The intervention was described in detail and was appropriately compared with the current practice.
The effectiveness data were derived from a number of published sources that were specific to South Africa, but the details of the methods used to derive these data and the inclusion criteria were not reported. No information was provided on the primary studies and no sensitivity analysis was conducted to assess whether the estimates were robust or not. Given this limited information, it is hard to assess the validity of the data.
The perspective was not explicitly reported, but the cost analysis suggests that it was that of the provider implementing the programme. The costs were only reported at an aggregated level, and the list of cost items, resource use quantities, and the unit costs were not provided. The price year was not reported and discounting, although relevant due to the long-term horizon of the analysis, was not undertaken. Overall, the cost analysis was not reported in enough detail.
Analysis and results:
The costs and benefits were not combined and a cost-consequence analysis was performed. The authors provided the full details of the models used (including a diagram) and the modelling assumptions. The modelling methodology appears to have been appropriate and was well reported. The issue of uncertainty was not addressed, which limits the generalisability of the findings. The quality of the data was acknowledged by the authors to be one of the main limitations of their study.
There were certain limitations to the study, especially in the cost analysis, and it is difficult to assess the authors’ conclusions.