Cost-Effectiveness and Cost–Benefit Analysis of the IMCI Digital App in Bangladesh (2025)

This study evaluates the cost-effectiveness and cost–benefit of the Integrated Management of Childhood Illness (IMCI) digital application compared with the traditional paper-based IMCI system in Bangladesh. Using quasi-experimental data from a pilot conducted in Barishal district (intervention) and Jhalokhathi district (control) during 2024–2025, the analysis adopts both health system and societal perspectives. Incremental costs included training, equipment, supervision, and connectivity, net of savings from discontinued paper registers. Health outcomes were measured as disability-adjusted life years (DALYs) averted through reductions in unnecessary outpatient visits and inpatient admissions, estimated under provider-reported, objective, and hybrid scenarios.

The results show that the IMCI digital app is highly cost-effective under all assumptions, with incremental cost-effectiveness ratios far below Bangladesh’s GDP per capita threshold. Benefit–cost ratios indicate exceptionally high economic returns, driven by avoided health system expenditures and reduced household out-of-pocket costs and productivity losses. National scale-up projections suggest substantial health gains and multi-billion-taka annual societal benefits, even under conservative cost assumptions. The findings provide strong economic justification for nationwide adoption of the IMCI digital app as a cost-effective, pro-poor digital health intervention aligned with Bangladesh’s Universal Health Coverage and Smart Health goals.