Abstract
BackgroundIntimate partner violence (IPV) poses a major public health concern. To date there are few rigorous economic evaluations of interventions aimed at preventing IPV in low-income settings. This study provides a cost and cost effectiveness analysis of SASA!, a community mobilisation intervention to change social norms and prevent IPV.MethodsAn economic evaluation alongside a cluster randomised controlled trial. Both financial and economic costs were collected retrospectively from the provider’s perspective to generate total and unit cost estimates over four years of intervention programming. Univariate sensitivity analysis is conducted to estimate the impact of uncertainty in cost and outcome measures on results.ResultsThe total cost of developing the SASA! Activist Kit is estimated as US$138,598. Total intervention costs over four years are estimated as US$553,252. The annual cost of supporting 351 activists to conduct SASA! activities was approximately US$389 per activist and the average cost per person reached in intervention communities was US$21 over the full course of the intervention, or US$5 annually. The primary trial outcome was past year experience of physical IPV with an estimated 1201 cases averted (90 % CI: 97–2307 cases averted). The estimated cost per case of past year IPV averted was US$460.ConclusionThis study provides the first economic evaluation of a community mobilisation intervention aimed at preventing IPV. SASA! unit costs compare favourably with gender transformative interventions and support services for survivors of IPV.Trial registrationClinicalTrials.gov #NCT00790959
Highlights
Intimate partner violence (IPV) poses a major public health concern
IPV places an economic burden on society with the global combined cost of physical IPV, sexual violence against women and female homicide committed by Michaels-Igbokwe et al BMC Public Health (2016):9 intimate partners estimated at nearly US $4.8 trillion [5]
This study presents a cost and cost effectiveness analysis of SASA!, a community mobilisation intervention aimed at reducing intimate partner violence in Kampala, Uganda
Summary
Intimate partner violence (IPV) poses a major public health concern. To date there are few rigorous economic evaluations of interventions aimed at preventing IPV in low-income settings. IPV places an economic burden on society with the global combined cost of physical IPV, sexual violence against women and female homicide committed by Michaels-Igbokwe et al BMC Public Health (2016): intimate partners estimated at nearly US $4.8 trillion (adjusted to 2013 US) [5]. In low income settings a variety of interventions aimed at preventing IPV have been implemented and yet few have been rigorously evaluated to determine their effectiveness and cost-effectiveness. This lack of data makes it difficult for decision makers to assess value for money and prioritise interventions in this field [6, 7]. There is a clear need for more evidence informed programming
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