This cost-benefit analysis was prepared at the request of the Lutheran Health Alliance
(LHA) to examine the value of implementing a Screen, Brief Intervention and Referral to
Treatment (SBIRT) program in Zambia. The purpose of SBIRT is to prevent and reduce harmful
alcohol consumption patterns. The SBIRT program analysis first details the implementation of
the pilot program in Mwembeshi, a rural community in Central Province, Zambia. We also
consider the costs and benefits associated with scaling the program up to the level of the Central
Province. Based on our modeling we recommend the implementation of the pilot program.
However, because the results are sensitive to the success rate of the program, we also
recommend that LHA monitor the success rate of the pilot program before scaling up to the
provincial level.
We incorporate various costs and benefits that accrue to LHA, the individual, or society.
Cost categories include the following: implementation costs; social network costs; and patient
opportunity costs. Benefit categories encompass health benefits; social benefits; productivity
benefits; and reduction in health care system benefits. Translating these costs and benefits into a
Zambian context required researching Zambian statistics, and when no appropriate statistics were
available, making reasonable assumptions for predicting the impacts of SBIRT in Zambia.
This framework yielded positive net benefits for both the village and province level
programs. In Mwembeshi, the net present value for a successfully treated individual is $2,530
For the Central Province, these figures is $2640. Taking a broader perspective, the estimated net
present value of the program overall for Mwembeshi was $202,200 and $35,947,000 for Central
Province. Net benefits remained positive using varying discount rates and a lower success rate.