Scoping review data extraction table.

Globally, families with children with developmental disabilities (DDs) experience challenges, including social isolation, stigma, and poverty, especially in low-income settings in Africa. Most children with DDs in Africa remain unidentified and receive no formal support. Caregiver interventions focusing on education and training for the carers/parents have been shown to be adaptable and low intensity in implementation, although the economic evidence is limited. This review aimed to describe the evidence and methodological aspects of economic evaluations for caregiver interventions for DDs. The Arksey and O’Malley framework was applied. Seven electronic databases, grey literature and cited references were systematically searched to identify eligible studies. published from 1993 to 2023. We assessed the quality of the included studies using the Drummond checklist. Data were systematically extracted, tabulated, and qualitatively synthesised using inductive thematic analysis. From 7811 articles, twenty studies all in high-income countries were included, and focused on caregiver interventions for autism spectrum disorder (n = 7), attention deficit hyperactivity disorder (ADHD) (n = 6), disruptive behaviour and behaviour problems with ADHD (n = 5), intellectual disabilities (n = 1) and language delay (n = 1). Economic evaluation analyses included cost effectiveness (n = 11), costing (n = 3), cost utility (n = 2), cost consequence (n = 1) cost benefit (n = 1), and combined analyses (n = 2). Nine studies reported the interventions as cost effective and five studies reported the intervention to be cost saving. The main methodological challenges were related to costing, outcome measurement in children and the appropriate time horizon for modelling. Caregiver interventions demonstrate cost-effectiveness, with the available evidence supporting the adoption of the interventions as a promising avenue to strengthen access and reduce the associated healthcare costs. The identified key methodological challenges highlighted further research areas. Prioritizing more economic evaluation studies in this area would inform decision-making on efficient resource allocation, promote inclusivity and equitable access to services for children with DDs.全球范围内，家中有发育障碍（Developmental Disabilities，DDs）儿童的家庭面临诸多困境，包括社会隔离、污名化与贫困，在非洲的低收入地区这一问题尤为突出。非洲的大多数发育障碍儿童仍未被识别，也未获得正式支持。针对照料者/家长开展教育与培训的照料者干预措施已被证实具备可适应性且实施强度较低，不过相关经济学证据较为有限。本综述旨在阐述针对发育障碍儿童照料者干预措施的经济学评估证据与方法学层面的问题。研究采用了Arksey与O'Malley框架。系统检索了7个电子数据库、灰色文献及参考文献，以筛选1993年至2023年间发表的符合纳入标准的研究。采用Drummond检查表对纳入研究的质量进行了评估。通过归纳式主题分析法，对提取的数据进行系统整理、制表并开展定性综合分析。最终从7811篇文献中纳入20项均来自高收入国家的研究，分别针对孤独症谱系障碍（Autism Spectrum Disorder，ASD，n=7）、注意缺陷多动障碍（Attention Deficit Hyperactivity Disorder，ADHD，n=6）、伴ADHD的破坏性行为与行为问题（n=5）、智力障碍（n=1）及语言延迟（n=1）儿童的照料者干预措施。经济学评估分析类型包括成本效果分析（n=11）、成本核算（n=3）、成本效用分析（n=2）、成本结果分析（n=1）、成本收益分析（n=1）及联合分析（n=2）。9项研究表明该干预措施具备成本效果，另有5项研究指出其可节约成本。主要的方法学挑战涉及成本核算、儿童结局测量以及建模所需的合理时间范围。照料者干预措施展现出良好的成本效果，现有证据支持推广该类干预措施，以此作为提升服务可及性、降低相关医疗成本的可行路径。本次研究明确的关键方法学挑战，也指明了未来的研究方向。优先在该领域开展更多经济学评估研究，可为资源高效配置的决策提供参考，助力提升发育障碍儿童服务的包容性与公平可及性。