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Protocol of economic evaluation and equity impact analysis of mHealth and community groups for prevention and control of diabetes in rural Bangladesh in a three-arm cluster randomised controlled trial
  1. Hassan Haghparast-Bidgoli1,
  2. Sanjit Kumar Shaha2,
  3. Abdul Kuddus2,
  4. Md Alimul Reza Chowdhury2,
  5. Hannah Jennings1,
  6. Naveed Ahmed2,
  7. Joanna Morrison1,
  8. Kohenour Akter2,
  9. Badrun Nahar2,
  10. Tasmin Nahar2,
  11. Carina King1,
  12. Jolene Skordis-Worrall1,
  13. Neha Batura1,
  14. Jahangir A Khan3,
  15. Anthony Mansaray4,
  16. Rachael Hunter5,
  17. A K Azad Khan2,
  18. Anthony Costello1,6,
  19. Kishwar Azad2,
  20. Edward Fottrell1
  1. 1 Institute for Global Health, University College London, London, UK
  2. 2 Diabetic Association of Bangladesh, Dhaka, Dhaka District, Bangladesh
  3. 3 Liverpool School of Tropical Medicine, Liverpool, UK
  4. 4 ICAP Sierra Leone, Freetown, Sierra Leone
  5. 5 Institute of Epidemiology & Health, University College London, London, UK
  6. 6 World Health Organization, Geneva, Switzerland
  1. Correspondence to Dr Hassan Haghparast-Bidgoli; h.haghparast-bidgoli{at}


Introduction Type 2 diabetes mellitus (T2DM) is one of the leading causes of death and disability worldwide, generating substantial economic burden for people with diabetes and their families, and to health systems and national economies. Bangladesh has one of the largest numbers of adults with diabetes in the South Asian region. This paper describes the planned economic evaluation of a three-arm cluster randomised control trial of mHealth and community mobilisation interventions to prevent and control T2DM and non-communicable diseases’ risk factors in rural Bangladesh (D-Magic trial).

Methods and analysis The economic evaluation will be conducted as a within-trial analysis to evaluate the incremental costs and health outcomes of mHealth and community mobilisation interventions compared with the status quo. The analyses will be conducted from a societal perspective, assessing the economic impact for all parties affected by the interventions, including implementing agencies (programme costs), healthcare providers, and participants and their households. Incremental cost-effectiveness ratios (ICERs) will be calculated in terms of cost per case of intermediate hyperglycaemia and T2DM prevented and cost per case of diabetes prevented among individuals with intermediate hyperglycaemia at baseline and cost per mm Hg reduction in systolic blood pressure. In addition to ICERs, the economic evaluation will be presented as a cost–consequence analysis where the incremental costs and all statistically significant outcomes will be listed separately. Robustness of the results will be assessed through sensitivity analyses. In addition, an analysis of equity impact of the interventions will be conducted.

Ethics and dissemination The approval to conduct the study was obtained by the University College London Research Ethics Committee (4766/002) and by the Ethical Review Committee of the Diabetic Association of Bangladesh (BADAS-ERC/EC/t5100246). The findings of this study will be disseminated through different means within academia and the wider policy sphere.

Trial registration number ISRCTN41083256; Pre-results.

  • health economics
  • health policy

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  • Contributors HH-B, EF, AK, HJ, JM, CK, JS-W, NB, JAK, RH, AKAK, AC and KA contributed to the study design. HH-B, EF and CK contributed to the statistical analyses. SKS, MARC, NA, KA, BN and TN contributed to data acquisition. AM contributed to the literature review and drafting the paper. HHB was responsible for the initial drafting of this manuscript. All authors contributed to the review of this manuscript and provided comments. All authors read and approved the final manuscript.

  • Funding The trial is funded by the Medical Research Council UK (MR/M016501/1) under the Global Alliance for Chronic Diseases (GACD) Diabetes Programme.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The D-Magic trial has been approved by the University College London Research Ethics Committee (4766/002) and by the Ethical Review Committee of the Diabetic Association of Bangladesh (BADAS-ERC/EC/t5100246).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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