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首页> 外文期刊>Trials >Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial
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Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial

机译：赞比亚一项全面的青少年怀孕预防计划的成本效益和扩展的成本效益分析：一项集群随机对照试验的研究方案

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Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living. The study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives. While the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be considered seriously when evaluating whether such a program can justify the required investments in a setting with scarce resources. The economic evaluations outlined in this paper will generate valuable information that can be used to guide large-scale implementation of programs to address the problem of the high prevalence of adolescent childbirth and school drop-outs in similar settings. ClinicalTrials.gov, NCT02709967. Registered on 2 March 2016. ISRCTN, ISRCTN12727868. Registered on 4 March 2016.
机译：早婚，怀孕和分娩是撒哈拉以南非洲少女辍学的主要原因。出生并发症也是少女死亡的主要原因之一。本文概述了赞比亚一项全面的青少年预防怀孕计划的成本效益分析（CBA）协议和扩展的成本效益分析（ECEA）。它旨在估算与健康相关和非健康结果相关的预期成本，金钱和非金钱收益，以及它们在不同生活水平人群中的分布。该研究将与一项整群随机对照试验一起进行，该试验正在检验以下假设：有或没有社区对话的经济支持是降低青少年生育率的有效策略。 CBA将通过比较每个干预方案的总成本与健康相关和非健康结果的货币收益来估算净收益。 ECEA将根据生活水平对每单位健康和非健康收益的干预措施费用进行估算。成本数据包括计划实施成本，医疗保健成本（即与青少年妊娠和低出生体重，早产，子痫，药物流产和堕胎后并发症等出生并发症相关的成本）以及教育和社区参与的成本。青年俱乐部会议。金钱利益是教育收益和避免的医疗费用。对于ECEA，健康收益包括青春期分娩率降低，非健康收益包括避免自付费用和财务风险保护。经济评估将从方案和社会角度进行。虽然计划的干预既全面又昂贵，但它有可能产生大量的短期和长期健康与非健康利益。在评估这种计划是否可以证明在资源匮乏的情况下进行所需投资是否合理时，应认真考虑这些收益。本文概述的经济评估将产生有价值的信息，这些信息可用于指导大规模实施计划，以解决类似情况下青少年生育率高和辍学率高的问题。 ClinicalTrials.gov，NCT02709967。 2016年3月2日注册。ISRCTN，ISRCTN12727868。 2016年3月4日注册。

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