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• Program evaluation determines whether a social intervention is producing an intended result.
• Cost-effectiveness studies determine the relative cost and effects two or more social interventions.
• Cost-benefit studies determine whether the results of a social intervention can be justified by its expense.
Intervention: One-on-one intervention with first-time mothers to increase the duration of exclusive breastfeeding.
Mean Months Exclusive
BreastfeedingPre-
Intervention
Mean Months Exclusive
BreastfeedingPost-
Intervention Change1.5 4.0 +2.5
Conclusion: The intervention produced the intended result.
• Intervention 1: One-on-one intervention with first-time mothers to increase the duration of exclusive breastfeeding. Cost = $2,500
• Intervention 2: One-on-one intervention plus phone support with first-time mothers to increase the duration of exclusive breastfeeding. Cost = $3,200
Cost-Effectiveness
Cost-Effectiveness Ratio = total cost / effectiveness
Intervention 1 costs $2,500 and results in a mean of 4 months of exclusive breastfeeding.$2,500 / 4 = $625Intervention 2 costs $3,200 and results in a mean of 7 months of exclusive breastfeeding.$3,200 / 7 = $457
Cost EffectCost-Effectiveness
RatioIntervention 1 $2,500 4 $625
Intervention 2 $3,200 7 $457
Conclusion: Intervention 2, while more costly, is more cost effective.
Can Intervention 2 be justified by its expense?
Cost-BenefitNet Benefit = total benefits – total costs
Total costs of intervention = $3,200Total benefits to mother and child = $5,600
Net Benefit = $5,600 - $3,200 = $2,400
Conclusion: Yes, Intervention 2 is justified by its expense
Cost-BenefitBenefit-Cost Ratio = total benefits / total costs
Total benefits to mother and child = $5,600Total costs of intervention = $3,200
$5,600 / $3,200 = $1.75
For every dollar spent on Intervention 2, $1.75 will be saved
Interventions to support healthy BMI
Intervention
Unhealthy BMIPre-
Intervention
Unhealthy BMIPost-
Intervention Change Cost Cost-Effectiveness Ratio
1 23% or .23 .16 .07 $15,000
2 31% or .31 .21 .10 $32,000
Which intervention is more cost effective?
