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Cost-effectiveness of Lifestyle Africa: an adaptation of the diabetes prevention programme for delivery by community health workers in urban South Africa
Whittington, Melanie D. Goggin, Kathy Tsolekile, Lungiswa Puoane, Thandi Fox, Andrew T. Resnicow, Ken Fleming, Kandace K. Smyth, Joshua M. Materia, Frank T. Hurley, Emily A.
Whittington, Melanie D.
Goggin, Kathy
Tsolekile, Lungiswa
Puoane, Thandi
Fox, Andrew T.
Resnicow, Ken
Fleming, Kandace K.
Smyth, Joshua M.
Materia, Frank T.
Hurley, Emily A.
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Abstract
Background
Lifestyle Africa is an adapted version of the Diabetes Prevention Program designed for delivery by community health workers to socioeconomically disadvantaged populations in low- and middle-income countries (LMICs). Results from the Lifestyle Africa trial conducted in an under-resourced community in South Africa indicated that the programme had a significant effect on reducing haemoglobin A1c (HbA1c).
Objective
To estimate the cost of implementation and the cost-effectiveness (in cost per point reduction in HbA1c) of the Lifestyle Africa programme to inform decision-makers of the resources required and the value of this intervention.
Methods
Interviews were held with project administrators to identify the activities and resources required to implement the intervention. A direct-measure micro-costing approach was used to determine the number of units and unit cost for each resource. The incremental cost per one point improvement in HbA1c was calculated.
Results
The intervention equated to 71 United States dollars (USD) in implementation costs per participant and a 0.26 improvement in HbA1c per participant.
Conclusions
Lifestyle Africa reduced HbA1c for relatively little cost and holds promise for addressing chronic disease in LMIC. Decision-makers should consider the comparative clinical effectiveness and cost-effectiveness of this intervention when making resource allocation decisions.
Description
Date
2023-05-23
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Publisher
Taylor and Francis Group
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Keywords
Economic analysis, HbA1c, Lifestyle interventions, Low- and middle-income countries, Probabilistic sensitivity analysis
Citation
Whittington, M. D., Goggin, K., Tsolekile, L., Puoane, T., Fox, A. T., Resnicow, K., Fleming, K. K., Smyth, J. M., Materia, F. T., Hurley, E. A., Vitolins, M. Z., Lambert, E. V., Levitt, N. S., & Catley, D. (2023). Cost-effectiveness of Lifestyle Africa: an adaptation of the diabetes prevention programme for delivery by community health workers in urban South Africa. Global health action, 16(1), 2212952. https://doi.org/10.1080/16549716.2023.2212952