Does integration of health survey bring cost effectiveness into evidence generation in post conflict settings of Tigray, Ethiopia?

Background Evidence generation in healthcare is increasingly hampered due to resource limitations in post conflict settings such as Tigray. As a result, funders are turning to new strategies to maintain cost containment while delivering high-quality evidence gathering. However, the cost effectiveness of integrated evidence generation in post conflict settings remains unclear. Methods To assess the mean cost, the cost of the integrated health survey was compared with the cost of unintegrated surveys. One sample t-test was used to analyze the data. The survey was integrated: 1) methodologically, a mixed cross-sectional design was used; 2) maternal and child health service indicators and COVID-19 vaccination included; 3) suspected cases of obstetric fistula and pelvic organ prolapses were linked to nearby health facilities; 4) data were collected from community and health workers; and 5) various stakeholders provided technical and financial resources. Six zones of the regions were included to get a total of 13,819 households from nineteen districts. A single structured questionnaire with 222 items was used and the data were analysed using R software version 4.3.2. Results The integrated health survey achieved a significantly decreased cost in evidence generation, p-value < 0.05. The comparison of cost effectiveness between the integrated and unintegrated health surveys results a t-value of 3.1944 and a p-value of 0.0248, indicates a statistically significant difference in their cost effectiveness. The lower p-value suggests that the observed cost effectiveness from integrated surveys was significantly different from the unintegrated surveys, with a high likelihood that this difference was not due to random chance. Conclusions The integrated health survey was likely to reduce cost as opposed to the unintegrated approach. Under resource constraints, doing an integrated survey with high quality would be a cost-effective strategy.