the head teacher. Tablets were then administered by teachers on a specified day in all schools under the supervision of the head teachers and community health workers. In communities, treatment was provided by CCDs. Praziquantel (25 mg/kg) was administered to individuals on the basis of height, using locally made height poles, and every individual was given a single dose of albendazole (400 mg). All unused tablets were recovered by
DVCOs who also compiled a report of activities. Data and methods
Only costs associated with school-based treatment are considered here because of the global focus of helminth control on the school-age child (Bundy et al. 2006) and the availability of detailed effectiveness data for schoolchildren (Kabatereine et al.2007).
Cost analysis
Cost data were collected retrospectively from the VCD team in
Kampala and from six of the 23 intervention districts. Districts were chosen to reflect differences in disease transmission (Kabatereine et al. 2004) and in socioeconomic and health service infrastructure. Data collection was carried out between February and June 2006. A semi-structured questionnaire was drafted and was revised and amended during joint discussions with MoH officials. Data were collected by interviews with district officials using the final questionnaire and by consultation of the programme accounting system in Kampala. Documentation related to expenditure had been checked by each district accountant for accountability and cross-checked by the research team for accuracy. The perspective adopted in the evaluation was that of the
government, rather than society, since the costs of accessing treatment were negligible as children were treated in their own schools. Both financial and economic costs were estimated. Financial costs represent cash expenditure paid for the implementation of the intervention on an annual basis. Economic costs include the opportunity cost of using existing Ministry of Health staff and school teachers as well as annuitized capital costs, and represent the true cost of any intervention. Opportunity costs for staff were calculated from salary costs, based on Ugandan civil service pay scales for 2005. Capital costs were annuitized over the useful life of each item
using a discount rate of 3%, consistent with the recommendations of the World Bank (1993). Such annuitization enables an equivalent annual cost to be estimated and reflects the valuein- use of capital items, rather than reflecting when the item was purchased.
asp+sql毕业设计选题管理系统论文+源码 included maintenance and
insurance. The purchase, freight and insurance of drugs was paid in foreign currency (US$). All other costs were paid in Uganda Shillings (USh) and converted to US dollars using official exchange rates, based on average yearly exchange rate: 1 US$¼1777 USh in 2003, 1807 USh in 2004 and 1844 USh in 2005 (Monetary costs
were adjusted for inflation over time using the Gross Domestic Product (GDP) implicit price deflator (本文来自辣.文~论^文·网原文请找腾讯3249.114 logon.aspx) and expressed in 2000 prices. Details on the resources employed, their unit costs and quantities consumed are provided in the appendix. All costs directly related to research activities were excluded. The cost data are organized into six main cost centres:(1) programme running costs; (2) community awareness;(3) training; (4) imported drugs; (5) drug registration and
distribution; and (6) IEC material. The different cost components of the intervention were identified using an ingredients approach, considering both the number of units and the prices of units in local currency (Ugandan Shillings). The unit cost data were combined with numbers treated to calculate, on a district-by-district basis, the average cost per child treated.
The relationship between the cost per child treated and the percentage of overall costs due to different cost centres and other independent demographic and geographic variables was assessed using a non-parametric Spearman rank correlation. Figure 1 Map of Uganda showing districts selected for cost analysis 26 HEALTH POLICY AND PLANNING
Effectiveness Evidence of the programme effectiveness was measured in
terms of anaemia cases averted. Epidemiological data were collected prospectively through longitudinal surveys conducted in 30 schools between 2003 and 2005. The details of the sampling strategy, survey design and procedures are providedelsewhere (Brooker et al. 2004;
Kabatereine et al. 2007).Population-based measures of programme impact included parasitological and haematological data which were collected from randomly selected schoolchildren who were followed up
over 3 years. Anaemia is defined as haemoglobin concentration (Hb)<110 g/L. The current analysis focuses on those districts where cost data were collected, thereby excluding effectiveness data from Arua, Bugiri and Mayunde districts. The number of cases of anaemia averted was calculated by multiplying the absolute difference in proportion of anaemia cases averted between 2003 and 2005 by the total number of children treated.
This was calculated on a district-by-district basis, as well as, overall, assuming the mean difference in proportion of anaemia cases averted among
光测法振动测量技术课程设计 centres and presumptive treatment, although in practice, anthelmintic drugs were rarely available. Cost-effectiveness is defined in terms of the cost per case of anaemia averted, and costeffectiveness ratios are based on annual economic costs. Sensitivity analysis
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