TY - JOUR
T1 - Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015–2024)
T2 - A scoping literature review
AU - Stansert Katzen, Linnea
AU - Miyares, Madelyn
AU - Vaughan, Kelsey
AU - Baskin, Cleo
AU - Ballard, Madeleine
AU - Kok, Maryse
AU - Jimenez, Ariwame
AU - Iberico, Matias
AU - Cook, Jessica
AU - Bienvenue Ishimwe, Angele
AU - Martin, Lily
AU - Kawooya, Patrick
AU - Aranda, Zeus
AU - Mantus, Molly
AU - Bruce Kumar, Meghan
AU - Finnegan, Karen E.
AU - Mudhune, Sandra
AU - Dennis, Mardieh
AU - Palazuelos, Daniel
AU - Mbewe, Dickson
AU - Nshimayesu, Michee
AU - Revill, Paul
AU - O’Donovan, James
PY - 2025/12/5
Y1 - 2025/12/5
N2 - Neglected tropical diseases (NTDs) are a diverse group of more than twenty diseases caused by parasitic, bacterial, and viral infections, affecting more than one billion individuals worldwide. Economic evidence can help guide the investment in Community Health Workers (CHWs) who can help expand access to preventive and curative NTD services in low- and middle-income countries (LMICs). A scoping review was conducted across ten databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to “Community Health Workers” and “Economic Evaluations” were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, costs, and outcomes were extracted, tabulated in Microsoft Excel, and analysed. Of the 29 included scenarios (n = 10 studies), 7 were about community mass drug administration and 22 focused on other topics - such as disease-specific prevention and treatment (e.g., dengue). Across scenarios, the most commonly reported outcomes were cost per service delivered (ranging from $0.13-$5.33) and cost per capita (ranging from $10.24-$21.09). Five scenarios reported on cost-effectiveness, with varied results (40–50% of scenarios were reported as cost effective). One study found that interventions were more likely to be cost-effective when they leveraged integrated care as opposed to vertical approaches. The evidence base for economic evaluations regarding CHW involvement in NTD programs is highly limited. From the 10 studies identified there was no clear conclusion with regards to cost-effectiveness or affordability of CHWs in NTD programs in LMICs. To better understand the critical role CHWs can play in both prevention- and treatment-focused NTD programs, further evidence of the cost-effectiveness and affordability of such interventions is needed.
AB - Neglected tropical diseases (NTDs) are a diverse group of more than twenty diseases caused by parasitic, bacterial, and viral infections, affecting more than one billion individuals worldwide. Economic evidence can help guide the investment in Community Health Workers (CHWs) who can help expand access to preventive and curative NTD services in low- and middle-income countries (LMICs). A scoping review was conducted across ten databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to “Community Health Workers” and “Economic Evaluations” were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, costs, and outcomes were extracted, tabulated in Microsoft Excel, and analysed. Of the 29 included scenarios (n = 10 studies), 7 were about community mass drug administration and 22 focused on other topics - such as disease-specific prevention and treatment (e.g., dengue). Across scenarios, the most commonly reported outcomes were cost per service delivered (ranging from $0.13-$5.33) and cost per capita (ranging from $10.24-$21.09). Five scenarios reported on cost-effectiveness, with varied results (40–50% of scenarios were reported as cost effective). One study found that interventions were more likely to be cost-effective when they leveraged integrated care as opposed to vertical approaches. The evidence base for economic evaluations regarding CHW involvement in NTD programs is highly limited. From the 10 studies identified there was no clear conclusion with regards to cost-effectiveness or affordability of CHWs in NTD programs in LMICs. To better understand the critical role CHWs can play in both prevention- and treatment-focused NTD programs, further evidence of the cost-effectiveness and affordability of such interventions is needed.
UR - https://www.scopus.com/pages/publications/105023997063
U2 - 10.1371/journal.pgph.0005551
DO - 10.1371/journal.pgph.0005551
M3 - Review article
SN - 2767-3375
VL - 5
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 12
M1 - e0005551
ER -