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Comment & Response |

Reducing Neonatal Mortality—Reply

Edward Fottrell, PhD1; Jolene Skordis-Worrall, PhD1; Tanja A. J. Houweling, PhD1
[+] Author Affiliations
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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In Reply We thank Dr Klar for her comments. The presentation of cost-effectiveness in our article1 follows the concise norm for similar trial articles. The account in the eAppendix provides the essential details of the cost-effectiveness analysis. Further analysis of costs, including sensitivity analysis, will be submitted for publication to add to the growing evidence base for women’s groups interventions.2 We would like to correct an important misunderstanding of our evidence—we show that the intervention is cost-effective, not that it saves money. This claim of cost-effectiveness relates to World Health Organization recommendations to compare cost-effectiveness ratios with local gross domestic product per capita.3 Health systems–strengthening initiatives were conducted in both intervention and control arms of the trial, and so their costs had no bearing on our cost-effectiveness calculation.


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March 1, 2014
Margo Klar, MPH
1Department of Epidemiology, College of Medicine, University of Florida, Gainesville2College 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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