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Costing of interventions and cost effectiveness should be included in evaluations53

Finally in the ‘do and review’ stages of the cycle, there is the need for ongoing, inbuilt, systematic evaluation of interventions, not only in terms of efficacy but also in terms of cost effectiveness.

The BCRP including collaboration with health economists who were able to bring expertise in modelling of cost effectiveness to the projects.  The overall conclusion is that this is an area that requires more attention and that there are limited examples of systematic evaluation of this kind in practice.

Specific recommendations include:

  • Collecting data about how services are delivered as well as what they are delivering and how much is being delivered
  • Encouraging evaluations which gather data that will allow analysis of factors such as the minimum or maximum input (dosage) for effective outcomes, i.e. “how much support is too little?”, and “at what upper limit does support cease to add further benefit?” In addition, it is important to know who should, did or can carry out interventions, to understand whether an intervention requires an expert practitioner for delivery or if it can be ‘manualised’ for others to use.