Citation

Rahman AKMF, Bose S, Linnan MJ, Rahman A, Mashreky SR, Haaland B, Finkelstein EA. Pediatrics 2012; 130(6): e1621-8.

Affiliation

Centre for Injury Prevention and Research, and International Drowning Research Centre – Bangladesh, New DOHS Mohakhali, Bangladesh; Duke-NUS Graduate Medical School, Singapore; The Alliance for Safe Children, Pathumwan, Bangkok, Thailand; and Health Services and Systems Research Program, Duke-NUS Graduate Medical School, Singapore

Copyright

(Copyright © 2012, American Academy of Pediatrics)

DOI

10.1542/peds.2012-0757

PMID

23147971

Abstract

OBJECTIVE: Interventions that mitigate drowning risk in developing countries are needed. This study presents the cost-effectiveness of a low-cost, scalable injury and drowning prevention program called Prevention of Child Injuries through Social-Intervention and Education (PRECISE) in Bangladesh. METHODS: Between 2006 and 2010, the 2 components of PRECISE (Anchal, which sequestered children in crèches [n = 18 596 participants], and SwimSafe, which taught children how to swim [n = 79421 participants]) were implemented in rural Bangladesh. Mortality rates for participants were compared against a matched sample of nonparticipants in a retrospective cohort analysis. Effectiveness was calculated via Cox proportional hazard analysis. Cost-effectiveness was estimated according to World Health Organization-CHOosing Interventions that are Cost Effective guidelines. RESULTS: Anchal costs between $50.74 and $60.50 per child per year. SwimSafe costs $13.46 per child. For Anchal participants, the relative risk of a drowning death was 0.181 (P = .004). The relative risk of all-cause mortality was 0.56 (P = .001). For SwimSafe, the relative risk of a drowning death was 0.072 (P < .0001). The relative risk of all-cause mortality was 0.750 (P = .024). For Anchal, the cost per disability-adjusted life-year (DALY) averted is $812 (95% confidence interval: $589-$1777). For SwimSafe, the cost per DALY averted is $85 ($51-$561). Combined, the cost per DALY averted is $362 ($232-$1364). CONCLUSIONS: Based on World Health Organization criteria, PRECISE is very cost-effective and should be considered for implementation in other areas where drowning is a significant problem.

Language: en