title: Cost of delivering child health care through community level health workers: how much extra does IMNCI program cost?
abstract: METHODS
  In the setting of a cluster randomized study to assess impact of the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program in the district of Faridabad in India, we randomly selected auxiliary nurse midwives (ANM), anganwadi workers (AWW) and accredited social health activists (ASHA) from intervention and control areas to collect cost data using an economic perspective. Bootstrap method was used to estimate 95% confidence interval.
  
  
  RESULTS
  The annual per-child cost of providing health services through an ANM, AWW and ASHA is INR 348 (USD 7.7), INR 588 (USD 13.1) and INR 87 (USD 1.9), respectively. The annual per-child incremental cost of delivering IMNCI is INR 124.8 (USD 2.77), INR 26 (USD 0.6) and INR 31 (USD 0.7) at the ANM, AWW and ASHA level, respectively.
  
  
  CONCLUSIONS
  Implementation of IMNCI imposes additional costs to the health system. A comprehensive economic evaluation of the IMNCI is imperative to estimate the net cost implications in India.
authors.affiliation: Post Graduate Institute of Medical Education and Research, School of Public Health.
authors.forename: Shankar
authors.initials: S
authors.lastname: Prinja
authors.forename: Sarmila
authors.initials: S
authors.lastname: Mazumder
authors.forename: Sunita
authors.initials: S
authors.lastname: Taneja
authors.forename: Pankaj
authors.initials: P
authors.lastname: Bahuguna
authors.forename: Nita
authors.initials: N
authors.lastname: Bhandari
authors.forename: Pavitra
authors.initials: P
authors.lastname: Mohan
authors.forename: Henri
authors.initials: H
authors.lastname: Hombergh
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics* / Q000379:methods; D002669:Child Welfare / Q000191:economics*; D002675:Child, Preschool; D003151:Community Health Centers / Q000458:organization & administration*; D003150:Community Health Workers; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis / Q000639:trends; D019033:Delivery of Health Care, Integrated / Q000191:economics* / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009721:Nurse Midwives
keywords: IMNCI; child health; cost; health worker; incremental cost