Evaluation report
Costing of a Multiple Family Group Strengthening Intervention (SMART Africa) to Improve Child and Adolescent Behavioral Health in Uganda
Yesim Tozan, Ariadna Capasso, Phionah Namatovu, Joshua Kiyingi, Christopher Damulira et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study estimated the costs of delivering a multiple family group intervention (SMART Africa) designed to improve child and adolescent mental health and reduce behavior problems in Uganda. The intervention was delivered by community health workers or parent peers in school settings to 2,391 children aged 8-13 and their caregivers across 26 primary schools. Per-child costs were US$346 for parent peer delivery and US$328 for community health worker delivery, with personnel costs being the largest expense. The intervention was found to be less expensive than similar family-based interventions in comparable settings.
Key points
- Total per-child costs were US$346 (parent peer-led) and US$328 (community health worker-led)
- Personnel costs accounted for approximately 70% of total intervention costs
- The intervention costs less than other family-based interventions (US$500-US$900) in similar settings
- This is the first economic costing study of an evidence-based multiple family group intervention using task-shifting in a low-resource setting
- Lower than anticipated attendance in the parent peer arm contributed to higher per-child costs in that arm
Limitations
The study provides only cost estimates from a provider perspective and does not measure whether the intervention achieved improved outcomes or cost-effectiveness relative to those outcomes. The analysis focuses on resource costs without reporting whether similar interventions achieved different health or behavioral results.
Abstract
Reliable cost estimates are key to assessing the feasibility, affordability, and cost-effectiveness of interventions. We estimated the economic costs of a multiple family group (MFG) intervention-child and adolescent mental health evidence-based practices (CAMH-EBP) implemented under the SMART Africa study, seeking to improve family functioning and reduce child and adolescent behavior problems-delivered through task-shifting by community health workers (CHWs) or parent peers (PPs) in school settings in Uganda. This prospective microcosting analysis was conducted from a provider perspective as part of a three-armed randomized controlled trial of the MFG intervention involving 2,391 participants aged 8-13 years and their caregivers in 26 primary schools. Activity-specific costs were estimated and summed, and divided by actual participant numbers in each study arm to conservatively calculate total per-child costs by arm. Total per-child costs of the MFG-PP and MFG-CHW arms were estimated at US$346 and US$328, respectively. The higher per-child cost of the MFG-PP arm was driven by lower than anticipated attendance by participants recruited to this arm. Personnel costs were the key cost driver, accounting for approximately 70% of total costs because of intensive supervision and support provided to MFG facilitators and intervention quality assurance efforts. This is the first study estimating the economic costs of an evidence-based MFG intervention provided through task-shifting strategies in a low-resource setting. Compared with the costs of other family-based interventions ranging between US$500 and US$900 in similar settings, the MFG intervention had a lower per-participant cost; however, few comparisons are available in the literature. More costing studies on CAMH-EBPs in low-resource settings are needed.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Multiple family group (MFG) strengthening intervention delivered through task-shifting by community health workers or parent peers in school settings
- Population
- 2,391 children aged 8-13 years and their caregivers in 26 primary schools in Uganda
Key finding
Per-child cost of US$346 for parent peer-delivered intervention