Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015–2024): A scoping literature review

Linnea Stansert Katzen, Madelyn Miyares, Kelsey Vaughan, Cleo Baskin, Madeleine Ballard, Maryse Kok, Ariwame Jimenez, Matias Iberico, Jessica Cook, Angele Bienvenue Ishimwe, Lily Martin, Patrick Kawooya, Zeus Aranda, Molly Mantus, Meghan Bruce Kumar, Karen E Finnegan, Sandra Mudhune, Mardieh Dennis, Daniel Palazuelos, Dickson Mbewe, Michee Nshimayesu, Paul Revill and James O’Donovan

PLOS Global Public Health, 2025, vol. 5, issue 12, 1-16

Abstract: Neglected tropical diseases (NTDs) are a diverse group of more than twenty diseases caused by parasitic, bacterial, and viral infections, affecting more than one billion individuals worldwide. Economic evidence can help guide the investment in Community Health Workers (CHWs) who can help expand access to preventive and curative NTD services in low- and middle-income countries (LMICs). A scoping review was conducted across ten databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to “Community Health Workers” and “Economic Evaluations” were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, costs, and outcomes were extracted, tabulated in Microsoft Excel, and analysed. Of the 29 included scenarios (n = 10 studies), 7 were about community mass drug administration and 22 focused on other topics - such as disease-specific prevention and treatment (e.g., dengue). Across scenarios, the most commonly reported outcomes were cost per service delivered (ranging from $0.13-$5.33) and cost per capita (ranging from $10.24-$21.09). Five scenarios reported on cost-effectiveness, with varied results (40–50% of scenarios were reported as cost effective). One study found that interventions were more likely to be cost-effective when they leveraged integrated care as opposed to vertical approaches. The evidence base for economic evaluations regarding CHW involvement in NTD programs is highly limited. From the 10 studies identified there was no clear conclusion with regards to cost-effectiveness or affordability of CHWs in NTD programs in LMICs. To better understand the critical role CHWs can play in both prevention- and treatment-focused NTD programs, further evidence of the cost-effectiveness and affordability of such interventions is needed.

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pgph00:0005551

DOI: 10.1371/journal.pgph.0005551

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