Universal Journal of Medical Science 2(3): 36-44, 2014 http://www.hrpub.org DOI: 10.13189/ujmsj.2014.020303 Cost-effectiveness Analysis of Utilization of Community Health Workers in Promotion of Maternal Health Services in Butere District, Rural Western Kenya Caroline Akinyi 1,* , Jeremie Nzanzu 2 , Dan Kaseje 3 , Rose Olayo 4 1 Department of Measurements in Health and Development, Great Lakes University of Kisumu (GLUK), (40103) 6683, Kisumu, Kenya 2 Department of Information Technology, Great Lakes University of Kisumu, (40100) 2224, Kisumu, Kenya 3 Department of Community Health and Development, Great Lakes University of Kisumu, (40100) 2224, Kisumu, Kenya 4 Department of Health Promotion, Great Lakes University of Kisumu, (40100) 2224, Kisumu, Kenya *Corresponding Author: akinyicaroline12@yahoo.com Copyright © 2014 Horizon Research Publishing All rights reserved. Abstract Cost-effectiveness analysis is a type of economic evaluation used to determine the best use of money available for medical care for informed decision making. This study carried out a cost-effectiveness analysis of using Community Health Workers (CHWs) as an integral part of Community Health Strategy implementation to promote uptake of maternal health services in Butere District, rural western Kenya. The main objective was to determine incremental cost-effectiveness ratio of utilization of CHWs in promotion of maternal health services in Butere District (intervention site) in selected Community Health Units. The costs and consequences of promoting maternal health services at the community level with CHWs were identified, measured, valued while using a quasi experimental study design. Annual cost incurred in utilizing CHWs to promote maternal health services in Butere District in 2011 was US$ 30,124, effectiveness of utilization of CHWs was 1,205 yearly DALY averted. The incremental cost-effectiveness ratio was US$25 per yearly DALY averted.Utilization of CHWs to promote maternal health services is a cost effective strategy in Butere District. Community Health Strategy should be up scaled as it is a cost effective intervention to promote uptake of maternal health services especially in the rural population where health seeking behaviours are low. Keywords Cost-effectiveness Analysis, Community Health Workers, Maternal Health Services 1. Introduction Cost-effectiveness analysis (CEA) is a form of economic evaluation and primary tool for comparing the estimation of cost of a health intervention alongside a measure of outcome (typically health gain). An intervention can be understood to be any activity, using human, financial, and other inputs, that aims to improve health. Effectiveness is measured in terms of averted deaths or averted Disability Adjusted Life Years. [1, 2, 3]. Estimates of cost-effectiveness for a particular health intervention, say in terms of cost per life saved, reducing the risk of a health problem, reducing the severity or duration of an illness or disability when compared with that of another, indicate where funds could be allocated to maximize health gain. Applied to the evaluation of community-based health programs it enables a decision-maker to choose between two or more modes of delivery for the same intervention (e.g., hospital- versus community-based care in order to identify which represents the most efficient, or ‘‘cost-effective’’, use of resources),[1,2]. The estimated cost-effectiveness of a new intervention is compared with the cost-effectiveness of an existing intervention or with a fixed price cut-off point representing the assumed social willingness to pay for an additional unit of health. The implicit assumption that the required additional resources would need to be transferred from another health intervention or from another sector is rarely discussed. Furthermore, cost-effective analysis can be used to inform decision makers in the health sector regarding their policies or used in a formulaic way to determine resource allocation, [4]. Allocative efficiency of health systems supports analytical efforts to study the cost-effectiveness of a broad range of interventions. New metric measure of cost- effectiveness is disability-adjusted life year (DALY) which was introduced by the World Health Organization and the World Bank in 1993 and has been used since, with some variations, for two related purposes. One is to measure the “burden of disease,” the extent to which premature deaths and disabilities cause a loss of health status compared to everyone’s living to old age in good health. The other purpose is to compare the value of health interventions that have multiple or different health outcomes occurring at different ages. In cost-effectiveness