Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial.

INTRODUCTION: Chronic malnutrition is a serious problem in southern Angola with a prevalence of 49.9% and 37.2% in the provinces of Huila and Cunene, respectively. The MuCCUA (Mother and Child Chronic Undernutrition in Angola) trial is a community-based randomised controlled trial (c-RCT) which aims to evaluate the effectiveness of a nutrition supplementation plus standard of care intervention and a cash transfer plus standard of care intervention in preventing stunting, and to compare them with a standard of care alone intervention in southern Angola. This protocol describes the planned economic evaluation associated with the c-RCT. METHODS AND ANALYSIS: We will conduct a cost-efficiency and cost-effectiveness analysis nested within the MuCCUA trial with a societal perspective, measuring programme, provider, participant and household costs. We will collect programme costs prospectively using a combined calculation method including quantitative and qualitative data. Financial costs will be estimated by applying activity-based costing methods to accounting records using time allocation sheets. We will estimate costs not included in accounting records by the ingredients approach, and indirect costs incurred by beneficiaries through interviews, household surveys and focus group discussions. Cost-efficiency will be estimated as cost per output achieved by combining activity-specific cost data with routine data on programme outputs. Cost-effectiveness will be assessed as cost per stunting case prevented. We will calculate incremental cost-effectiveness ratios comparing the additional cost per improved outcome of the different intervention arms and the standard of care. We will perform sensitivity analyses to assess robustness of results. ETHICS AND DISSEMINATION: This economic evaluation will provide useful information to the Angolan Government and other policymakers on the most cost-effective intervention to prevent stunting in this and other comparable contexts. The protocol was approved by the República de Angola Ministério da Saúde Comité de Ética (27C.E/MINSA.INIS/2022). The findings of this study will be disseminated within academia and the wider policy sphere. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT05571280).

Método de Popov. Su importancia en la medicina de la comunidad / Popov's method. Importance in community medicine

Se realiza un trabajo con la participación de la comunidad y los Comités de Defensa de la Revolución (CDR), en un plan piloto de psiquiatría en la comunidad en la ciudad de Las Tunas, donde se pesquisan todos los pacientes que requieren atención psiquiátrica en el primer nivel, y que tienen el registro asistencial (historias clínicas, tarjetero, etc.) en el mismo local de consulta. El trabajo se realiza basado en el método de las "primeras consultas" del profesor soviético G. Popov, según recomendación en I Foro Nacional de Epidemiología y Salud Mental, celebrado en Camagüey en 1975. Se describe la metodología empleada y la importancia de este método en los policlínicos comunitarios, dada la factibilidad de tener el registro en el mismo local de consulta, tal como se plantea en estas unidades. Se analizan los resultados estadísticos correspondientes a la tabulación posterior y se llega a conclusiones generales y particulares. Finalmente recomiendan realizar estos estudios de morbilidad en el primer nivel de atención dada su facilidad y aplicación(AU)