Affordability of an NGO-government partnership for community-based disability rehabilitation

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES

African Journal of Disability Pub Date : 2023-12-22 DOI:10.4102/ajod.v12i0.1283

Kelsey R. Vaughan, Ram K. Thapa

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引用次数: 0

Abstract

Background: Tunafasi is a community-based rehabilitation (CBR) programme for persons with disability, implemented by a local non-governmental organisation in Uvira, Democratic Republic of Congo, in partnership with government. To assess affordability and support discussions with the government about continued financing and implementation, Tunafasi representatives commissioned a cost-effectiveness study of the programme’s health component.Objectives: This study aimed to estimate the programme’s impacts, costs, cost per disability-adjusted life year (DALY) averted and affordability of the health component implemented from February 2019 to December 2021.Method: Health-related improvements were assessed for a sample of 511 persons with disability and converted to DALYs averted. Total expenditure during the period February 2019 to December 2021 was estimated from audited financial statements. The cost per DALY averted was estimated by dividing total programme expenditure by the sum of DALYs averted and compared against newly generated, country-specific thresholds to assess affordability.Results: The programme cost $55 729.00 to implement from February 2019 to December 2021 and averted 234 DALYs in 511 persons, at a cost per DALY averted of $224.00. This falls above the affordability threshold of $54.00 – $199.00.Conclusion: While the cost per DALY averted is higher than what thresholds consider affordable for Democratic Republic of Congo, improved engagement from CBR facilitators and greater possibilities for treatment in the post-pandemic era should improve results.Contribution: This new CBR implementation modality offers a possibly affordable solution to African governments struggling to operationalise disability commitments such as United Nations Convention on the Rights of Persons with Disabilities.

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非政府组织与政府合作促进社区残疾康复的可负担性

背景：Tunafasi 是一项针对残疾人的社区康复计划，由刚果民主共和国乌维拉当地的一个非政府组织与政府合作实施。为了评估经济承受能力并支持与政府就继续资助和实施该计划进行讨论，Tunafasi 的代表委托对该计划的健康部分进行成本效益研究：本研究旨在估算 2019 年 2 月至 2021 年 12 月期间实施的健康部分的影响、成本、避免残疾调整生命年（DALY）的成本和可负担性：方法：以 511 名残疾人为样本，评估与健康相关的改善情况，并将其转换为避免残疾调整生命年。2019 年 2 月至 2021 年 12 月期间的总支出根据经审计的财务报表估算。通过将计划总支出除以避免的残疾调整寿命年数总和，估算出每避免残疾调整寿命年数的成本，并与新生成的针对具体国家的阈值进行比较，以评估可负担性：结果：2019 年 2 月至 2021 年 12 月期间，该计划的实施成本为 55 729.00 美元，避免了 511 人的 234 个残疾调整生命年，每避免一个残疾调整生命年的成本为 224.00 美元。这高于 54.00 美元至 199.00 美元的可负担阈值：虽然避免每 DALY 的成本高于刚果民主共和国认为可负担得起的阈值，但 CBR 促进者的更多参与以及后流行病时代治疗的更大可能性应能改善结果：这种新的社区康复实施模式为努力履行《联合国残疾人权利公约》等残疾承诺的非洲国家政府提供了一种可能负担得起的解决方案。

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来源期刊

African Journal of Disability HEALTH CARE SCIENCES & SERVICES-

CiteScore

2.10

自引率

5.90%

发文量

审稿时长

20 weeks

期刊介绍： The African Journal of Disability, the official journal of CRS, AfriNEAD and CEDRES, introduce and discuss issues and experiences relating to and supporting the act of better understanding the interfaces between disability, poverty and practices of exclusion and marginalisation. Its articles yield new insight into established human development practices, evaluate new educational techniques and disability research, examine current cultural and social discrimination, and bring serious critical analysis to bear on problems shared across the African continent. Emphasis is on all aspects of disability particularity in the developing African context. This includes, amongst others: -disability studies as an emerging field of public health enquiry -rehabilitation, including vocational and community-based rehabilitation -community development and medical issues related to disability and poverty -disability-related stigma and discrimination -inclusive education -legal, policy, human rights and advocacy issues related to disability -the role of arts and media in relation to disability -disability as part of global Sustainable Development Goals transformation agendas -disability and postcolonial issues -globalisation and cultural change in relation to disability -environmental and climate-related issues linked to disability -disability, diversity and intersections of identity -disability and the promotion of human development.