What the Akwenda CP Program Costs and What It Achieves in Uganda

The Akwenda Intervention Program is a community‑based effort that helps children and young people with cerebral palsy living in rural Uganda. It brings together several services like therapy, training for families, and local support. Researchers ran a study with 94 kids aged two to twenty‑three, about half of them girls, and their caregivers. Some families got the program while others continued with usual care.

To understand the money side, the team looked at what the program cost from a health‑provider view and also tracked extra money families spent out of pocket over a year. The average extra cost for each child in the program was about $1,070. This figure includes the resources needed to deliver the services but does not count every possible expense.

They then measured how the program changed several outcomes. For kids they used gross motor scores, a disability inventory adapted for Uganda, and a participation picture tool. For caregivers they used a challenge scale and a quality‑of‑life family impact module. The cost to gain one unit of improvement varied widely, from as low as $26 to as high as $352 for most measures. One mobility score had a much higher and uncertain cost. When they looked at the smallest meaningful change, the cost ranged from $230 to $600.

Because there is no set willingness‑to‑pay threshold in Uganda for these outcomes, the researchers presented uncertainty analyses using bootstrapping, cost‑effectiveness planes, and exploratory acceptability curves. The results show that the Akwenda program improves movement, participation, and caregiver well‑being at a predictable extra price. This information can help decision‑makers think about scaling similar community‑based rehab in low‑resource settings.