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Costs and coverage of community health worker-led hypertension and diabetes screening in rural Lesotho (ComBaCaL): cost–consequence analysis of a cohort study

December 20, 2025 By

Authors: Nicoló Spaolonzi, MSca ∙ Ravi Gupta, MPHd ∙ Giuliana Sanchez-Samaniego ∙ Frédérique Chammartin ∙ Alexander W Carter ∙ Thesar Tahirsylaj ∙ Fabian Raeber ∙ Malebona Mathulise ∙ Thuso Kabi ∙ Mosoetsi Mokaeane ∙ Malehloa Maphenchane ∙ Manthabiseng Molulela ∙ Makhebe Khomolishoele ∙ Mota Mota ∙ Sesale Masike ∙ Matumaole Bane ∙ Mamoronts’ane Pauline Sematle ∙ Retselisitsoe Makabateng ∙ Lebohang Sao ∙ Mosa Tlahali ∙ Malitaba Litaba ∙ Pauline Grimm ∙ Pedram Sendi ∙ Alain Amstutz ∙ Felix Gerber ∙ Prof Niklaus Daniel Labhardt

In rural Lesotho, community health workers (CHWs) used a tablet-based clinical decision support app to screen adults for hypertension and diabetes, reaching high coverage at moderate costs. Over 6 months, CHWs screened 88% of eligible adults for hypertension and 95% for diabetes. The cost per person screened was $41 in the project model and $17 in a routine implementation scenario, with costs per diagnosis of $332 and $137, respectively. These results show that CHW-led, tech-supported screening can effectively and affordably expand access to hypertension and diabetes detection in low-resource settings.

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Resource Topic: CHW programs, Diabetes, Hypertension

Resource Type: Cohort Study

Year: 2025

Region: Africa

Country: Lesotho

Publisher May Restrict Access: No

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