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Cost Effectiveness Analysis

Jonathan Bland
Issues in Public Health
Professor Aqueelah Barrie

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In a rural area of Guatemala, three groups of villages received different public health
interventions. The Minister of Health wants to know which of these interventions was the
most cost-effective for averting death among children who are 3 years of age and
younger. Persons in the first group of villages were provided with both nutrition and
healthcare services (NUTHC). Those in the second group of villages received nutrition
services only (NUT) and those in the third group received healthcare only (HC). Analyze
the table below and answer the following questions:
Intervention
Up to 3
years
NUTHC-1st village
NUT-2nd village
HC-3rd village

$160.30
$131.20
$76.36

Cost per death averted

Perinatal
Infants
(< 28 days
(< 1 years of
of age)
age)
$9.85
$40.35
$7.75
$38.40
$14.15
$25.56

1-3 years
old
$110.10
$85.05
$35.65

1. Which intervention is the most cost-effective for averting infant death in these
villages?
2. Do interventions have the same effect on all age groups according to the table
data? Explain.
3. Why do you think one intervention is more cost effective in one age group than in
another age group? Are there biological, social, and environmental risk factors
that are different among these age groups that may explain these differences?
Explain your answer.
4. If you were short on resources, what intervention would you chose?

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Answers:
1. The 3rd village is the most cost effective. Simply being the cheapest. Although
with the information presented we are not given the number of deaths as to the
village so we are assuming that all villages have the same number of deaths for
the answer.
2. Yes, if they all protected the same number of children each village. The cost
effectiveness should be valued at how many children were saved because of the
interventions in place. It might cost more in village #3 to save the child under 28
days as it does in village #1 but the over-all cost for that village was less than
that of the total for that village. From this chart we are given the cost to save the
child we are not given the number of children saved versus the children that were
lost.
3. Perinatal children need more health care than those of older ages, formula, baby
food, and sanitary care. As to the older children they are learning to eat what the
parents cook. They do not need special diets as to that of their younger siblings.
The children who are 28 days younger are at risk of infections more so than that
of their older relatives. They do not have a great immune system, so infants are
always more at risk. The environment also plays a role in their immune system. If
they are in an unsanitary conditions infants will have a better chance at becoming
sick just being around those areas.
4. I would choose health care services. This way the health care services were
there to take care of the villagers and when they became sick they could help

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explain good nutrition to the villagers. If there were no health care services and
only nutrition, what happens to a child who develops a cold? They could have the
best nutrition in the world but that will not stop most bacteria and viruses from
making the children get sick. Health care would save the child.