Cost effectiveness of child survival initiatives : a literature review

Section I explains fundamental economic concepts used in the analyses and points out methodologic differences found in the articles reviewed. Section II is a narrative review of both universally accepted and controversial cost-benefit considerations of health projects. The major child survival initiatives - immunizations, oral rehydration therapy, breastfeeding, and child spacing - are examined separately in Section III for a discussion of specific costs and benefits. The paper does not draw firm conclusions about child survival initiatives; rather, it points out the weaknesses in methodology, theory, and assumptions and the overall lack of quality data for economic analysis. To make cost-effectiveness and cost-benefit analyses more useful, the paper recommends wider dissemination of relevant information; development of a more universal outcome indicator and of methodologic conventions for cost calculations; and interdisciplinary research that combines the areas of anthropology, sociology, economics, and epidemiology. Includes 10-page bibliography.