
背景情况:
- 维生素A缺乏 (VAD) 严重影响了科特迪瓦的儿童健康,过去的调查表明患病率和风险很高.
- 自2016年以来,国家从大规模运动过渡到常规的维生素A补充剂 (VAS) 整合到卫生服务中.
- 关于这些常规VAS交付策略的成本效益的证据有限.
研究的目的:
- 评估三种常规VAS交付策略的成本,覆盖范围和成本效益.
- 为了比较常规固定的,先进的基于社区的和追赶的VAS方法的效率.
- 在低资源环境中,为可持续和有效的儿童健康干预提供信息.
主要方法:
- 在Ferkessédougou和Niakaramadougou卫生区进行了一项混合方法研究.
- 在六个类别 (规划,采购,培训,社会动员,分销,监督) 中收集了量化成本数据.
- 使用两阶段集群采样的事件后覆盖调查 (PECS) 评估了VAS覆盖率;分析了每名补充儿童和每名DALY避免的成本效益.
主要成果:
- 该计划的总成本为2550万加元法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰西法兰超过70%的人员成本.
- 费尔克塞塞杜古 (Ferkessédougou) 的基于社区的先进战略是最具成本效益的 (458 FCFA/儿童),其次是尼亚卡拉马杜古 (Niakaramadougou) 的追赶战略 (606 FCFA/儿童).
- 所有策略都低于科特迪瓦的成本效益值,每DALY转移的成本从30,093 FCFA到89,550 FCFA.
结论:
- 所有评估的常规VAS交付策略都证明了成本效益.
- 基于社区的先进策略在覆盖范围和效率之间提供了最佳的平衡.
- 建议在卫生系统限制范围内扩展先进策略,以提高资源有限的环境中的可持续性和覆盖率.
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