Abstract
Community health volunteers (CHVs) are being used within a growing number of healthcare interventions, and they have become a cornerstone for the delivery of mass drug administration within many neglected tropical disease control programs. However, a greater understanding of the methods used to value the unpaid time CHVs contribute to healthcare programs is needed. We outline the two main approaches used to value CHVs’ unpaid time (the opportunity cost and the replacement cost approaches). We found that for mass drug administration programs the estimates of the economic costs relating to the CHVs’ unpaid time can be significant, with the averages of the different studies varying between US$0.05 and $0.16 per treatment. We estimated that the time donated by CHVs’ to the African Programme for Onchocerciasis Control alone would be valued between US$60 and $90 million. There is a need for greater transparency and consistency in the methods used to value CHVs’ unpaid time.
Highlights
Clinical Infectious Diseases VIEWPOINTSWe found that for mass drug administration programs the estimates of the economic costs relating to the community health volunteers (CHV)’ unpaid time can be significant, with the averages of the different studies varying between US$0.05 and $0.16 per treatment
Mass drug administration (MDA) is used to control several of the most prevalent neglected tropical diseases (NTDs)
community health volunteers (CHV) are being used for a growing number of healthcare interventions, and they have become a cornerstone for the control of many NTDs
Summary
We found that for mass drug administration programs the estimates of the economic costs relating to the CHVs’ unpaid time can be significant, with the averages of the different studies varying between US$0.05 and $0.16 per treatment. When performing economic evaluations of healthcare interventions, it is standard practice to use what are known as “economic costs” [21] These economic costs (described further in Box 1) represent the full value of all resources used for an intervention, including the value of donated resources. The value of the unpaid time that CHVs donate to healthcare interventions needs to be estimated and included as an economic cost within relevant economic evaluations. Due to the need to intensify NTD interventions and the increasingly significant role that CHVs have within global health, it is important to understand the methods used to place an economic value on the unpaid time that CHVs contribute to healthcare interventions. Within this paper we discuss this issue, focusing on MDA for the NTDs as a case study
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