Cost analysis of integrated community case management of childhood malaria, diarrhea and pneumonia enhanced by mobile health technology in rural Zambia


Submitted: 30 January 2019
Accepted: 17 October 2019
Published: 19 March 2020
Abstract Views: 910
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Authors

  • Godfrey Biemba National Health Research Authority, Lusaka, Zambia; Department of Global Health, Boston University School of Public Health, Boston, MA, United States.
  • Arnold Mulenga Ministry of Health, Lusaka, Zambia.
  • Boniface Chiluba Zambia Centre for Applied Health Research and Development, Lusaka, Zambia.
  • Ulla K. Griffiths United Nations International Children’s Fund (UNICEF), New York, United States.
  • Kojo Yeboah-Antwi Department of Global Health, Boston University School of Public Health, Boston, MA, United States.
  • William MacLeod Zambia Centre for Applied Health Research and Development, Lusaka, Zambia.
  • Karsten Lunze Department of Global Health, Boston University School of Public Health, Boston, MA, United States.
  • Davidson H. Hamer Department of Global Health, Boston University School of Public Health, Boston, MA; Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA, United States.

Integrated community case management (iCCM) of malaria, diarrhea, and pneumonia is a comprehensive, equitybased strategy to improve treatment access for underserved children under five years old. This paper presents data on cost of iCCM and incremental costs of mHealth enhanced supervision and supply chain management in Zambia. We collected cost data using three questionnaires applied at national, district, health facility and community levels. We interviewed 40 health facility supervisors and 75 community health workers. A provider perspective and an ingredient costing method was used. We entered and analyzed data in a customized excel costing tool. The result shows that total iCCM cost per patient contact was USD 18.43. The incremental cost of using the mHealth intervention per child contact for all iCCM conditions was USD 11.35. The incremental cost per treatment of diarrhea, pneumonia, and malaria with mHealth intervention was USD 9.58, USD 10.37 and USD 12.82. Program costs accounted for 67% of the total, and the largest share was associated with supervision estimated at 36%, followed by supply chain management at 27%. This study has provided valuable information to policy makers on how much it costs to implement iCCM program using mHealth interventions.


Biemba, G., Mulenga, A., Chiluba, B., Griffiths, U. K., Yeboah-Antwi, K., MacLeod, W., Lunze, K., & Hamer, D. H. (2020). Cost analysis of integrated community case management of childhood malaria, diarrhea and pneumonia enhanced by mobile health technology in rural Zambia. Journal of Public Health in Africa, 10(2). https://doi.org/10.4081/jphia.2019.1039

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