Background
DISEASE, DISEASES
The recent global consensus that community-based primary healthcareCBPHC) is the single most important means of achieving universal health coverage (UHC) and the Sustainable Development Goals has been re-visited [However, the resolution also warned that one-third of the world’s population will not have access to essential healthcare 2030 if the current pace of progress remains unchanged [Correspondingly, interest in revitalising national programmes involving community health workers (CHWs) is growing. Several case studies have demonstrated that community-based interventions, ranging from family planning to neonatal survival, can be effectively delivered by CHWs in low- and middle-income countries [Nonetheless, many existing CHW programmes are small scale, run by nongovernmental organisations, and not integrated into national health systems, and in many cases, these programmes fail to be scaled up [Ghana has a long history of integrating CHWs into its primary health system, called Community-Based Health Planning and Services (CHPS), making it a suitable country for evaluating system-integrated CHW programmes [Regular home visits are among CHWs’ primary CBPHC interventions. Home visits are related to health promotion and surveillance across various topics, ranging from newborns to non-communicable diseases [We implemented a method of activating CHVs to conduct home visits in Volta, a region rarely visited by CHOs, and evaluated whether it contributed to childhood disease prevention. Our study aimed to evaluate the causal effect of activating CHVs for childhood disease prevention and its economic feasibility from a societal perspective through a field experiment. We performed cost-effectiveness and cost-benefit analyses of CHV activation in Ghana’s primary healthcare system. The health impact evaluation of our field experiment has been previously published, and this economic evaluation is a follow-up study to the previous health impact evaluation.