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Comment & Response |

Reducing Neonatal Mortality:  Are High-Coverage Women's Participatory Groups the Cost-effective Solution We Have Been Searching for?

Margo Klar, MPH1,2
[+] Author Affiliations
1Department of Epidemiology, College of Medicine, University of Florida, Gainesville
2College of Public Health and Health Professions, University of Florida, Gainesville
JAMA Pediatr. 2014;168(3):292-293. doi:10.1001/jamapediatrics.2013.4870.
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To the Editor As a Gates grant recipient working on a technology to improve birth outcomes in low-resource environments, I welcome cost-effectiveness in community-based interventions. Unfortunately, after reading Fottrell et al,1 I am left with several thoughts. First, the claim that women’s group participation is a cost-effective intervention is exciting; however, the cost analysis is not explained, even minimally. One has to read the eAppendix even for basic information. Readers recognize that women’s groups focusing on the dissemination of information on maternal and child health to others have a great potential to save lives and money. There was no clear indication as to how and why this conclusion was drawn within the article. Fottrell et al should explain if the cost-effectiveness is inclusive of the health system–strengthening costs and what that entails financially, which indicates a significant improvement in itself.

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March 1, 2014
Edward Fottrell, PhD; Jolene Skordis-Worrall, PhD; Tanja A. J. Houweling, PhD
1Institute for Global Health, University College London, London, England
JAMA Pediatr. 2014;168(3):292-293. doi:10.1001/jamapediatrics.2013.4873.
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