Economic Evaluations of Interventions for Children in the Developing World: The WHO-CHOICE Approach

There are logistical and analytical challenges when conducting economic evaluations in the developing world, ranging from lack of data on costs to determining generalizability. This chapter describes the WHO-CHOICE approach, a generalized form of cost-effectiveness analysis. By using the 'null' scenario which assumes an absence of interventions for treating or preventing a condition of interest, this method allows existing and new interventions to be analysed at the same time. Costeffectiveness analysis for child health interventions are presented including oral rehydration therapy, case management for pneumonia, Vitamin A and zinc supplementation and fortification, provision of supplementary food during weaning with nutrition counseling, and measles vaccination using the WHO-CHOICE approach. Methods for costing interventions and assessing the population impact of the interventions are presented. Results are expressed in terms of cost per disabilityadjusted life year (DALY) averted. The chapter concludes with a discussion of the value of the WHO-CHOICE approach to inform resource allocation.