title: Provision of hearing aids to children in Bangladesh: costs and cost-effectiveness of a community-based and a centre-based approach.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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 Rehabilitation Delivery 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.
authors: a Department of Clinical Sciences , Lund University , Malmö , Sweden.
authors: Björn
authors: 0000-0001-7630-7904
authors: B
authors: Ekman
authors: a Department of Clinical Sciences , Lund University , Malmö , Sweden.
authors: Johan
authors: 0000-0003-4432-5256
authors: J
authors: Borg
mesh_terms: D000293:Adolescent; D001299:Audiometry; D001459:Bangladesh; D002648:Child; D003153:Community Health Services / Q000191:economics* / Q000379:methods*; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D005260:Female; D006310:Hearing Aids / Q000191:economics*; D034381:Hearing Loss / Q000191:economics* / Q000534:rehabilitation*; D018574:Home Care Agencies / Q000191:economics*; D006801:Humans; D008297:Male
keywords: Bangladesh; DALY; community-based; cost-effectiveness; costs; effects; hearing aids