Introduction This paper presents the cost and cost-effectiveness of the Good School Toolkit (GST), a programme aimed at reducing physical violence perpetrated by school staff to students in Uganda.
Methods The effectiveness of the Toolkit was tested with a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. A full economic costing evaluation and cost-effectiveness analysis were conducted alongside the trial. Both financial and economic costs were collected retrospectively from the provider’s perspective to estimate total and unit costs.
Results The total cost of setting up and running the Toolkit over the 18-month trial period is estimated at US$397 233, excluding process monitor (M&E) activities. The cost to run the intervention is US$7429 per school annually, or US$15 per primary school pupil annually, in the trial intervention schools. It is estimated that the intervention has averted 1620 cases of past-week physical violence during the 18-month implementation period. The total cost per case of violence averted is US$244, and the annual implementation cost is US$96 per case averted during the trial.
Conclusions The GST is a cost-effective intervention for reducing violence against pupils in primary schools in Uganda. It compares favourably against other violence reduction interventions in the region.
- economic evaluation
- cost-effectiveness analysis
- violence against children
- violence in schools
- primary education
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Handling editor Seye Abimbola
Contributors GG designed the study, led data collection, analysis and interpretation, and drafted the manuscript. LK provided the trial effectiveness data and participated in the writing of the manuscript. WS supported data collection and with SN was involved in the results interpretation and writing of the manuscript. DN and KD are PIs of the trial, obtained funding, provided comments on data interpretation and participated in drafting of the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Funding MRC/DfID/Wellcome Trust (MR/L004321/1) to KD and Hewlett Foundation to DN.
Competing interests The Good School Toolkit was developed by DN at Raising Voices. DN approached KD with the idea to do a study, was involved in the conceptualisation and design of the trial, commented on the interpretation of results, but was not involved in data collection, management, or analysis. SN and WS were employed by Raising Voices as learning coordinator and implementation manager at the time of the study. WS facilitated the data collection but did not directly collect any data nor manage the data. WS and SN commented on the results but did not influence their interpretation. No other authors have any conflict of interest to declare.
Patient consent Not required.
Ethics approval The study was approved by the London School of Hygiene and Tropical Medicine Ethics Committee (6183) and the Uganda National Council for Science and Technology (SS2520).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
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