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Journal Article

Citation

Mehra N, Wang SJS, Reyes J, Ambjørnsen MM, Jarl J. Cost Eff. Resour. Alloc. 2021; 19(1): e66.

Copyright

(Copyright © 2021, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12962-021-00320-5

PMID

34627272

Abstract

BACKGROUND: Globally, violence disproportionately affects young people, leading to injury, hospitalisation, death, social dysfunction, and poor mental wellbeing. Moreover, it has far-reaching economic consequences for whole nations, due to loss of productivity. Research suggests that attaining a higher level of education promotes factors that insulate youths from poverty and violence.

PURPOSE: In this study, we investigated the outcomes, the cost, and the cost-effectiveness of a non-formal education program with an additional psychosocial component. The short-term outcome measure was an increase in educational attainment, a crucial step for youth empowerment. The program analysed was the Alternative Learning System (ALS) offered by the Balay Rehabiliation Centre in Bagong Silang, an urban slum in Manila, which targeted out of school youth.

METHODS: The cost-effectiveness analysis of ALS compared to a 'do nothing approach' was performed from the perspective of the service provider. The study sample comprised 239 learners who were enrolled in the ALS during 2015-2018. For the 'do nothing' comparator, a counterfactual scenario was hypothesised. The average cost of the intervention per enrolled learner, and the incremental cost effectiveness ratio (ICER) for passing the Accreditation and Evaluation (A&E) exam at elementary or secondary level, were calculated.

RESULTS: The ALS intervention studied resulted in 41% (n = 97) of the learners passing the examination over a period of four years (from 2015-2018). The estimated total cost of the intervention was $371,110, corresponding to $1550 per enrolled learner. The incremental cost-effectiveness ratio for a pass in the exam was found to be $3830. Compared to other, international, alternative learning interventions, the ALS intervention as used in Bagong Silang was found to be more cost-effective.

CONCLUSION: From the service provider perspective, the ALS for out-of-school young people was found to be a valuable investment to benefit poor young people living in slums in Manila.


Language: en

Keywords

Youth; Young people; Alternative learning system; Economic evaluation; Psychosocial intervention; Urban violence

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