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Cost and cost-effectiveness of a parenting programme to prevent violence against adolescents in South Africa
Open accessAbstract
INTRODUCTION: This paper presents the costs and cost-effectiveness of 'Parenting for Lifelong Health: Sinovuyo Teen', a non-commercialised parenting programme aimed at preventing violence against adolescents in low-income and middle-income countries. METHODS: The effectiveness of Sinovuyo Teen was evaluated with a cluster randomised controlled trial in 40 villages and peri-urban townships in the Eastern Cape of South Africa from 2015 to 2016. The costs of implementation were calculated retrospectively and models of costs at scale estimated, from the perspective of the programme provider. Cost-effectiveness analysis considers both the cost per incident of abuse averted, and cost per disability-adjusted life year averted. Potential economic benefits from the societal perspective were estimated by developing a framework of possible savings. RESULTS: The total implementation cost for Sinovuyo Teen over the duration of the trial was US$135 954, or US$504 per family enrolled. Among the 270 families in the treatment group, an estimated 73 incidents of physical and emotional abuse were averted (95% CI 29 to 118 incidents averted). During the trial, the total cost per incident of physical or emotional abuse averted was US$1837, which is likely to decrease to approximately US$972 if implemented at scale. By comparison, the economic benefits of averting abuse in South Africa are large with an estimated lifetime saving of US$2724 minimum per case. CONCLUSION: Parenting programmes are a cost-effective intervention to prevent the abuse of adolescents by their caregivers in South Africa, when compared with existing violence prevention programmes and cost-effectiveness thresholds based on GDP per capita.
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Metadata
- Authors
- Redfern, A., Cluver, L. D., Casale, M., & Steinert, J. I.
- Affiliations
- University of Oxford (GB)
- University of Cape Town (ZA)
- Corresponding author
- Redfern, Alice
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2019-05
- Volume
- 4
- Issue
- 3
- Pages
- e001147
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC6528756
- OpenAlex
- W2944647080
- Cited by
- 36
- References
- 41
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 1 · 2021: 16 · 2020: 3
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UWC Research Repository (University of the Western Cape) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- FP7 Ideas: European Research Council (313421)
- John Fell Fund, University of Oxford
- Leverhulme Trust (PLP-2014-095)
- Oxford University Clinical Academic Graduate School
- Unicef Innocenti Office of Research, Unicef South Africa
- University of Oxford's ESRC Impact Accelration Account (1311-KEA-004 and 1602-KEA-189)
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- parent training, violence against adolescents, child abuse prevention, cost-effectiveness, disability-adjusted life years, caregiver abuse, low- and middle-income countries, Eastern Cape, economic savings
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