Provision of hearing aids to children in Bangladesh: costs and cost-effectiveness of a community-based and a centre-based approach

Abstract

Purpose: The aim of this study is to provide evidence on the costs and health effects of two alternative hearing aid delivery models, a community-based and a centre-based approach. The study is set in Bangladesh and the study population is children between 12 and 18 years old.Methods: Data on resource use by participants and their caregivers were collected by a household survey. Follow-up data were collected after two months. Data on the costs to providers of the two approaches were collected by means of key informant interviews.Results: The total cost per participant in the community-based model was BDT 6,333 (USD 79) compared with BDT 13,718 (USD 172) for the centre-based model. Both delivery models are found to be cost-effective with an estimated cost per DALY averted of BDT 17,611 (USD 220) for the community-based model and BDT 36,775 (USD 460) for the centre-based model.Conclusions: Using a community-based approach to deliver hearing aids to children in a resource constrained environment is a cost-effective alternative to the traditional centre-based approach. Further evidence is needed to draw conclusions for scale-up of approaches; rigorous analysis is possible using well-prepared data collection tools and working closely with sector professionals.Implications for RehabilitationDelivery models vary by resources needed for their implementation.Community-based deliver models of hearing aids to children in low-income countries are a cost-effective alternative.The assessment of costs and effects of hearing aids delivery models in low-income countries is possible through planned collaboration between researchers and sector professionals.