Documenting the Costs of Social Behavior Change Interventions for Health in Low- and Middle-income Countries

However, there is limited cost data compilation for SBC interventions, which is essential for budgeting, price setting, program planning, and economic evaluation to inform the allocation of scarce resources. A literature review and synthesis of published costs associated with SBC programming in low- and middle-income countries were conducted by Breakthrough RESEARCH. The peer-reviewed SBC cost literature was searched using various databases, including a grey literature and secondary sources. The literature was summarized by study design characteristics, and unit costs for SBC interventions were analyzed to determine the mean, median, and quartile costs. A total of 147 studies with 847 cost observations were included in the analysis, of which 355 cost observations were unit costs and 120 were comparable for synthesis purposes. The SBC intervention categories identified were interpersonal communication (31%), mass media (21%), packages delivering more than one SBC intervention category (15%), other SBC intervention types (13%), and studies with more than one SBC intervention category (20%). The median unit costs varied by SBC intervention, driven by differences in the unit of analysis. Mass media unit costs ranged from $0.17 to $0.58 per person exposed, while interpersonal communication unit costs were $4.04 per person participating in group settings and $8.34 per person participating in individual settings. The findings of this review can assist with SBC cost comparisons, budgeting, and planning, and increase understanding of how SBC costs vary among interventions and contexts. However, there are still several gaps in SBC cost studies that would benefit from new, quality costing research. The Breakthrough RESEARCH project, funded by the United States Agency for International Development (USAID), aimed to address the deficiencies in SBC cost data compilation and economic evaluation. The project's findings and recommendations can inform the allocation of scarce resources and improve the effectiveness of SBC programs. The review highlights the importance of understanding the costs associated with SBC interventions, particularly in low- and middle-income countries. The findings can assist policymakers, program managers, and researchers in making informed decisions about SBC program design, implementation, and resource allocation. The Breakthrough RESEARCH project's findings and recommendations can also inform the development of more effective SBC programs, which can improve health outcomes and reduce health disparities in low- and middle-income countries. The project's results can also contribute to the development of more accurate and comprehensive SBC cost estimates, which can inform the allocation of scarce resources and improve the effectiveness of SBC programs.