Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015–2024): A scoping literature review

Neglected tropical diseases (NTDs) are a diverse group of more than twenty diseases caused by parasitic, bacterial, and viral infections, affecting more than one billion individuals worldwide. Economic evidence can help guide the investment in Community Health Workers (CHWs) who can help expand access to preventive and curative NTD services in low- and middle-income countries (LMICs). A scoping review was conducted across ten databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to "Community Health Workers" and "Economic Evaluations" were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, costs, and outcomes were extracted, tabulated in Microsoft Excel, and analysed. Of the 29 included scenarios (n = 10 studies), 7 were about community mass drug administration and 22 focused on other topics - such as disease-specific prevention and treatment (e.g., dengue). Across scenarios, the most commonly reported outcomes were cost per service delivered (ranging from $0.13-$5.33) and cost per capita (ranging from $10.24-$21.09). Five scenarios reported on cost-effectiveness, with varied results (40-50% of scenarios were reported as cost effective). One study found that interventions were more likely to be cost-effective when they leveraged integrated care as opposed to vertical approaches. The evidence base for economic evaluations regarding CHW involvement in NTD programs is highly limited. From the 10 studies identified there was no clear conclusion with regards to cost-effectiveness or affordability of CHWs in NTD programs in LMICs. To better understand the critical role CHWs can play in both prevention- and treatment-focused NTD programs, further evidence of the cost-effectiveness and affordability of such interventions is needed.

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Journal
PLOS Global Public Health
Published
2025-12-05
DOI
https://doi.org/10.1371/journal.pgph.0005551
Primary Topic
Parasites and Host Interactions
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article
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article

Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015–2024): A scoping literature review

Lily Martin, Daniel Palazuelos, Karen E. Finnegan, Ariwame Jimenez et al.
PLOS Global Public Health
Parasites and Host Interactions
article

Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015–2024): A scoping literature review

Lily Martin, Daniel Palazuelos, Karen E. Finnegan, Ariwame Jimenez, Paul Revill, Kelsey Vaughan, James O’Donovan, Molly Mantus, Angele Bienvenue Ishimwe, Mardieh Dennis, Maryse Kok, Linnea Stansert Katzen, Madeleine Ballard, Sandra Mudhune, Dickson Mbewe, Meghan Bruce Kumar, Cleo Baskin, Matias Iberico, Zeus Aranda, Jessica Cook, Patrick Kawooya, Michee Nshimayesu, Madelyn Miyares
article en

Abstract

Neglected tropical diseases (NTDs) are a diverse group of more than twenty diseases caused by parasitic, bacterial, and viral infections, affecting more than one billion individuals worldwide. Economic evidence can help guide the investment in Community Health Workers (CHWs) who can help expand access to preventive and curative NTD services in low- and middle-income countries (LMICs). A scoping review was conducted across ten databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to "Community Health Workers" and "Economic Evaluations" were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, costs, and outcomes were extracted, tabulated in Microsoft Excel, and analysed. Of the 29 included scenarios (n = 10 studies), 7 were about community mass drug administration and 22 focused on other topics - such as disease-specific prevention and treatment (e.g., dengue). Across scenarios, the most commonly reported outcomes were cost per service delivered (ranging from $0.13-$5.33) and cost per capita (ranging from $10.24-$21.09). Five scenarios reported on cost-effectiveness, with varied results (40-50% of scenarios were reported as cost effective). One study found that interventions were more likely to be cost-effective when they leveraged integrated care as opposed to vertical approaches. The evidence base for economic evaluations regarding CHW involvement in NTD programs is highly limited. From the 10 studies identified there was no clear conclusion with regards to cost-effectiveness or affordability of CHWs in NTD programs in LMICs. To better understand the critical role CHWs can play in both prevention- and treatment-focused NTD programs, further evidence of the cost-effectiveness and affordability of such interventions is needed.

PLOS Global Public HealthVol. 5(12)
Boston University (US), University of North Carolina at Chapel Hill (US), Tulane University (US), Uppsala University (SE), Brigham and Women's Hospital (US), Partners In Health (US), Harvard University (US), University of Liverpool (GB), Liverpool School of Tropical Medicine (GB), Stellenbosch University (ZA), Malawi-Liverpool-Wellcome Trust Clinical Research Programme (MW), Kenya Medical Research Institute (KE), Northumbria University (GB), NYU Langone Health (US), Universidad de las Américas (NI), Impact Solutions (United Kingdom) (GB), LVCT Health (KE), University of Global Health Equity (RW), Department of Health (ZA), Harvard Global Health Institute (US), University of York (GB), Fundação Oswaldo Cruz (BR), Uganda Christian University (UG), Icahn School of Medicine at Mount Sinai (US)
Openalex Percentile: Top 59%
Parasites and Host Interactions
DOIOpen Access PDFOpenAlex
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