In Simple Words
Adding small performance payments and micro-entrepreneurial sales to health workers raises their initial operating cost slightly, but dramatically increases the number of lives saved. Because the volume of successful health outcomes rises far faster than the extra cost, the overall cost to save a single year of human life drops significantly compared to standard volunteer setups.
Research question
Traditional volunteer community health worker programs often demonstrate low cost-effectiveness due to high attrition and low service activity, making public health investments inefficient.
Participants
~7,000 households and >11,000 children across 214 rural villages in Uganda.
Study Design
Randomized Controlled Trial (RCT) evaluating mortality impacts after 3 years combined with economic cost-effectiveness analysis measured in US dollars per year of life saved (YLS) in 2013.
Results
The average cost per year of life saved by Community Health Promoters was US$65 in 2013, compared to baseline cost-effectiveness estimates for volunteer-based health programs ranging from US$82 to US$3,396 per year of life saved.
Takeaway
Transition unpaid volunteer community health programs into incentivized micro-entrepreneurship models to reduce the financial cost per year of life saved below $70.
Source and citation
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Plain-English glossary
Original explanations, informed by the references below. Examples are illustrations, not data from the studies above. The research text stays unchanged.
- Randomized controlled trial
A study that uses chance, like drawing lots, to decide who receives each option being compared. Researchers compare the groups’ outcomes to estimate the effect of those options.
ExampleA lottery assigns volunteers to a training programme or a comparison group. Researchers then compare their outcomes.
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