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Economic evaluation of the Afya trial in Kenya for retaining women in pre- and postnatal care

This protocol describes the planned economic evaluation of the Afya trial in Kenya, which assesses the impact, cost-effectiveness and scalability of conditional cash transfers to encourage women to use prenatal and postnatal healthcare services.

Fedra Vanhuyse, Caroline Ochieng / Published on 27 November 2019

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Citation

Batura, N., Skordis, J., Palmer, T., Odiambo, A., Copas, A., Vanhuyse, F., Dickin, S., Eleveld, A., Mwaki, A., Ochieng, C. and Haghparast-Bidgoli, H. (2019). Cost-effectiveness of conditional cash transfers to retain women in the continuum of care during pregnancy, birth and the postnatal period: protocol for an economic evaluation of the Afya trial in Kenya. BMJ Open, 9(11). https://doi.org/10.1136/bmjopen-2019-032161

A wealth of evidence from a range of country settings indicates that antenatal care, facility delivery and postnatal care can reduce maternal and child mortality and morbidity in high-burden settings. However, the utilization of these services by pregnant women, particularly in low/middle-income country settings, is well below that recommended by the WHO. The Afya trial aims to assess the impact, cost-effectiveness and scalability of conditional cash transfers to promote increased utilisation of these services in rural Kenya and thus retain women in the continuum of care during pregnancy, birth and the postnatal period. This protocol describes the planned economic evaluation of the Afya trial.

The economic evaluation will be conducted from the provider perspective as a within-trial analysis to evaluate the incremental costs and health outcomes of the cash transfer programme compared with the status quo. Incremental cost-effectiveness ratios will be presented along with a cost-consequence analysis where the incremental costs and all statistically significant outcomes will be listed separately. Sensitivity analyses will be undertaken to explore uncertainty and to ensure that results are robust. A fiscal space assessment will explore the affordability of the intervention. In addition, an analysis of equity impact of the intervention will be conducted.

The study has received ethics approval from the Maseno University Ethics Review Committee, REF MSU/DRPI/MUERC/00294/16. The results of the economic evaluation will be disseminated in a peer-reviewed journal and presented at a relevant international conference.

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SEI authors

Fedra Vanhuyse
Fedra Vanhuyse

Head of Division: Societies, Climate and Policy Support

SEI Headquarters

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Topics and subtopics
Health : Well-being
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SEI Headquarters
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Kenya

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